Capsaicin: Difference between revisions

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|alcohol=Alcohol-Capsaicin interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
|alcohol=Alcohol-Capsaicin interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
}}
}}
{{Chembox new
| ImageFile1 = Capsaicin_chemical_structure.png
| ImageSize1 = 250px
| ImageFile2 = Capsaicin-3D-vdW.png
| ImageSize2 = 250px
| IUPACName = 8-Methyl-N-vanillyl-trans-6-nonenamide
| OtherNames = (E)-N-(4-Hydroxy-3-methoxybenzyl)<br>-8-methylnon-6-enamide,<br> trans-8-Methyl-N-vanillylnon<br>-6-enamide, (E)-Capsaicin,<br> CPS, C
| Section1 = {{Chembox Identifiers
|  CASNo = 404-86-4
|  EINECS = 206-969-8
|  PubChem = 1548943
|  SMILES = CC(C)/C=C/CCCCC<br>(NCC1=CC(OC)=C(O)C=C1)=O
  }}
| Section2 = {{Chembox Properties
|  Formula = (CH<sub>3</sub>)<sub>2</sub>CHCH=CH(CH<sub>2</sub>)<sub>4</sub><br>CONHCH<sub>2</sub>C<sub>6</sub>H<sub>3</sub>-4-(OH)-3-(OCH<sub>3</sub>)<br>
C<sub>18</sub>H<sub>27</sub>NO<sub>3</sub>
|  MolarMass = 305.41 g/mol
|  Appearance =
|  Density =
|  MeltingPt = 62 - 65 °C
|  BoilingPt = 210 - 220 °C
|  Solubility =
  }}
| Section3 = {{Chembox Hazards
|  MainHazards = Toxic ('''T''')
|  RPhrases = {{R24/25}}
|  SPhrases = {{S26}}, {{S36/37/39}}, {{S45}}
|  FlashPt =
|  Autoignition =
  }}
}}
'''Capsaicin''' {{IPA|/&#716;k&aelig;p&#712;se&#716;&#618;.s&#618;n/}} (8-methyl-''N''-vanillyl-6-nonenamide) is the active component of [[chilli pepper]]s, which are [[plants]] belonging to the [[genus]] ''[[Capsicum]]''. It is an [[Irritation|irritant]] for [[mammal]]s, including [[human]]s, and produces a sensation of burning in any [[Biological tissue|tissue]] with which it comes into contact. Capsaicin and several related compounds are called '''capsaicinoids''' and are produced as a [[secondary metabolite]] by chilli peppers, probably as deterrents against [[herbivore]]s. Pure capsaicin is a [[hydrophobic]], colorless, odorless, crystalline to waxy compound.
== History ==
The molecule was first isolated in 1816 in crystalline form by P. A. Buchtholz and again 30 years later by L. T. Tresh, who gave it the name capsaicin. In 1878, the Hungarian doctor Endre Hogyes (calling it capsicol) isolated it and proved that it not only caused the burning feeling when in contact with [[mucous membrane]]s but also increased secretion of [[gastric juice]]. Capsaicin was first synthesized in 1930 by E. Spath and F. S. Darling. In 1964, similar substances were isolated from [[chilli pepper]]s by the Japanese chemists S. Kosuge and Y. Inagaki, who named them capsaicinoids.
== Capsaicinoids ==
Capsaicin is the main capsaicinoid in chilli peppers, followed by [[dihydrocapsaicin]]. These two compounds are also about twice as potent to the taste and nerves as the minor capsaicinoids [[nordihydrocapsaicin]], [[homodihydrocapsaicin]], and [[homocapsaicin]]. Dilute solutions of pure capsaicinoids produced different types of pungency; however, these differences were not noted using more concentrated solutions.
Capsaicin is believed to be synthesized in the interlocular septa of chilli peppers by addition of a branched-chain [[fatty acid]] to [[vanillylamine]]. Biosynthesis depends on the gene ''AT3'', which resides at the ''pun1'' [[Locus (genetics)|locus]], and which encodes a putative [[acyltransferase]].<ref>
Stewart C Jr, Kang BC, Liu K, Mazourek M, Moore SL, Yoo EY, Kim BD, Paran I, Jahn MM. The Pun1 gene for pungency in pepper encodes a putative acyltransferase. Plant J. 2005 Jun;42(5):675-88.  [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=15918882&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]  Accessed June 15, 2007</ref>
