Axsam, Capsin, Capzasin-P, Dolorac, No Pain-HP, Pain Doctor, Pain-X, R-Gel, Rid a Pain HP, Zostrix, Zostrix-HP
Therapeutic: nonopioid analgesics (topical)
Temporary management of pain due to rheumatoid arthritis and osteoarthritis. Treatment of pain associated with postherpetic neuralgia or diabetic neuropathy. Unlabeled Use: Treatment of postmastectomy pain syndrome. Treatment of complex regional pain syndrome.
May deplete and prevent the reaccumulation of a chemical (substance P) responsible for transmitting painful impulses from peripheral sites to the CNS. Therapeutic Effects: Relief of discomfort associated with painful peripheral syndromes.
Adverse Reactions/Side Effects
Resp: cough. Derm: transient burning.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Use appropriate pain scales (visual analogue scales, others) to document whether this drug is successful in helping manage the patient's pain.
Monitor the application site, and report any prolonged burning sensations or other skin reactions.
Implement appropriate physical agents, therapeutic exercises, and manual techniques to reduce pain and complement the effects of this drug.
Help patient explore other nonpharmacologic methods to reduce chronic pain, such as relaxation techniques, exercise, counseling, and so forth.
Check that the patient and family or caregivers understand topical application procedures and adhere to the recommended dosing schedule.
Instruct patient to report any troublesome side effects such as severe or prolonged cough.
Metabolism and Excretion: Unknown.
Contraindicated in: Hypersensitivity to capsaicin or hot peppers; Not for use near eyes or on open or broken skin.
Use Cautiously in: OB/Lactation/Pedi: Safety not established for pregnant women, breast-feeding infants, or children <2 yr.
Drug-Drug: None significant.
Topical (Adults and Children ≥2 yr): Apply to affected areas 3–4 times daily.
Cream: 0.025% OTC, 0.075% OTC. Gel: 0.05% OTC. Lotion: 0.025% OTC. Roll-on: 0.075% OTC. In combination with: methyl salicylate (Ziks OTC). See Appendix B.