Capsaicin patch

[Sanchik]

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anyone using the 8% patch for peripheral neuropathy?

 

[lobelsteve]

anyone using the 8% patch for peripheral neuropathy?

Clinically as effective as a blow torch, only with more pain than the torch.

 

[Sanchik]

🙂

 

[Axehandler]

Sure, use it all the time for patients I hope will quit coming back. Also used for patients who are chronically late for appointments or call the office with too much drama😉

 

[Sanchik]

It's funny I met a neurologist at a big academic center and we talked about our neuropathy pts and he went on and on about how great it is. perhaps he was talking about the lower strength patches.

 

[lobelsteve]

It's funny I met a neurologist at a big academic center and we talked about our neuropathy pts and he went on and on about how great it is. perhaps he was talking about the lower strength patches.

He failed to mention the $1000 he gets for lunches to talk about how great it is.

 

[loveoforganic]

Some of the best pepper spray on the market is only 2%... I can't imagine that feeling all that wonderful

 

[Ligament]

I've used it, it works pretty well. It kinda hurts. I do intercostal nerve blocks first then apply it. Then it does not hurt at all.

Don't expect to get "reimbursed" for it if you buy it. Make the patient purchase it themselves and bring to you.

 

[TX PAIN DOC]

Agree, my partner did two for PHN, one Mcare and one private, both denied reimbursement. I don't think its approved for peripheral neuropathy just post-herpetic neuralgia.

 

[deleted185747]

I've used it, it works pretty well. It kinda hurts. I do intercostal nerve blocks first then apply it. Then it does not hurt at all.

The patch is supposed to deplete substance P within the axon and cell body right? Would a local block stop the process that the patch is trying to accomplish? And, does local anesthetic stop substance P from being transmitted/transferred?

 

[giddyup]

they say try spreading EMLA cream or the like on the area beforehand then wipe it off right before applying the patch. anyone tried that? if so, success?

 

[epidural man]

The patch is supposed to deplete substance P within the axon and cell body right? Would a local block stop the process that the patch is trying to accomplish? And, does local anesthetic stop substance P from being transmitted/transferred?

I have used it for all sorts of stuff. If it is on the extremity, I block the leg first. I have had mixed success with it, but the really impressive ones have had CRPS-type allodynia and it took away the allodynia - pretty cool if you ask me.

I have also used it on post-surgical thoracotomy pain with not much success. I'll try calmare next. 🙂

they say try spreading EMLA cream or the like on the area beforehand then wipe it off right before applying the patch. anyone tried that? if so, success?

Dr Wallace, at UCSD who was heavily involved with the quetenza research doesn't use emla or topical lidocaine. I think his point is this - lidocaine blocks sodium channels, and capsaicin works on TRPV-1 receptors and the EMLA shouldn't be that effective in stopping that sensation of heat. I think they just pretreat with some oral valium and percocet and the patients do just fine.

 

[epidural man]

Oh yeah,

and the 2 patients we actually used it on label...they responded pretty well to the treatment.

 

[Ligament]

I have used it for all sorts of stuff. If it is on the extremity, I block the leg first. I have had mixed success with it, but the really impressive ones have had CRPS-type allodynia and it took away the allodynia - pretty cool if you ask me.

I have also used it on post-surgical thoracotomy pain with not much success. I'll try calmare next. 🙂




Dr Wallace, at UCSD who was heavily involved with the quetenza research doesn't use emla or topical lidocaine. I think his point is this - lidocaine blocks sodium channels, and capsaicin works on TRPV-1 receptors and the EMLA shouldn't be that effective in stopping that sensation of heat. I think they just pretreat with some oral valium and percocet and the patients do just fine.

Thanks for your experiences. How are you procuring Qutenza? Does your clinic buy it, if so, have you been reimbursed in full?

 

[epidural man]

Thanks for your experiences. How are you procuring Qutenza? Does your clinic buy it, if so, have you been reimbursed in full?

Luckily, I don't have to worry about insurances and reimbursment and all that stuff.

If I did, I doubt I would be using it much because it sounds like insurances are not reimbursing for it.

It is too bad too since capaicin clearly works - but getting patients to use it (creams and such) is impossible. Occasionally you will get someone to use it regularly. I think a single "blast" in an hour is a really great idea.

The company is developing a 30% paste that will be applied and removed in 5 minutes with similar efficacy. Probably 30x the cost too. 🙂