capsaicin topical (OTC)

Brand and Other Names:Capzasin P, Zostrix, more...Capzasin-HP, Axsain, No Pain-HP, Pain Doctor, Pain-X, Rid-A-Pain, Salonpas Hot, Trixaicin, Menthac

Dosing & Uses


Dosage Forms & Strengths

topical cream

  • 0.025%
  • 0.035%
  • 0.075%
  • 0.1%

topical gel

  • 0.025%

topical liquid

  • 0.025%

Skeletomuscular Pain

Apply to affected area TID or QID for 3-4 consecutive weeks and evaluate efficacy; efficacy decreased if used <3 times daily; not to exceed 4 applications/day; wash hands with soap and water after applying

Diabetic Neuropathy (Off-label)

Cream: Apply to affected area TID/QID times daily for 3-4 consecutive weeks and evaluate efficacy; not to exceed 4 applications/day; wash hands with soap and water after applying

Orphan Indications

Painful HIV-associated neuropathy

Treatment of intermetatarsal neuroma (Morton's Neuroma) that does not respond to conservative treatment and requires either neurectomy or neurolysis

Postherpetic neuralgia


Orphan indication sponsors

  • NeurogesX, Inc; San Carlos Business Park 981F Industrial Road; San Carols, CA 94070-4117
  • Vallinex Incorporated; 2400 Boston Street, Suite 330; Baltimore, MD 21224
  • TheraQuest Biosciences, LLC; 146 Medinah Drive; Blue Bell, PA 19422-3212

Safety and efficacy not established


Adverse Effects


Transient increased pain at application site (dissipates w/ continued use)

Application site erythema (63%)

Pain (42%)


Nausea (5%)

Vomiting (3%)

Hypertension (2%)

Dryness (2%)

Swelling (2%)

Pruritus (6%)

Papules (6%)

Edema (4%)

Sinusitis (3%)

Bronchitis (2%)





Skin odor







Self-medication: Use on wounds; concurrent use with other topical analgesics; damaged, irritated, broken skin or application into skin folds; within one our before or after bath, hot tub, sauna, or shower; do not cover with bandage; not for use with external heat source, including heating pad


For external use only

Do not apply to face or scalp to avoid exposure to eyes or mucous membranes

Transient burn sensation may occur but generally disappears after several days

Not for use immediately before or after activities such as, swimming, showering, bathing, strenuous exercise, sunbathing, sauna, steam bath, or other types of heat, or exposure to sunlight to treated areas

Accidental exposure to eyes and mucous membranes can occur from touching drug product or items exposed to drug product and then touching eyes and mucous membranes

If irritation of eyes or mucous membranes occurs, flush eyes and mucous membranes with cool water

First, to third-degree chemical Burns may occur upon application; discontinue use and seek medical attention if signs of skin injury, including pain, blistering, or swelling occurs

Contact healthcare professional if excessive redness, blistering, burning or irritation develops, symptoms persist for >7 days, symptoms get worse, symptoms resolve and then recur, or if difficulty breathing or swallowing occurs

Do not handle contact lenses for at least 1 hr after handling drug product

Use caution in patients with uncontrolled hypertension, history of cerebrovascular events


Pregnancy & Lactation

Pregnancy Category: B

Lactation: Unknown whether distributed in breast milk; do not apply to nipple or areola

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.



Mechanism of Action

Transient receptor potential vanilloid-1 (TRPV1) agonist; topical application causes initial TRPV1 stimulation that may cause pain, followed by pain relief by reduction in TRPV1-expressing nociceptive nerve endings



Capzasin topical
0.025-10 % gel
Capzasin topical
0.15 % liquid
Medicated Heat Patch topical
0.025 % transdermal system
Arthritis Pain Relief (capsaicin) topical
0.1 % cream
Zostrix-HP topical
0.1 % cream
Capsimide topical
0.025 % transdermal system
capsaicin topical
0.025 % cream

Copyright © 2010 First DataBank, Inc.


Patient Handout

A Patient Handout is not currently available for this monograph.
Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.