Besides six natural capsaicinoids also one synthetic member capsaicinoid exists. It is [[nonivamide|vanillylamide of n-nonanoic acid]] (VNA) and it is used as a reference substance for determining capsaicinoids relative pungency.
{| class="wikitable"
|-
! Capsaicinoid name || Abbrev. || Typical</br>relative</br>amount || [[Scoville scale|Scoville]]</br>heat units || Chemical structure
|-
| Capsaicin            || C    || 69% || 15,000,000
| [[Image:Capsaicin chemical structure.png|200px|Chemical structure of capsaicin]]
|-
| [[Dihydrocapsaicin]]    || DHC  || 22% || 15,000,000
| [[Image:Dihydrocapsaicin chemical structure.png|200px|Chemical structure of dihydrocapsaicin]]
|-
| [[Nordihydrocapsaicin]]  || NDHC ||  7% ||  9,100,000
| [[Image:Nordihydrocapsaicin chemical structure.png|200px|Chemical structure of
nordihydrocapsaicin]]
|-
| [[Homodihydrocapsaicin]] || HDHC ||  1% ||  8,600,000
| [[Image:Homodihydrocapsaicin chemical structure.png|200px|Chemical structure of homodihydrocapsaicin]]
|-
| [[Homocapsaicin]]        || HC  ||  1% ||  8,600,000
| [[Image:Homocapsaicin chemical structure.png|200px|Chemical structure of homocapsaicin]]
|-
| [[Nonivamide]]        || PAVA  ||    || 
| [[Image:Nonivamide.png|200px|Chemical structure of nonivamide]]
|-
|}
== Natural function ==
Capsaicin is present in large quantities in the placental tissue which holds the seeds, the internal membranes and to a lesser extent in the other fleshy parts of the [[fruit]]s of plants in the genus ''[[Capsicum]]''.  Despite popular belief, the seeds do not produce any capsaicin.<ref>{{cite web| author=New Mexico State University - College of Agriculture and Home Economics| title=Chile Information -
Frequently Asked Questions| year=2005| url=http://spectre.nmsu.edu/dept/academic.html?i=1274&s=sub| accessdate=May 17| accessyear=2007}}</ref> 
Unlike many such fruits which have evolved to aid in [[seed dispersal]] by attracting animals, which consume the fruits and swallow the seeds, which pass through the [[digestive tract]] and are subsequently deposited elsewhere,  the seeds of ''Capsicum'' plants are predominantly dispersed by [[bird]]s, in which capsaicin has [[analgesic]] properties rather than acting as an irritant.  Chilli pepper seeds consumed by birds pass through the digestive tract unharmed, whereas those consumed by mammals do not germinate at all.<!-- Tewksbury & Nabhan 2001, Nature 412 -->  The presence of capsaicin in the fruits therefore protects them from being consumed by mammals.
It was recently discovered that the same pathway of pain utilized by capsaicin is a component of tarantula venom, becoming the first demonstrated shared target between plant and animal in defense from mammals. <ref> {{cite web| author=Siemens J, Zhou S, Piskorowski R, Nikai T, Lumpkin EA, Basbaum AI, King D, Julius D.| title=Spider toxins activate the capsaicin receptor to produce inflammatory pain. | year=2006| url=http://www.nature.com/nature/journal/v444/n7116/edsumm/e061109-04.html |doi:10.1038/nature05243}}</ref>
== Uses ==
=== Food ===
Because of the burning sensation caused by capsaicin when it comes in contact with human mucous membranes as found in the eye or the mouth, it is commonly used in food products to give them added spice or "heat" ([[pungency]]). The degree of heat found within a food is often measured on the [[Scoville scale]], although the [[high performance liquid chromatography]] method is now preferred . Typically the capsaicin is obtained from [[chilli pepper]]s. [[Hot sauce]] is an example of a product customarily containing large amounts of capsaicin and may contain chilli peppers or pure capsaicin.
