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capsaicin (Zostrix, Qutenza)

Tradename: Zostrix, Qutenza. Epidemiology: - capsaicin is the spice that make hot peppers 'hot' - the Carolina Reaper is one of the hottest peppers in the world [9] Indications: - temporary relief of pain due to: a) rheumatoid arthritis b) osteoarthritis c) neuralgia (diabetic, shingles, post Herpetic neuralgia) d) musculoskeletal pain [4] - minor sprains [6] * on list of medications to avoid; limited effectivness [8] Dosage: - apply up to QID - Qutenza must be applied to the skin by a healthcare professional - it can be used for 60 minutes, once every 3 months [5] Cream: 0.025%, 0.075%. 45 g Transdermal patch Qutenza: 8% Adverse effects: 1) burning of skin & mucous membranes 2) stinging 3) erythema Mechanism of action: - capsaicin activates TRPV1 in your mouth & through the GI tract signaling a burning sensation [9] - depletion of substance P Notes: - Qutenza cost: $700/treatment (2010)

General

analgesic (antalgic) dermatologic agent

Properties

MISC-INFO: pregnancy-category ? safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  3. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  4. Journal Watch 24(11):91, 2004 Mason L, Moore RA, Derry S, Edwards JE, McQuay HJ. Systematic review of topical capsaicin for the treatment of chronic pain. BMJ. 2004 Apr 24;328(7446):991. Epub 2004 Mar 19. Review. PMID: 15033881 http://bmj.bmjjournals.com/cgi/content/full/328/7446/991
  5. FDA NEWS RELEASE, Nov. 17, 2009 FDA Approves New Drug Treatment for Long-Term Pain Relief after Shingles Attacks http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm191003.htm - Qutenza prescribing information http://www.qutenza.com/_docs/qutenza_full_PI_.pdf
  6. Deprecated Reference
  7. Prescriber's Letter 17(5): 2010 COMMENTARY: Qutenza: A High Dose Capsaicin Patch GUIDELINES: Treatment of Postherpetic Neuralgia (QSS-ANN, 2004) GUIDELINES: Prevention of Herpes Zoster (ACIP, 2008) Detail-Document#: 260521 (subscription needed) http://www.prescribersletter.com
  8. Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/
  9. Deshauer S Are Spicy Foods Dangerous to Your Organs? Spicy foods may have health benefits, but they also carry some risk. MedPage Today. Oct 24, 2024 https://www.medpagetoday.com/popmedicine/popmedicine/112558

Component-of

benzocaine/capsaicin/lidocaine/methyl salicylate camphor/capsaicin camphor/capsaicin/eucalyptus oil/menthol/methyl salicylate camphor/capsaicin/menthol camphor/capsaicin/menthol/methyl salicylate camphor/capsaicin/menthol/methyl salicylate/peppermint oil/zinc oxide capsaicin/chondroitin sulfate/glucosamine/lidocaine capsaicin/histamine capsaicin/histamine/menthol capsaicin/lidocaine/menthol capsaicin/lidocaine/menthol/methyl salicylate capsaicin/lidocaine/salicylate capsaicin/menthol capsaicin/menthol/methyl salicylate capsaicin/methyl salicylate capsaicin/salicylate capsaicin/turpentine