Adult Dosing

Pain

Capsaicin, Capzasin No-Mess, Capzasin-HP, Capzasin-P, Salonpas Hot, Zostrix, Zostrix Diabetic Foot Pain Cream, Zostrix Neuropathy, Zostrix-HP

• Apply to affected areas tid-qid

Post-herpetic neuralgia

Qutenza

• Apply 1-4 patches x 1

• Remove patch(es) after 60 mins; may cut to size/shape of treatment area
• May repeat no more often than q3 months
• Pre-treat with topical anesthetic
• Do not apply to broken skin, face, or scalp

Pediatric Dosing

Pain

Capsaicin

• (> 2 yrs): Apply to affected areas tid-qid
• Note: Wear gloves during application. Wash hands immediately after application

Zostrix neuropathy

• (> 10 yrs): Apply to affected areas tid-qid

[Outline]

• Adult Dosing
• Pediatric Dosing

• Temporary relief of pain from rheumatoid arthritis and osteoarthritis
• Relief of neuralgia (e.g., pain after shingles, diabetic neuropathy)

• Hypersensitivity to drug, class or preparation

• N/A

Renal Dose Adjustment

• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Hepatic impairment: No dose adjustments

• Wear gloves during application. Wash hands immediately after application
• Capsaicin can cause intense burning sensation during the initial treatment period
• Assess location and intensity of pain periodically throughout therapy
• Do not apply transdermal patch on broken skin
• Avoid use near eyes or mucous membranes
• Inhalation of airborne capsaicin may cause coughing and sneezing; if irritation of eyes or airway occurs, flush the mucous membranes or eyes with water
• Transient increases in blood pressure may occur in patients during and shortly after the therapy with transdermal patches. Monitor blood pressure during and following the treatment procedure

Cautions: Use cautiously in

• Hypertension (qutenza)
• Recent cardiovascular event (qutenza)
• Recent cerebrovascular event (qutenza)
• Pediatric population (safety not established for children < 2yrs)
• Pregnancy (safety unknown)
• Lactation(Safety undetermined)

Pregnancy Category: Unknown (category B for qutenza)

Breastfeeding: Safety unknown

Cream

• LOCAL: Burning, erythema, hyperalgesia
• SYSTEMIC: Neurotoxicity, cough/respiratory infection

TDP

• LOCAL: Application site erythema/pain/pruritus/papules/edema
• RESP: Cough, sneezing, nasopharyngitis, sinusitis, bronchitis
• CV: Hypertension
• GI: Nausea, vomiting
• DERM: Pruritis

• Counterirritant analgesic; exact mechanism of action unknown; selectively binds nerve membrane TRPV1 receptors, initially stimulates then desensitizes and degenerates cutaneous nociceptive neurons; may deplete and prevent reaccumulation of substance P which reduces pain impulse transmission to the CNS
• Minimal systemic absorption
• Metabolism: Unknown
• Excretion: Unknown
• Half-Life: Unknown

US Trade Name(s)

• Capzasin-HP
• Capzasin No-Mess
• Capzasin-P
• Qutenza
• Salonpas Hot
• Zostrix
• Zostrix Diabetic Foot Pain Cream
• Zostrix Neuropathy
• Zostrix-HP

US Availability

capsaicin (generic)

• CRE: 0.025%, 0.075%

Capzasin-HP

• OTC CRE: 0.1%

Capzasin No-Mess

• OTC SOLN: 0.15%

Capzasin-P

• OTC CRE: 0.035%

Qutenza

• PATCH: 8%

Salonpas Hot

• OTC PATCH: 0.025%

Zostrix

• CRE: 0.025%

Zostrix Diabetic Foot Pain Cream

• CRE: 0.075%

Zostrix-HP

• CRE: 0.075 %

Zostrix Neuropathy

• CRE: 0.025 %

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• Axsain
• Qutenza
• Zacin

UK Availability

Axsain

• CRE: 0.075%

Qutenza

• PATCH: 8 %

Zacin

• CRE: 0.025%

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Dermatologic

Counterirritant Analgesic