Cooling and mechanical stimulation are the only proven methods to relieve the pain, however many questionable tips are widely perpetuated, including [[oil]] and oily food (probably because capsaicin in its pure state is poorly soluble in water but soluble in oil). However, the burning sensation will slowly fade away without any measure taken. Milk is the most popular form of relief; molecularly it attracts the burning ligands away from taste receptors (Dustrophsky, 2006). <ref>{{cite web| author=Dave DeWitt | title=Burning in the Mouth, Fire in the Belly| year=1999| url=http://www.fiery-foods.com/dave/taste9.html| accessdate=May 18| accessyear=2007}}</ref>
=== Medical ===
Capsaicin is currently used in topical [[ointment]]s to relieve the pain of peripheral [[neuropathy]] such as post-herpetic [[neuralgia]] caused by [[shingles]]. It may be used in concentrations of between 0.025% and 0.075%.
It may also be used as a cream for the temporary relief of minor aches and pains of [[muscle]]s and joints associated with [[arthritis]], simple backache, strains and [[sprain]]s. The treatment typically involves the application of a topical [[anesthetic]] until the area is numb. Then the capsaicin is applied by a [[therapist]] wearing [[rubber glove]]s and a face mask. The capsaicin remains on the skin until the patient starts to feel the "heat", at which point it is promptly removed. Capsaicin is also available in large [[adhesive bandage]]s that can be applied to the back.
The result appears to be that the [[nerve]]s are overwhelmed from the burning sensation and are unable to report pain for an extended period of time. With chronic exposure to capsaicin, [[neuron]]s are depleted of [[neurotransmitters]] and it leads to reduction in sensation of pain and blockade of [[neurogenic inflammation]]. If capsaicin is removed, the neurons recover.{{Fact|date=July 2007}}
Capsaicin is being explored as a possible cure for diabetes by [http://www.freerepublic.com/focus/f-news/1754006/posts researchers in Toronto, Canada].  Early work curing diabetic mice looks promising.  Capsaicin was injected into pancreatic sensory nerves of mice with Type 1 diabetes because of a suspected link between the nerves and diabetes.
The [[American Association for Cancer Research]] reports studies suggesting capsaicin is able to kill [[prostate cancer]] cells by causing them to undergo [[apoptosis]]. <ref>{{cite web| author=American Association for Cancer Research| title=Pepper component hot enough to trigger suicide in prostate cancer cells| year=2006| url=http://www.eurekalert.org/pub_releases/2006-03/aafc-pch031306.php| accessdate=January 27| accessyear=2007}}</ref> The studies were performed on tumors formed by human prostate cancer [[cell cultures]] grown in mouse models, and showed tumors treated with capsaicin were about one-fifth the size of the untreated tumors.  It has long been noted that in Thailand, where lots of spicy food is consumed, there is very low incidence of gastrointestinal cancers, including colorectal, stomach,  cancers, compared to the rest of Asia, including Japan and China.<ref>[http://jjco.oxfordjournals.org/cgi/content/full/32/suppl_1/S82]</ref>  Mexico also has low rates of the same cancers compared to the USA.
Another study carried out at the [[University of Nottingham]] suggests capsaicin is able to trigger apoptosis in human [[lung cancer]] cells as well.<ref>{{cite web| author=BBC News| title=How spicy foods can kill cancers| year=2007 | url=http://news.bbc.co.uk/2/hi/health/6244715.stm| accessdate=January 09| accessyear=2007}}</ref>
Capsaicin is also the key ingredient in the experimental drug Adlea, which is in Phase 2 trials as a long-acting analgesic to treat post-surgical and osteoarthritis pain for weeks to months after a single injection to the site of pain.
