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Capsaicin
Aka: Capsaicin, Zostrix
- Indications
- Peripheral Neuropathy (e.g. Postherpetic Neuralgia, Diabetic Neuropathy)
- Muscle pain or Joint Pain
- Canabinoid Hyperemesis
- Mechanism
- Capsaicin is derived from chili peppers (genus Capsicum) such as jalapeno peppers
- Capsaicin is a Transient Receptor Potential Vanilloid 1 (TRPV1) agonist
- TRPV1 activates cation channels on pain nerve fibers (nociceptive fibers)
- Nociceptive nerves depolarize, transmitting pain signal to the spinal cord
- Capsaicin depletes Substance P from pain fibers, desensitizing nerves and preventing pain transmission
- Requires frequent and repeat applications for affect
- Inconsistent use not effective
- Dose: Capsaicin Cream (OTC)
- Apply Capsaicin cream as a thin film (0,025% to 0.075%) to affected area 3-5 times daily
- Dose: Capsaicin Patch (high dose - 8%)
- Applied in office
- Pre-treat area by applying 4% Lidocaine cream for 60 minutes
- Check area for Anesthesia following application
- Apply Capsaicin 8% cream with gloves and leave on for 60 minutes
- Wash off after 1 hour
- Adverse effects
- Burning sensation on initial application
- Increased pain for up to first week of application
- Precautions
- Wash hands thoroughly after Capsaicin application
- Resources
- Capsaicin (PubChem)
- https://pubchem.ncbi.nlm.nih.gov/compound/Capsaicin
- References
- Chang and Quick (2019) Stat Pearls
- https://www.ncbi.nlm.nih.gov/books/NBK459168/
- Fattori (2016) Molecules 21(7): 844 +PMID:27367653 [PubMed]
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273101/