Qutenza
Qutenza (capsaicin) is a prescription topical system that's applied directly on the skin to relieve nerve pain (peripheral neuropathy) from shingles or diabetes. A healthcare professional will help you apply and remove the patch because it contains a high strength of capsaicin, which can damage areas like your skin, eyes, or nose if not used correctly. The dose can be repeated 3 months later if you're still having pain. Common side effects include application site pain and irritation.
What is Qutenza (capsaicin)?
What is Qutenza (capsaicin) used for?
- Treatment of shingles-related nerve pain (postherpetic neuralgia)
- Treatment of diabetes-related nerve pain in the feet (diabetic peripheral neuropathy)
How Qutenza (capsaicin) works
Qutenza (capsaicin) is a transient receptor potential vanilloid 1 receptor (TRPV1) agonist. It's thought to work on the TRPV1 proteins in your body to lower the number of pain signals sent to the brain. By lowering your sensitivity to pain, Qutenza (capsaicin) helps to relieve nerve pain.
Drug facts
Side effects of Qutenza (capsaicin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Shingles-related nerve pain:
- Redness at application site (63%)
- Pain at application site (42%)
Diabetic nerve pain in the feet:
- Burning sensation at application site (14%)
- Pain in arms or legs (11%)
- Pain at application site (10%)
Less Common Side Effects
Shingles-related nerve pain:
- Swelling or raised areas of skin at application site
- Itching or dryness at application site
- General itching
- Common cold
- Nausea
- Vomiting
- High blood pressure
Diabetic nerve pain in the feet:
- Redness at application site
- Upper respiratory tract infection
- Cough
- Headache
- High blood pressure
The following Qutenza (capsaicin) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common - all forms
Burning, itching, dryness, pain, redness, swelling, or soreness at the application site
Less common - all forms
Body aches or pain
chills
difficulty with breathing
dry or productive cough
ear congestion
headache
loss of voice
stuffy or runny nose
tightness in the chest
unusual tiredness or weakness
Less common - patch only
Blurred vision
breakdown of the skin
dizziness
nervousness
pain in the arms or legs
pounding in the ears
slow or fast heartbeat
Incidence not known - patch only
Bloating or swelling of the face, arms, hands, lower legs, or feet
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
increased sensitivity to pain or touch
scarring of the skin
stabbing pain
throat irritation
unusual weight gain or loss
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known - patch only
Abnormal skin odor
change in or loss of taste
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Qutenza (capsaicin)
Pros
- Applied directly at the site for pain relief
- A dose typically lasts for up to 3 months
- Can be used with other pain medications if needed
Cons
- Commonly causes temporary pain at the application site
- Must be applied by a healthcare professional
- Can take up to a few weeks to start working
Pharmacist tips for Qutenza (capsaicin)
- If Qutenza (capsaicin) is handled incorrectly, it can cause severe irritation to certain areas of your body like your skin, nose, eyes, or lungs. So during your appointment, don't touch the affected area or the medication. If you do, let your care team know right away so they can help you remove it.
- The affected area(s) of your skin might be sensitive to heat (e.g., hot showers, direct sunlight, intense exercise) for a few days after receiving Qutenza (capsaicin).
- It's common for Qutenza (capsaicin) to cause pain or a burning sensation during application and removal of the patch. If this happens, let your prescriber know so you can receive an ice pack or pain medication to help.
- Since the pain caused by Qutenza (capsaicin) can raise your blood pressure, your prescriber might want to monitor your blood pressure on the treatment day. Make sure to tell them if you have a history of heart problems or high blood pressure before receiving the medication.
How Qutenza (capsaicin) is applied
- Qutenza (capsaicin) is a patch that's applied onto your skin by a healthcare professional (HCP). It's not a patch that you can take home and apply yourself.
- Before applying the patch, your HCP will examine the affected area(s). If needed, they might need to clip hair that's in the area.
- Your HCP might apply a topical local anesthetic to numb the area that'll then need to be wiped off before applying Qutenza (capsaicin).