=== Non-lethal force ===
Capsaicin is also the active ingredient in the chemical riot control agent [[pepper spray]]. When the spray comes in contact with [[skin]], especially [[eye]]s or [[mucous membrane]]s, it is very painful. Refer to the [[Scoville scale]] for a comparison of pepper spray to other sources of capsaicin.
In large quantities, capsaicin can cause [[death]]. Symptoms of overdose include difficulty breathing, blue skin, and convulsions. The large amount needed to kill an adult human and the low concentration of capsaicin in chillis make accidental poisoning by chilli consumption exceedingly unlikely.
=== Possible drug abuse deterrent ===
Clifford Woolf, the Richard J. Kitz Professor of Anesthesia Research at [[Harvard Medical School]], has suggested using capsaicin to deter abuse of certain extended-release drugs such as [[OxyContin]] and [[Ritalin]].<ref>Cromie WJ (2006) "Using chilli peppers to burn drug abusers" [http://www.news.harvard.edu/gazette/daily/2004/12/21-capsaicin.html ''Harvard University Gazette'' accessed 24 January 2006]</ref> When taken as prescribed, opioid prescription drugs such as [[OxyContin]] or stimulant drugs such as [[Adderall XR]] release their active chemical over time, but when crushed and snorted, taken as a suppository, chewed, or injected, the larger than normal dosage is absorbed all at once and a much stronger effect is produced that can be highly addictive and dangerous due to the higher risk of overdose. Woolf has argued that adding capsaicin into the capsules would be a safe way to deter abuse. A person taking the capsule in the prescribed way (i.e., swallowing it whole) would suffer no ill effects from the additive. However, a person crushing it would expose the irritant. Anyone then swallowing it, snorting it, or injecting it would be exposed to the full power of the chemical. "Imagine snorting an extract of 50 jalapeño peppers and you get the idea," Woolf said in an interview with the Harvard University Gazette. [[As of 2006]], Woolf's proposal is still in the preliminary stages of development and the additive has not yet entered the production stage.
=== Pest deterrent ===
Capsaicin is also used to deter pests. A common example is the use of ground-up or crushed dried chilli pods in birdseed to deter squirrels, since birds are unaffected by capsaicin.  Insects are also unaffected.
== Mechanism of action ==
The burning and painful sensations associated with capsaicin result from its chemical interaction with sensory [[neuron]]s. Capsaicin, as a member of the [[vanilloid]] family, binds to a [[transmembrane receptor|receptor]] called the [[vanilloid receptor subtype 1]] (VR1). <ref> {{Citation | title=Feel the Burn | journal=American Scientist | volume=95 | issue=4 | first1=Gina M. | last1=Story | first2=Lillian | last2=Cruz-Orengo | year=2007 | pages=pp. 326-333}} </ref> First cloned in 1997, VR1 is an [[ion channel]]-type receptor. VR1, which can also be stimulated with heat and physical abrasion, permits [[cation]]s to pass through the [[cell membrane]] and into the cell when activated. The resulting "[[depolarization]]" of the neuron stimulates it to [[action potential|signal]] the brain. By binding to the VR1 receptor, the capsaicin molecule produces the same effect that excessive heat or abrasive damage would cause, explaining why the spiciness of capsaicin is described as a burning sensation.
