III. Mechanism

  1. Capsaicin is derived from chili peppers (genus Capsicum) such as jalapeno peppers
  2. Capsaicin is a Transient Receptor Potential Vanilloid 1 (TRPV1) agonist
    1. TRPV1 activates cation channels on pain nerve fibers (nociceptive fibers)
    2. Nociceptive nerves depolarize, transmitting pain signal to the spinal cord
  3. Capsaicin depletes Substance P from pain fibers, desensitizing nerves and preventing pain transmission
    1. Requires frequent and repeat applications for effect
    2. Inconsistent use is not effective

IV. Dose: Capsaicin Cream (OTC)

  1. Neuropathic pain
    1. Apply Capsaicin cream as a thin film (0.025% to 0.075%) to affected area 3-4 times daily
  2. Cannabinoid Hyperemesis Syndrome (off label)
    1. Apply Capsaicin cream as a thin film (0.075%) to 15 x 25 cm periumbilical area every 4 hours until symptoms resolve

V. Dose: Capsaicin Patch (high dose - 8%)

  1. Applied in office
  2. Pre-treat area by applying 4% Lidocaine cream for 60 minutes
  3. Check area for Anesthesia following application
  4. Apply Capsaicin 8% cream with gloves and leave on for 60 minutes
  5. Wash off after 1 hour

VI. Adverse effects

  1. Local Irritation
    1. Erythema (63%)
    2. Burning Sensation (42%)
      1. Most significant on initial application
    3. Less commonly, Pruritus, edema and local swelling
  2. Increased pain for up to first week of application

VII. Precautions

  1. Wash hands thoroughly after Capsaicin application

VIII. Resources

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

capsaicin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
CAPSAICIN 0.025% CREAM Generic OTC $0.07 per gram

Ontology: Capsaicin (C0006931)

Definition (NCI_NCI-GLOSS) A component of certain plants, including cayenne and red pepper, used topically for peripheral nerve pain. Also being studied for controlling mucositis pain after chemotherapy and radiation therapy.
Definition (NCI) A chili pepper extract with analgesic properties. Capsaicin is a neuropeptide releasing agent selective for primary sensory peripheral neurons. Used topically, capsaicin aids in controlling peripheral nerve pain. This agent has been used experimentally to manipulate substance P and other tachykinins. In addition, capsaicin may be useful in controlling chemotherapy- and radiotherapy-induced mucositis.
Definition (NCI_CRCH) Capsaicinoid compound with side chain CO(CH2)4(CH)2CH(CH3)2. The chemical structure is CC(C)C=CCCCCC(=O)NCC1=CC(=C(C=C1)O)OC.
Definition (CSP) N-(4-hydroxy-3-methoxyphenylmethyl) -8-methyl-6-nonenamide; chili pepper extract and neuropeptide releasing agent selective for primary sensory peripheral neurons, used to experimentally manipulate substance P and other tachykinins, and as an analgesic for Herpes zoster infection.
Definition (MSH) An alkylamide found in CAPSICUM that acts at TRPV CATION CHANNELS.
Concepts Pharmacologic Substance (T121) , Lipid (T119)
MSH D002211
SnomedCT 400416009, 95995002
English 8-Methyl-N-Vanillyl-6-Nonenamide, Capsaicin, Capsaicine, 6-Nonenamide, N-((4-hydroxy-3-methoxyphenyl)methyl)-8-methyl-, (E)-, (E)-N-[(4-Hydroxy-3-methoxyphenyl)methyl]-8-methyl-6-nonenamide, N-(4-hydroxy-3-methoxyphenylmethyl) -8-Methyl-6-Nonenamide, 8 Methyl N Vanillyl 6 Nonenamide, CAPSAICIN, capsaicin, Capsaicin [Chemical/Ingredient], capsaicine, (E)-N-[(4-hydroxy-3-methoxy-phenyl)methyl]-8-methyl-non-6-enamide, Capsaicin (product), Capsaicin (substance)
Swedish Kapsaicin
Czech kapsaicin
Finnish Kapsaisiini
German Trans-8-Methyl-N-vanillyl- 6-nonensäureamid, Capsaicin
Japanese カプサイシン
French N-(4-Hydroxy-3-méthoxybenzyl)-8-méthylnon-6-énamide, 8-Méthyl-N-vanillyl-non-6-énamide, N-(4-Hydroxy-3-méthoxybenzyl)-8-méthyl-non-6-énamide, Capsaïcine
Polish Kapsaicyna
Spanish capsaicina (producto), capsaicina (sustancia), capsaicina, Capsaicina
Italian Capsaicina
Portuguese Capsaicina

Ontology: Zostrix (C0308191)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D002211
English Zostrix Neuropathy, zostrix, Link Brand of Capsaicin, Medicis Brand of Capsaicin, Zostrix