capsicum

Capsicum is a genus of plants that includes chili peppers and bell peppers, native to the Americas. Several varieties of chili peppers are grown world over in many shapes and sizes. Bell peppers are mild, some are even sweet and can be eaten directly or as a vegetable. Chili peppers have varying degrees of pungency and are used as a spice in foods and also for therapeutic purposes, primarily for topical pain relief (analgesic) and anti-inflammatory effects.

The medicinal property of capsicum comes from capsaicin, an oleoresin and the active compound in chili peppers that causes a burning sensation when it comes into contact with any tissue. Capsaicin may be taken orally in food, lozenges and other products, applied on the skin as topical creams and lotions, or used as a nasal spray. Pepper sprays used as disabling weapons contain chili peppers.

The analgesic effects of capsaicin work on the counter-irritation principle. Capsaicin initially irritates nerve cells (neurons), but continued exposure desensitizes the neurons, providing relief from pain or itching. Topical capsaicin works on the nerve endings under the skin in the area applied, while systemic capsaicin works on the nerve terminals in the spinal cord that carry pain signals to the brain.

Capsaicin desensitizes transient receptor potential vanilloid-1 (TRPV1), also known as capsaicin receptors. TRPV1 are ion channels on nerve cell membranes and desensitizing them prevents transmission of pain. In addition, capsaicin also locally depletes substance P, a natural chemical involved in neurotransmission of pain.

The suggested uses of capsaicin include:

• Post-herpetic neuralgia, the residual nerve pain from shingles
• Nerve pain from nerve diseases
• Joint pain due to osteoarthritis
• Minor muscle pains
• Itching (pruritus)
• Post-mastectomy pain syndrome
• Burning mouth syndrome
• Postoperative sore throat
• Overactive bladder
• Peripheral circulatory problems
• Clotting disorders
• Diarrhea
• Digestion problems
• Heart disease (prevention)
• Fibromyalgia
• Prurigo nodularis, an inflammatory skin condition with itchy rash
• Improving cough reflex sensitivity in patients with a history of dysphagia and other swallowing related disorders
• Chemotherapy and radiotherapy induced mucous membrane inflammation (mucositis)
• Migraine (intranasal)

Capsaicin may be effective for providing local relief for pain and itching, however, there is inadequate scientific evidence to support the other uses.

• Do not use if you have hypersensitivity to chili peppers.
• Do not apply on damaged skin or open wounds.
• Do not take orally if you have gastrointestinal infection or inflammation.
• Capsaicin may increase the risk of bleeding. Do not use if you have a bleeding disorder and stop using capsaicin at least 2 weeks before surgery.
• Eating a large amount of chili peppers can cause a spike in blood pressure.
• Avoid taking concurrently with sedative medications.

Common side effects of capsicum include:

• Local burning sensation
• Contact dermatitis
• Bleeding
• Hives (urticaria) with topical use
• Flushing
• Sweating
• Cough
• Nasal discharge (rhinorrhea)
• Mucous membrane irritation
• Eye irritation
• Eye tearing (lacrimation)
• Gastrointestinal irritation
• Gastroenteritis
• Liver damage
• Kidney damage

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There isn’t an established standard dose of capsicum.

Suggested dosing:

Topical

• Apply 0.025%-0.075% three to four times daily; minimum 4 weeks
• Make take up to 14 days for full analgesic effect
• Avoid using near eyes or on sensitive skin
• Wash hands after applying

Oral

• Fruit: 30-120 g orally three times daily
• Tincture: 0.6-2 ml/dose orally
• Oleoresin: 0.6-2 mg/dose orally

Intranasal

• Migraine (Ausanil): spray 1-2 times into nostril

Prurigo Nodularis

• Apply 0.025%-0.3% topically 4-6 times/day

• Eating too much capsicum can result in nausea, vomiting, abdominal pain, diarrhea, and a burning sensation in the gastrointestinal tract.
• Exposure to mucous membranes can cause severe irritation, pain, and burning. If capsaicin gets in the eye, it can cause
  • prolonged burning pain with tearing,
  • light sensitivity (photophobia), and
  • blurry vision.
• Inhalation can cause
  • dry coughing spells,
  • wheezing, and
  • shortness of breath (dyspnea).
• Sips of cold milk or water may help with a burning sensation in the mouth and esophagus. Rinsing with a lot of water can help relieve burning in the eyes and any capsaicin on the skin should be washed off with soap and water thoroughly. Respiratory symptoms may have to be treated with appropriate therapy such as intravenous corticosteroids and nebulizer therapy.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Capsicum has no known severe interactions with other drugs.
• Capsicum has no known serious interactions with other drugs.
• Capsicum has no known moderate interactions with other drugs.
• Mild interactions of capsicum include:
  • benazepril
  • captopril
  • enalapril
  • fosinopril
  • imidapril
  • lisinopril
  • moexipril
  • perindopril
  • quinapril
  • ramipril
  • trandolapril

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information.

Check with your doctor or health care provider if you have any questions about the medication.

• There are no controlled studies on capsaicin use during pregnancy, however, a small amounts of capsaicin absorbed from skin application is unlikely to cause any adverse effects in the fetus.
• Capsicum eaten as food is likely safe during pregnancy. Check with your healthcare provider before taking capsaicin as an herbal supplement during pregnancy.
• Capsaicin topical application is likely safe while breastfeeding. Exercise caution about eating foods heavily spiced with capsicum.

• Wash hands thoroughly after a topical application of capsaicin.
• Do not apply external heat after topical application.
• Keep out of reach of children.
• In case of accidental contact with eyes, nose or any sensitive areas, rinse with a lot of water and seek medical help if required, or contact Poison Control.