The VR1 [[ion channel]] has subsequently been shown to be a member of the superfamily of [[transient receptor potential|TRP]] [[ion channels]], and as such is now referred to as {{Gene|TRPV1}}. There are a number of different [[transient receptor potential|TRP]] [[ion channels]] that have been shown to be sensitive to different ranges of temperature and probably are responsible for our range of temperature sensation. Thus, capsaicin does not actually cause a [[chemical burn]], or indeed any damage to tissue at all; it causes only the sensation of one.
==Toxicity==
===Acute health effects===
Capsaicin is a highly irritant material requiring proper protective goggles, respirators, and proper hazmat handling procedures. It is hazardous in cases of skin contact (irritant, sensitizer), of eye contact (irritant), of ingestion, of inhalation (lung irritant, lung sensitizer). Severe over-exposure can result in death.<ref name="tox">{{Cite web|url=http://www.sciencelab.com/xMSDS-Capsaicin_Natural-9923296|title=Capsaicin Material Safety Data Sheet|accessdate=2007-07-13|publisher=sciencelab.com|year=2007|format=pdf}}</ref> Painful exposures to capsaicin-containing peppers are among the most common plant-related exposures presented to poison centers.<ref name="tox2">{{cite book | title=Goldfrank's Toxicologic Emergencies| last=Goldfrank| first=L R. (ed.)| pages=1167| publisher=McGraw-Hill| location=New York, New York}}</ref> They cause burning or stinging pain to the skin, and if ingested in large amounts by adults or small amounts by children, can produce nausea, vomiting, abdominal pain, and burning diarrhea.<ref name="tox2" /> Eye exposure produces intense tearing, pain, [[conjunctivitis]], and [[blepharospasm]].<ref name="tox2" />
===Treatment after exposure===
The primary treatment is removal from exposure. Contaminated clothing should be removed and placed in airtight bags to prevent secondary exposure. Skin irrigation with copious cold water is used for significant dermal exposures.<ref name="tox2" /> Symptomatic treatments, such as topical ophthalmic anesthetics, nebulized bronchodilators, or oral antihistamines and corticosteroids, are indicated as appropriate in more severely affected victims.<ref name="tox2" /> Capsaicin-induced dermatitis has been treated variably with immersion in water or oil, vinegar, bleach, lidocaine gel, and topical antacid suspensions. Cold water produces earlier symptomatic relief, but oil immersion has longer-lasting benefit.<ref name="tox2" />
===Effects of dietary consumption===
The effects of ingestion of small quantities has given different experimental results. One study showed no mucosal erosions or other abnormalities after eating ground jalapeño peppers.<ref name="bleed1">{{cite journal | author=Graham DY, Smith JL, Opekun AR.| title=Spicy food and the stomach. Evaluation by videoendoscopy.| journal=JAMA| year=1988| volume=260| issue=23| page=3473-5| url=http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=3210286&dopt=citation}}</ref> Whereas another showed mucosal microbleeding and even one case of grossly visible gastric bleeding after eating red and black peppers.  This study also showed ''"no spice was significantly different from aspirin in any parameter studied."''<ref name="effects-pepper">{{cite journal | author=Myers BM, Smith JL, Graham DY.| title=Effect of red pepper and black pepper on the stomach.| journal=Am J Gastroenterol| year=1987| volume=82| issue=3| page=211-214| url=http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=3103424&dopt=citation}}</ref> Other studies have shown an association between chronic consumption of capsaicin-rich foods and stomach cancer, yet one such study was not adjusted to any other factors in diet.<ref name="cancer2">{{cite journal |author=López-Carrillo L, López-Cervantes M, Robles-Díaz G, ''et al'' |title=Capsaicin consumption, Helicobacter pylori positivity and gastric cancer in Mexico |journal=Int. J. Cancer |volume=106 |issue=2 |pages=277-82 |year=2003 |pmid=12800206 |doi=10.1002/ijc.11195}}</ref> Another of the said studies also showed a similar risk to stomach cancer with higher consumption of [[rice]].<ref name="cancer1">{{cite journal | author=Mathew A, Gangadharan P, Varghese C, Nair MK.| title=Diet and stomach cancer: a case-control study in South India.| journal=Eur J Cancer Prev.| year=2000| volume=9| issue=2| page=89-97| url=http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=10830575&dopt=citation}}</ref>
