Dosing and uses of Qutenza (capsaicin transdermal)
Adult dosage forms and strengths
transdermal patch
- 8%; contains 640mcg/sq.cm (179mg/patch)
Neuropathic Pain
Qutenza is indicated for neuropathic pain associated wtih postherpetic neuralgia
Single 60-minute application of up to 4 patches to dry, intact (unbroken) skin
May repeat no more frequently than q3Months
Administration
Application preparation (Quetenza)
- Use nitrile gloves during application process, latex gloves do not provide adequate protection
- Clipping hair (do not shave) if necessary
- Gently wash treatment area with mild soap and water, dry thoroughly
- Patch may be cut to match size and shape of treatment area (cut to size/shape before removing protective release liner)
- Pretreat area with topical anesthetic to reduce pain associated with patch application
- Apply patch within 2 hours of opening package
Patch removal (Qutenza)
- Gently remove and slowly roll them inward (avoid aerosolization)
- Cleanse skin by generously applying cleansing gel (supplied with patch) to affected area, leave on for at least 1 minute, then remove with dry wipe and gently wash area with mild soap and water
Pediatric dosage forms and strengths
Safety and efficacy not established
Qutenza (capsaicin transdermal) adverse (side) effects
>10%
Transient increased pain at application site (63%)
Application site erythema (42%)
1-10%
Nausea (5%)
Vomiting (3%)
Pruritus at application site (2%)
Papules at application site (6%)
Skin dryness at application site (2%)
< 1%
Exfoliation
Dizziness
Cough
Skin odor
Headache
Dysguesia
Warnings
Contraindications
Hypersensitivity
Cautions
Monitor for at least 1 hour after patch application because of risk for increased blood pressure
Do not apply to face or scalp to avoid exposure to eyes or mucous membranes
Remove patch gently to avoid aerosolization (airborne capsaicin can result in coughing or sneezing)
Treated area may be sensitive to heat for several days (eg, hot water, direct sunlight, vigorous exercise)
Use caution in patients with uncontrolled hypertension, history of cerebrovascular events
Pregnancy and lactation
Pregnancy category: B
Lactation: Not known whether distributed in breast milk, do not nurse
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.
Pharmacology of Qutenza (capsaicin transdermal)
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
Pharmacokinetics
Absorption: systemic absorption negligible
Peak plasma concentration: Transient, low (<5 ng/mL) systemic exposure in one-third of patients following 60-min application; 4.6 ng/mL was highest level detected
Half-life: 1.64 hr
