Capsaicin 8% Topical Patch (Qutenza)—A Review of the Evidence

Abstract

Qutenza is a high-potency capsaicin (8%) topical patch, labeled for treating pain associated with postherpetic neuralgia (PHN). Qutenza decreases pain sensation by reducing transient receptor potential vanilloid 1 (TRPV1) expression and decreasing the density of epidermal nerve fibers in the application area. Systemic absorption from Qutenza is low. Qutenza has not been directly compared to any other medications for the treating PHN. Two pivotal clinical trials compared Qutenza to a control patch (0.04% capsaicin) in PHN. The primary endpoint of both trials was the reduction in numeric pain rating scale (NPRS) score. Qutenza reduced pain from baseline to weeks 2 to 8 (29.6% and 32% reductions) compared to control (19.9% and 24.4% reductions; P ≤ .01). The improvement in NPRS scores persisted, with score reductions greater with Qutenza (29.9% and 32.3% reductions) compared to control (20.4% and 25% reductions; P ≤ .03) for the period 2 to 12 weeks. Safety and efficacy of capsaicin 8% has been demonstrated in open-label trials for up to 48 weeks. The most common adverse drug reactions occurring with capsaicin 8% are application site erythema (63%) and application site pain (42%). Some patients experienced transient increases in blood pressure during Qutenza application. Qutenza must be administered by a physician or under the close supervision of a physician. Prior to application, pretreat the affected area with a topical anesthetic to reduce application site pain. Some patients may require systemic analgesics during and after treatment for treatment-associated pain. Applications of Qutenza can be repeated no sooner than once every 3 months, as needed.

Unravelling the Mystery of Capsaicin: A Tool to Understand and Treat Pain

“…The patch contains 640 g/cm 2 , meaning that each patch contains a total of 179 mg of capsaicin (Jones et al, 2011). To determine systemic capsaicin exposure after single 60-or 90-min NGX-4010 applications, plasma samples were collected from 173 patients with PHN, painful HIV-associated neuropathy (HIV-AN), and painful diabetic neuropathy (PDN).…”

Marker Based Analytical Studies on Rasam: A South Indian Traditional Functional Food

“…[14] Capsaicin transdermal patch for the management of this particular therapeutic indication (pain due to post-herpetic neuralgia) was approved as a therapeutic by the U.S. FDA. [15] Hence, capsaicin was studied as a biological and chemical marker for chili pepper in rasam. Solubility of capsaicin in water is 1.3 mg/mL hence, it was identified in both samples RS3 and RS4 (Table 2).…”

Pain Management in Mesothelioma

“…Though there have been no prospective studies in cancer patients, a retrospective review from Australia looked at 97 patients treated with lidocaine 5% patches and their results supported its use in post herpetic, post-surgical and cancer related neuropathic pain (17). The high potency 8% capsaicin topical patch has proven efficacy in post herpetic neuralgia (18). A single application of the patch for 30 -60 minutes can result in pain relief for up to three months.…”