== References ==
<div class="references-small">
<references/>
</div>
* Dray A (1992) "Mechanism of action of capsaicin-like molecules on sensory neurons" [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1331641&dopt=Abstract ''Life Sci'' 51(23):1759-65]
* Garnanez RJ, McKee LH (2001) "Temporal effectiveness of sugar solutions on mouth burn by capsaicin" [http://ift.confex.com/ift/2001/techprogram/paper_8185.htm IFT Annual Meeting 2001]
* Henkin R (1991) '"Cooling the burn from hot peppers" ''JAMA'' 266(19):2766
* Nasrawi CW, Pangborn RM (1990) "Temporal effectiveness of mouth-rinsing on capsaicin mouth-burn" [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2385629&query_hl=1 ''Physiol Behav'' 47(4):617-23]
* Tewksbury JJ, Nabhan GP (2001) "Seed dispersal: Directed deterrence by capsaicin in chillies" [http://www.nature.com/nature/journal/v412/n6845/full/412403a0.html ''Nature'' 412, 403-404 (26 July 2001)], doi: 10.1038/35086653
* Michael L. Kirifides1, Michael P. Kurnellas1, Larry Clark2 and Bruce P. Bryant1, "Calcium responses of chicken trigeminal ganglion neurons to methyl
anthranilate and capsaicin" The Journal of Experimental Biology 207, 715-722
Published by The Company of Biologists 2004
* Tarantula Venom, Chilli Peppers Have Same "Bite," Study Finds http://news.nationalgeographic.com/news/2006/11/061108-tarantula-venom.html
== See also ==
* [[Piperine]], the active piquant chemical in [[black pepper]]
* [[Allyl isothiocyanate]], the active piquant chemical in [[mustard plant|mustard]], [[radish]]es, [[horseradish]], and [[wasabi]]
* [[Allicin]], the active piquant flavor chemical in uncooked [[garlic]] and [[onions]] (see those articles for discussion of other chemicals in them relating to pungency, and eye irritation)
* [[Naga jolokia|Naga Jolokia pepper]], the world's most capsaicin-rich fruit
== External links ==
* [http://www.epa.gov/oppsrrd1/REDs/factsheets/4018fact.pdf EPA Capsaicin Reregistration Eligibility Decision Fact Sheet]
* [http://sulcus.berkeley.edu/mcb/165_001/papers/manuscripts/_784.html Capsaicin and Its Therapeutic Potential]
* [http://www.chm.bris.ac.uk/motm/chilli/capsaicin.htm Molecule of the Month]
* [http://ec.europa.eu/food/fs/sc/scf/out120_en.pdf European Commission], opinion of the Scientific Committee on Food on capsaicin.
* An online article on [http://www.fiery-foods.com/Dave/cap2000.html popular capsaicin applications] by Dave DeWitt
* A [[WikiHow]] article on [http://www.wikihow.com/Cool--Burns-from-Chilli-Peppers How to Cool Chilli Pepper Burns].
* [[The Straight Dope]] staff report: [http://www.straightdope.com/mailbag/mchili.html Are birds immune to hot pepper, enabling them to eat vast amounts and spread the seeds?]
[[Category:Capsaicinoids]]
[[cs:Kapsaicin]]
[[da:Capsaicin]]
[[de:Capsaicin]]
[[es:Capsaicina]]
[[fr:Capsaïcine]]
[[id:Capsaicin]]
[[it:Capsaicina]]
[[he:קפסאיצין]]
[[lt:Kapsicinas]]
[[hu:Kapszaicin]]
[[nl:Capsaïcine]]
[[ja:カプサイシン]]
[[pl:Kapsaicyna]]
[[pt:Capsaicina]]
[[fi:Kapsaisiini]]
[[sv:Capsaicin]]
[[th:แคปไซซิน]]
[[vi:Capsaicin]]
[[zh:辣椒素]]
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Revision as of 18:31, 18 December 2014