- Once Qutenza (capsaicin) is applied, it's left on for either 30 minutes for diabetes-related nerve pain or 1 hour for shingles related-nerve pain.
- After removal, your HCP will apply a cleansing gel for about a minute and then clean it off with soap and water.
Common questions about Qutenza
Qutenza is kept on for 30 minutes to treat diabetes-related nerve pain or 1 hour to treat shingles-related nerve pain. A healthcare professional will help you apply and remove the medication.
In shingles-related nerve pain studies, there was about a 30% drop in pain scores in people who used Qutenza after 2 months. In diabetes-related nerve pain studies, there was about a 29% drop in pain scores in people who used Qutenza after 2 months. Talk to your prescriber if you have questions about how well this medication might work for you.
In clinical studies, some people with diabetic nerve pain felt relief as early as 19 days after their healthcare provider applied Qutenza. In another study, people with shingles-related nerve pain felt better 1-2 weeks after receiving the treatment. But the pain typically comes back after a while. So you might need to visit your prescriber every 3 months as needed to repeat treatment if your pain returns.
Qutenza is a topical patch that's applied directly onto your skin by a healthcare professional. It's not a patch that you can take home and apply yourself. That's because Qutenza contains a higher strength of capsaicin compared to capsaicin products you can find over the counter. Because of this, the healthcare professional will handle it with extreme caution so it doesn't harm you.
Your prescriber can cut Qutenza to match the size and shape of the affected area(s). The patch should be cut before removing the protective release liner to avoid accidentally touching the side of the patch containing the medication.
It's common to feel pain during application and removal with Qutenza, but it should go away by the end of the treatment day. In clinical studies, 10% of people treated for diabetes-related nerve pain and 42% of people treated for shingles-related nerve pain reported pain at the application site. To lower your risk for pain, your prescriber might apply a topical local anesthetic before applying Qutenza to numb the area.
No. Unlike some other capsaicin products, Qutenza is only available by prescription from a healthcare professional.
Since Qutenza is applied directly onto your skin, not much is expected to be absorbed into your body. And animal studies show Qutenza didn't cause harm to unborn babies when applied to pregnant mothers. But it hasn't been studied in humans, so it's best to talk to your OB-GYN provider about the risks and benefits of the medication.
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Risks and warnings for Qutenza (capsaicin)
Qutenza (capsaicin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Pain during application and removal
Qutenza (capsaicin) can cause pain or a burning sensation during application and removal, even after your healthcare professional numbs the skin with a local anesthetic. The pain should go away by the end of the treatment day. If Qutenza (capsaicin) causes pain, let your HCP know so they can treat it with an ice pack or pain medication.
High blood pressure
- Risk factors: Uncontrolled high blood pressure | History of heart problems or stroke
The pain caused by Qutenza (capsaicin) can lead to a small and temporary rise in your blood pressure. You might be at higher risk of complications from this rise in blood pressure if you already have uncontrolled high blood pressure or if you have a history of heart problems or stroke. Your care team might monitor your blood pressure during treatment with Qutenza (capsaicin).
Loss of sensation
It's possible for Qutenza (capsaicin) to lower your sensory function, such as sensing heat with your skin. This problem tends to be mild and goes away. If your sensory function worsens or completely goes away, contact your prescriber. You might have to stop using Qutenza (capsaicin).
Qutenza (capsaicin) dosage
Typical dosage for Qutenza (capsaicin)
Qutenza (capsaicin) is available as a topical system (patch) that's applied directly to your skin. This medication is applied onto your skin by a healthcare professional.
- Diabetes-related nerve pain in the feet: The typical dose is 1 to 4 patches applied on the affected area(s) for 30 minutes.
- Shingles-related nerve pain: The typical dose is 1 to 4 patches applied on the affected area(s) for 1 hour.
The dose can be repeated every 3 months if your pain returns.
Interactions between Qutenza (capsaicin) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
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