Axsain, Capsaicin, Capsin, Capsacin-P, Dolorac, Zostrix, Zostrix-HP
Classifications: topical analgesic; Therapeutic: topical analgesic
0.025%, 0.075% lotion; 0.025%, 0.075%, 0.25% cream; 0.025%, 0.05% gel
Capsaicin is an alkaloid derived from plants and used as a topical analgesic. Capsaicin depletes and prevents reaccumulation
of Substance P, the primary chemical mediator of pain impulses from the periphery to the CNS.
Renders skin and joints insensitive to pain; therefore, it serves as an effective peripheral analgesic.
Temporary relief of pain from arthritis, neuralgias, diabetic neuropathy, and herpes zoster.
Phantom limb pain, psoriasis, intractable pruritus.
Hypersensitivity to capsaicin or any ingredient in the cream.
Patients on ACE inhibitors. Safety and efficacy in children <2 y have not been established.
Route & Dosage
Adult/Child (>2 y): Topical Apply to affected area not more than 34 times/d
- Apply to affected areas only and avoid contact with eyes or broken or irritated skin.
- If applied with bare hand, wash immediately following application. An applicator or gloved hand may be used to apply cream.
- Avoid tight bandages over areas of application of the cream.
Adverse Effects (≥1%)CNS:
Concentration >1%: neurotoxicity, hyperalgesia. Skin: Burning, stinging, redness,
May increase incidence
of cough with ace inhibitors
: 26 wk.
Assessment & Drug Effects
- Monitor for significant pain relief, which may require 46 wk of application three or four times daily.
- Monitor for and report signs of skin breakdown as these generally indicate need for drug discontinuation.
Patient & Family Education
- Report local discomfort at site of application if discomfort is distressing or persists beyond the first 34 d of use.
- Use caution in handling contact lenses following application of cream. Wash hands thoroughly before touching lenses.
- Notify physician if symptoms do not improve or condition worsens within 1428 d.
- Apply frequently three or four times daily to maximize therapeutic effectiveness.