Capsaicin
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

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Overview

Capsaicin is a topical analgesic that is FDA approved for the treatment of {{{indication}}}. Common adverse reactions include {{{adverseReactions}}}.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Indications

  • For the temporary relief of minor aches and pains of muscles and joints associated with arthritis, simple backache, strains and sprains
  • For use in treating neuralgias, consult a physician

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Indications and Dosage

  • Arthritis - Pain: TOPICAL, apply thin film to the affected area 3 to 4 times per day.
  • Musculoskeletal pain: TOPICAL, apply thin film to the affected area 3 to 4 times per day.
  • Neuropathic pain, associated with postherpetic neuralgia: (patch) a single 60-minute application of up to 4 patches every 3 months as needed; do not apply more frequently than every 3 months>
  • Psoriasis: apply cream 6 times/day for 3 days, then 4 times/day

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Capsaicin in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

There is limited information regarding Capsaicin FDA-Labeled Indications and Dosage (Pediatric) in the drug label.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

  • Safety and effectiveness of capsaicin 8% patch (Qutenza(R)) not established in pediatric patients [3]; consult a physician before using capsaicin cream on patients under 18 years of age [

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Capsaicin in pediatric patients.

Contraindications

There is limited information regarding Capsaicin Contraindications in the drug label.

Warnings

For external use only.

Do not apply to wounds or to damaged or irritated skin.

When using this product

  • You may experience a burning sensation which is normal and related to the way the product works. With regular use, this sensation generally disappears within several days.
  • Do not get it on mucous membranes, into eyes, or on contract lenses. If this occurs, rinse the affected area thoroughly with water.
  • Do not apply immediately before or after activities such as bathing, swimming, sun bathing, or strenuous exercise.
  • Do not apply heat to the treated areas immediately before or after use.
  • Do not tightly wrap or bandage the treated area.
  • Avoid inhaling airborne material from dried residue. This can result in coughing, sneezing, tearing, throat or respiratory irritation.

Stop use and ask a doctor if

  • Condition worsens or does not improve after regular use.
  • Blistering occurs.
  • Difficulty breathing or swallowing occurs.
  • Severe burning persists.

Keep out of reach of children.

  • If swallowed, get medical help or contact a Poison Control Center immediately.

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Capsaicin Clinical Trials Experience in the drug label.

Postmarketing Experience

Common

  • Dermatologic: Application site erythema (63% ), application site pain (42% ), application site rash (6% ), pruritus, application Site (6% )
  • Gastrointestinal: Nausea (5% )
  • Respiratory: Nasopharyngitis (4% )
  • Cardiovascular: Hypertension (2% )Serious'

Drug Interactions

There is limited information regarding Capsaicin Drug Interactions in the drug label.

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): There is no FDA guidance on usage of Capsaicin in women who are pregnant.
Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Capsaicin in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Capsaicin during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Capsaicin in women who are nursing.

Pediatric Use

There is no FDA guidance on the use of Capsaicin in pediatric settings.

Geriatic Use

There is no FDA guidance on the use of Capsaicin in geriatric settings.

Gender

There is no FDA guidance on the use of Capsaicin with respect to specific gender populations.

Race

There is no FDA guidance on the use of Capsaicin with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Capsaicin in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Capsaicin in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Capsaicin in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Capsaicin in patients who are immunocompromised.

Administration and Monitoring

Administration

There is limited information regarding Capsaicin Administration in the drug label.

Monitoring

There is limited information regarding Capsaicin Monitoring in the drug label.

IV Compatibility

There is limited information regarding the compatibility of Capsaicin and IV administrations.

Overdosage

There is limited information regarding Capsaicin overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.

Pharmacology

There is limited information regarding Capsaicin Pharmacology in the drug label.

Mechanism of Action

There is limited information regarding Capsaicin Mechanism of Action in the drug label.

Structure

There is limited information regarding Capsaicin Structure in the drug label.

Pharmacodynamics

There is limited information regarding Capsaicin Pharmacodynamics in the drug label.

Pharmacokinetics

There is limited information regarding Capsaicin Pharmacokinetics in the drug label.

Nonclinical Toxicology

There is limited information regarding Capsaicin Nonclinical Toxicology in the drug label.

Clinical Studies

There is limited information regarding Capsaicin Clinical Studies in the drug label.

How Supplied

There is limited information regarding Capsaicin How Supplied in the drug label.

Storage

Store at 15° - 30°C (59° - 86°F)

Images

Drug Images

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Package and Label Display Panel

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Patient Counseling Information

  • For persons under 18 years of age, ask a doctor before using.
  • To avoid getting cream on hands use applicator pad to apply a thin film of cream to the affected area and gently rub in until fully absorbed. Discard applicator pad after use.
  • For optimum relief, apply 3 to 4 times daily.
  • Best results typically occur after 2 to 4 weeks of continuous use.
  • Unless treating hands, wash hands thoroughly with soap and water immediately after use.
  • See package insert for more information.

Precautions with Alcohol

Alcohol-Capsaicin interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Capsaicin Brand Names in the drug label.

Look-Alike Drug Names

There is limited information regarding Capsaicin Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

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