Pharmacology and clinical application of capsaicin-containing preparations

Abstract: Percutaneous application is one of the various methods of drug application. Drugs for topical application can be differentiated into drugs having local effects without any systemic influence, transdermal therapeutical Systems emitting medicinal substances continuously with a defined speed over a certain period of time and preparations without active substances developing their effects by physical and chemical milieu changes at the place of application. The different capsaicin preparations are exclusively intended for topical application and are prepared from Capsici fructus (paprika) and Capsici fructus acer (cayenne pepper). Spanish or cayenne pepper contains capsaicinoides, vanillylamidetype substances with 63-77% capsaicin.Topical application of capsaicin results in an initial phase of excitation of peripheral nocireceptors with a more or less strong erythema including sensations of pain and heat followed by a phase of insensitivity. With regard to the intensity and the mechanism of effects, a specific selective effect and a none-specific neurotoxic effect on all nerve cells occurring after application of high doses of the drug preparations can be differentiated. Since the edition of a capsicum monograph in 1990, further clinical studies concerning especially the treatment of diabetic neuropathy, postherpetic neuralgia and rheumatic diseases have been published. According to the results of these trials indications and duration of treatment with capsaicin-containing preparations should be reassessed.

Keyword(s): Capsici fructus

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