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Zucapsaicin for the management of Osteoarthritis

Zucapsaicin is thought to be same as other capsaicinoids, such as capsaicin, which interferes with pain signal transmission to the spinal cord.

It is used in conjunction with an oral NSAID or COX-2 inhibitor for short- term (≤3 months) management of severe pain that happens with osteoarthritis of the knee not controlled by NSAID or COX-2 inhibitor monotherapy.

Zucapsaicin dose in Adults

Dosage for pain relief in osteoarthritis of the knee:

A pea-sized amount is applied to 3 locations around affected knee thrice a day
A gap of 4 hours should be given between applications (maximum: 3 applications/day).
Therapy should be limited to less than 3 months.
Missed dose:
- Apply the dose as soon as possible, but not within 4 hours of the next dose.

Zucapsaicin dose in Children

Not applicable.

Zucapsaicin pregnancy Risk Factor: B

Animal reproduction studies have not shown any adverse events.
After topical administration, Zucapsaicin cannot be absorbed systemically.
The fetus is not exposed to significant amounts of the drug during pregnancy.

Zucapsaicin use during breastfeeding:

Whether zucapsaicin is present in breast milk is unknown.
The producer advises women who are nursing to use zucapsaicin with caution.

Zucapsaicin dose in Renal disease:

There are no dosage adjustments given in the manufacturer’s labeling
But dosage adjustment does not appear to be required since there is no systemic absorption following topical administration of zucapsaicin.

Zucapsaicin dose in Liver disease:

There are no dosage adjustments given in the manufacturer’s labeling
But dosage adjustment does not appear to be required since there is no systemic absorption following topical administration of zucapsaicin.

Common Side Effects of Zucapsaicin Include:

Local:
- Application site burning

Less Common Side Effects of Zucapsaicin Include:

Central Nervous System:
- Localized Warm Feeling
- Localized Numbness
Dermatologic:
- Burning Sensation Of Skin
Local:
- Application Site Reaction
- Application Site Irritation
- Application-Site Pruritus
- Application Site Rash
Neuromuscular & Skeletal:
- Arthralgia
Ophthalmic:
- Eye Irritation
Respiratory:
- Cough
- Sneezing

Contraindication to Zucapsaicin Include:

Hypersensitivity to zucapsaicin and any part of the formulation
It shouldn't be used on broken or irritated skin, or areas that have a compromised skin barrier.

Warnings and precautions

Cough:
- Can cause cough
- Do not apply to the face.
- After each application, wash your hands thoroughly.

Monitor:

None required.

How to administer Zucapsaicin?

It is used for external use only on intact skin
It should not be applied to broken or irritated skin.
It should be gently rubbed in a circular motion into affected knee until no remaining drug is left on the skin.
Do not cover the treated area by an occlusive dressing.
Hands should be washed thoroughly after each application.
Do not take a hot bath or shower immediately before or after administration (can cause a burning sensation).
Contact should be avoided with eyes, lips, and genital area.
Do not concomitantly apply with other topical medications to treated areas.

Mechanism of action of Zucapsaicin:

Actions are thought to be same to other capsaicinoids, such as capsaicin, which is a transient receptor potential vanilloid 1 receptor (TRPV1) agonist, which activates TRPV1 ligand-gated cation channels on nociceptive nerve fibers, causing depolarization, initiation of action potential & pain signal transmission to the spinal cord.
Capsaicin can cause depletion proinflammatory neuropeptides (eg. substance P, calcitonin-related peptide), desensitization and inhibition of pain transmission.
Capsaicin triggers the release of substance P, which is the main chemomediator for pain impulses from the peripheral to the CNS and from the sensory neurons.
Capsaicin is able to deplete the neuron of substance PP and prevents its reaccumulation after multiple applications.

Absorption: Systemic absorption is very low

International Brands of Zucapsaicin:

Capinorod

Zucapsaicin Brands in Pakistan:

No Brands available in Pakistan.