Overview
Capsaicin is used to relieve pain and has various uses. It is a naturally occurring compound found in chili peppers which gives it a characteristic spicy taste. The drug was approved by the Food and Drug Administration in 2009. However, a few products of the drug are approved for pain relief. The products are usually used as topical analgesics or dermatological products.
How Does Capsaicin Work?
The drug has various mechanisms of action, all of which are targeted to relieve pain. The drug actively binds to the receptor named transient receptor potential vanilloid type 1, which is located in the nerve endings. They are involved in the perception of pain, heat, and inflammation. Prolonged activation of the receptor leads to the initial sensation of burning pain, followed by the depletion of neuropeptide, which is involved in pain transmission. Eventually, the process desensitizes the neurons and leads to pain reduction.
Uses:
The uses of Capsaicin have been mentioned below:
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The drug is commonly used as topical creams and gels to manage different types of pain. They include osteoarthritis, rheumatoid arthritis, and musculoskeletal pain. The topical application first causes a burning sensation, which is followed by pain relief caused by desensitization of sensory neurons.
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The drug has been used for its potential effects on weight loss and metabolic health. It increases the energy consumption of the body, enhances fat oxidation, and suppresses appetite. However, the evidence for its use in promoting health is yet to be known.
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Nasal sprays of this drug have been used to treat non-allergic rhinitis, which is characterized by a runny nose and congestion. The application of the drug leads to temporary desensitization of sensory nerves.
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The drug has demonstrated anti-inflammatory effects by inhibiting the inflammatory mediators produced by tumor necrosis factors. It also helps to reduce inflammation in psoriasis.
Dosage:
The dosage of the drug could differ depending on specific products and formulations. The drug is available in the following formulations as topical cream:
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0.025 percent.
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0.035 percent.
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0.075 percent.
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0.1 percent.
Following the instructions given by the healthcare professional is mandatory for optimal results. The general guidelines involved in the common forms of Capsaicin are mentioned below:
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When the drug is used as a topical cream or gel, it is recommended to apply a thin layer of product on the affected area. This is repeated thrice a day. Usually, the drug is started at a lower concentration.
For Patients :
What Is Pain?
An unpleasant sensory and emotional experience is associated with tissue damage. It is a protective mechanism to alert the body from potential harm and can be classified into several types.
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Nociceptive pain occurs as a response to actual tissue damage. It could be either somatic pain which arises from the stimulation of pain receptors in skin and muscles. Or else, it could be visceral pain derived from integral organs, which can be deep and dull.
Things to Inform the Doctor Before They Prescribe Capsaicin:
Before undergoing any treatment, it is safer to inform the doctor about the existing medical conditions, allergic reactions, and drug history. This enables the physician to prescribe drugs that do not interact or cause adverse effects to the body.
Starting Capsaicin :
How to Take Capsaicin?
The drug is available in the form of topical gel or cream, which has to be applied thrice a day for pain relief.
How to Store Capsaicin?
The drug has to be stored in the original packing to prevent contamination. Always refers to the product packaging and labeling for the manufacturer. The drug should be stored at room temperature between 59 degrees Fahrenheit to 86 degrees Fahrenheit. Avoid storing them in extremely hot and cold environments. Prevent the product from extreme moisture and direct heat and sunlight. Keep the drug in dry places away from humidity areas. It is safer to protect the medicines in childproof containers. Always check for the expiration date before consuming the drug.
How to Handle Capsaicin?
Wear protective gloves to protect the hands from potential irritation or burning. Nitrile gloves are highly recommended. Avoid contact with eyes as it may cause intense burning. In case of accidental contact, wash with cool water. After handling the drug, wash hands thoroughly with soap and water. It helps to remove residual stains. Always follow the instructions provided by the product manufacturer for better safety.
How to Dispose of Capsaicin?
Always check the product label to follow specific instructions for disposal. Contact the local waste management for safe disposal of the drug. Look for specific instructions provided by the manufacturer. Seal the container to prevent accidental access by children and pets. Avoid disposing of the product into the drain as it could contaminate the water sources and blockages.
Avoid Self-Medication:
Self-medication can harm the body in various ways. Always avoid self-medication and administer drugs according to the doctor’s prescription.
Things to Do After Starting Taking Capsaicin:
After starting the drug, closely monitor for any form or type of side effects to prevent unwanted complications. In case of any such adverse reactions, immediately report to the healthcare professional.
Look Out for Side Effects:
The side effects caused by Capsaicin are described below:
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Skin Irritation - When the drug is topically applied, it causes redness and a burning sensation. It is typically mild and temporary, but some individuals are highly sensitive to the drug and experience more irritation. It is advised to perform a patch test on small areas of skin before applying in larger areas to check for adverse effects.
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Eye Irritation - The drug should be kept away from the eyes and mucous membranes as it causes severe irritation. Avoid touching the face and sensitive areas after using the drug.
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Allergies - Some Individuals experience allergic reactions to the drug, and the symptoms include rash, swelling, and hives.
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Stomach Upset - The drug can affect the gastrointestinal tract and can cause nausea, vomiting, and stomach pain.
Dietary Alterations:
No dietary alterations are required while using Capsaicin. However, consuming a balanced and healthy diet can help to maintain the body's health.
What Should Be Done When a Dose Is Missed?
