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TRPV1 Agonist·Analgesia - Topicals & Local
Post-herpetic neuralgia, localized osteoarthritis, diabetic neuropathy
Max Dose
Apply QID
Onset
2-4 WEEKS
Burning
INITIAL
Wash Hands
MANDATORY
Overview
Active component of chili peppers. Radically depletes Substance P from sensory nerve endings. Highly effective for localized neuropathic pain and osteoarthritis, but burns fiercely upon initial application.
Maximum Dose
Apply a thin layer QID.
Clinical Focus
The patient MUST wash their hands immediately after application to prevent catastrophic eye or mucosal burns.
Bottom Line
Capsaicin cream is a topical analgesic for neuropathic and musculoskeletal pain, but requires consistent application for 2-4 weeks before benefit and causes initial burning sensation.
Brand Names
Zostrix (0.025%), Zostrix HP (0.075%), Qutenza (8% patch - Specialist only)
Topical Routes
Creams. High-potency clinical patches (used in pain clinics).
Prescribing & PBS
Over The Counter (OTC).
Primary
Post-herpetic neuralgia, localized osteoarthritis, diabetic neuropathy.
Clinical Place
Excellent opioid-sparing adjunct for chronic, localized peripheral pain.