Capsaicin 8% Patch in Peripheral Neuropathy Not Diabetic but at a Cost…

Capsaicin 8% patch was compared to pregabalin (lyrica) for effects on non-diabetic peripheral neuropathy.  A treatment with Capsaicin can cut skin sensitivity (dynamic mechanical allodynia) in half and render 29% free of sensitivity. Was embarrassed to publish this once I found out how much the patch costs ($800/patch in 2012)

Eur J Pain. 2018 Apr;22(4):700-706.
doi: 10.1002/ejp.1155
Superiority of capsaicin 8% patch versus oral pregabalin on dynamic mechanical allodynia in patients with peripheral neuropathic pain.
Cruccu G et al
https://www.ncbi.nlm.nih.gov/pubmed/29194851

  • 253 case of nerve injury or non-diabetic peripheral neuropathy with pain >/= 4/10
  • half group was put on pregabalin 150 – 600 mg/day
  • area involved determined by lightly brushing edges – marked
  • can use up to 4 patches to area marked

instructions are here;
http://www.qutenza.com/_docs/qutenza_full_PI_.pdf

  • medical office treatment
  • apply a topical numbing gel – lidocaine was recommended but not convinced works that well – maybe occlude  and have on 30-60 minutes
  • take a painkiller -plus I would use ketamine 10 mg M deltoid once or twice every 15 minutes as I am comfortable  used to using it
  • wear gloves
  • apply to affected areas and cover
  • have on 30-60 minutes
  • removed by slowly rolling edge
  • apply cleansing gel and wipe off
  • avoid touching eyes
  • skin will be sensitive a few days
  • do every 3 months

results at week 8:
Complete resolution of pain in 24.1% of patches and 12.3% of pregabalin at 8 weeks side effects were pain and eythema at time of treatment but were manageable.

Comment – would be a great addition to treatment except the cost

“One capsaicin 8% patch costs approximately $800 (US) in 2012

as per:
Groninger H, Schisler RE. Topical Capsaicin for Neuropathic Pain #255. Journal of Palliative Medicine. 2012;15(8):946-947. doi:10.1089/jpm.2012.9571.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462404/

If you need cheap, start with amitriptyline hs and work up.

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