In case of missing a dose, it is not very serious like other medical conditions. As the drug is available as a topical gel, it is mostly recommended to be applied thrice daily. But if no pain is exhibited by the individual, it is better to avoid frequent use.
What Should Be Done to Treat Capsaicin Overdose?
Overdosing on the drug is extremely rare, but in case of overdosing, it is better to seek medical assistance.
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First of all, remove the source of substance in contact with the skin immediately and rinse the area with cold water to alleviate the burning sensation.
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If the drug has been inhaled or causes respiratory distress, move to an area with fresh air to improve air circulation.
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Avoid inducing vomiting, as it is not generally recommended. Vomiting could further irritate the esophagus.
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A healthcare professional may completely evaluate for risks and administer medications and supportive care.
For Doctors :
Indication:
The drug is indicated for temporary relief in conditions like postherpetic neuralgia and diabetic neuropathy. In addition, it can also be prescribed for osteoarthritis. It is used to prevent itching caused by dermatologic conditions.
Pharmacology:
Mechanism of Action:
When the drug is in close contact with the sensory nerve endings, it activates the TRPV1 channels, which initially leads to heat and pain. Following the action, it results in the desensitization of nerve fibers. Through repeated exposure, the P substance depletes and reduces the transmission of pain signals.
Pharmacodynamics:
Taxonomy: Since the drug is a derivative of the plant capsicum, the exact taxonomy has not been clearly stated.
Ingredients:
Active Ingredient: Capsaicin.
Inactive Ingredients:
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Emollients - These are moisturizing agents to soothe the skin.
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Stabilizers - They help to maintain the stability and shelf-life of products.
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Humectants - They retain moisture in the skin.
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Antioxidants - It is included to prevent the product from degrading due to exposure to air or light.
Absorption:
When the drug is applied topically, the absorption into the body is restricted. The degree of absorption could be influenced by the concentration of the drug and the area of application. Additionally, the duration of contact and the individual’s skin condition could also affect the absorption.
Distribution:
After absorption into the bloodstream, the distribution of the drug is limited; It has a relatively short life which typically ranges from 30 minutes to a few hours.
Metabolism:
The drug primarily undergoes metabolism in the liver through various enzymatic processes. Specific metabolic pathways have been extensively studied.
Elimination:
Most metabolites of the drug are excreted via urine. Once excreted, the drug is no longer present in the body.
Administration of the Drug:
The drug is most commonly administered as topical gels or creams over the affected areas. A few forms of the drug are available in the form of tablets over the counter.
Clinical Studies for Capsaicin:
Various studies have been published to evaluate the effectiveness of the drug in various conditions. A few clinical studies are given below:
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In the Journal of pain medicine, a study was published to assess the use of Capsaicin in neuropathic pain. The researchers concluded the drug had significant pain relief in patients.
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Another study established for chronic pain management also proved effective in reducing the severity of the drug.
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A published article in the Journal of Rheumatology proved that the cream provided pain relief and improved physical functioning in patients with knee osteoarthritis.
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Additionally, research on drug efficacy in patients with fibromyalgia proved that the cream applied to tender points reduced pain and improved sleep quality.
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The drug has also been proven to reduce itching in pruritus significantly.
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Another research on the drug has validated the efficacy of the drug in increased energy expenditure and fat oxidation, which helps to manage weight potentially.
Drug Interactions:
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The drug could interact with other topical medications which are applied to the same area. It is advised to separate the application of the medications to prevent potential irritation.
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Corticosteroids and local anesthetics could interact with the drug.
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The drug is not expected to have systemic effects on blood clotting.
Other Specifications:-
Capsaicin in Pregnant Women:
There is limited research to evaluate the drug's safety during pregnancy specifically. Topical use of the drug is considered to have a lower risk of drug administration. However, the possibility of skin irritation and allergic reactions should be considered due to the high sensitivity of women during pregnancy.
Capsaicin in Lactating Women:
Similar to pregnancy, very limited information is available on the use of Capsaicin in lactating women. The drug could be excreted via the milk. Hence it is safer to avoid it. Also, the fetus (child) could have variable tolerance to spicy foods.
Capsaicin in Pediatric Patients:
The drug is usually not recommended for pediatric patients as it can potentially cause skin irritation. However, older children could have better tolerance, but the side effects are not clearly established. The long-term effects of the drug are not clearly known.
Capsaicin in Geriatric Patients:
Elders have very thin and delicate skin, which could increase skin irritation when applied topically. So it is important to start with a lower dose and gradually increase it. Patients with pre-existing medical conditions should often monitor their health carefully. Some patients have cognitive impairment and could have difficulty instructing the topical application of the drug. So the caretakers or health providers must carefully minimize the risk of accidental ingestion.
Capsaicin in Renal Impairment Patients:
The drug should be approached with caution, and it is essential to consult the healthcare professional before using the drug. The drug is usually metabolized in the liver and excreted through the kidneys. This can cause high levels of drugs in the bloodstream. Patients with renal impairment are known to have increased sensitivity to the drug. So special considerations and dosage adjustments are recommended.
Capsaicin in Hepatic Impairment Patients:
As the drug is metabolized in the liver, hepatic impairment can affect the drug clearance from the body and may pose potential risks to the patient. It could increase the risk of skin irritation and cause adverse effects. Proper guidance by the health professional is recommended for each case.
