Capsaicin

Drug Name
Capsaicin

Brand Name(s)
Zostrix®, Rub A-535 Capsaicin Cream®, etc.

Drug Class
Non-prescription medication

Capsaicin is a potential alternative for osteoarthritis (OA) pain not relieved with acetaminophen or for people who cannot tolerate or are reluctant to use oral medications.

  • What types of arthritis is capsaicin used for?

    Capsaicin is a potential alternative for osteoarthritis (OA) pain not relieved with acetaminophen or for people who cannot tolerate or are reluctant to use oral medications. Capsaicin may be effective in those who have OA in only one or two joints, such as the knee or hand. Capsaicin may also be tried in combination with oral medications when OA pain relief is not adequate. 

    Capsaicin may be used in addition to disease-modifying anti-rheumatic drugs (DMARDs) or biologics to treat the pain of inflammatory arthritis; however, capsaicin is not routinely used in the treatment of inflammatory arthritis.

  • How is capsaicin administered?

    Capsaicin is found naturally in hot peppers and is available in topical creams that may be applied directly to the skin over a joint to help lessen the pain of OA.Capsaicin is a potential alternative for osteoarthritis (OA) pain not relieved with acetaminophen or for people who cannot tolerate or are reluctant to use oral medications. Capsaicin may be effective in those who have OA in only one or two joints, such as the knee or hand. Capsaicin may also be tried in combination with oral medications when OA pain relief is not adequate.

    Capsaicin may be used in addition to disease-modifying anti-rheumatic drugs (DMARDs) or biologics to treat the pain of inflammatory arthritis; however, capsaicin is not routinely used in the treatment of inflammatory arthritis.

  • What is the typical dose and when do I take it?

    Apply sparingly three or four times daily and massage into the affected area.  

  • How long will it take to work?

    Capsaicin does not provide immediate relief to pain; pain relief may take up to two weeks with daily administration. Maximal effect can take up to four weeks.

  • When should I not use capsaicin and call my doctor?

    Do not use capsaicin topical preparations if you have had a previous allergic reaction to the medication. Capsaicin should not be used on raw, broken or irritated skin.
     
    Capsaicin products are for external use only. If rash occurs, discontinue use. If condition worsens or symptoms persist, discontinue use and contact your health-care provider.
     
    Avoid contact with eyes. After application, wash hands thoroughly to prevent spreading the product to eyes and mouth. Flush with water if contact does occur. 

    The application of external heat, such as an electric heating pad, a hot water bottle or sweating through exercise, may result in excessive skin irritation or burn.

  • What are the side effects of capsaicin?

    Skin irritation, local burning, stinging or redness may be most prominent during the first week of treatment. These side effects often prevent long-term use.

  • What helps to reduce side effects?

    Apply topical capsaicin products as recommended and contact your health-care provider if you have any concerns while using the medication.  

    Skin irritation diminishes or disappears with continued use at the recommended dose. If capsaicin is applied less frequently than recommended or used intermittently, the burning effect may persist.

  • Do I need any monitoring while using capsaicin?

    On occasion, you may need blood work while using topical capsaicin.  Your health-care provider may meet with you regularly to ensure that your pain is adequately controlled.


This information was last updated November 2017, with expert advice from:

Jason Kielly, B.Sc. (pharm.), Pharm.D.
Assistant Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health

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