- Joined
- Aug 8, 2007
- Messages
- 11
- Reaction score
- 0
has anybody starting using qutenza for post-herpetic neuralgia? if so, are you applying it in the clinic or booking them as a procedure in order to give IV analgesics if necessary?
....has anybody starting using qutenza for post-herpetic neuralgia? if so, are you applying it in the clinic or booking them as a procedure in order to give IV analgesics if necessary?
i suggest you lather a TON of capsaicin over an area of SEVERE allodynia -- and then ask yourself if you'd want a physician around...
EMLA cream applied an hour prior qutenza should suffice. It's not widely available yet and you can't find them in pharmacy. Your clinic has to order them from some distributor in kentucky. By the way it cost about 700 for 1 patch 1300 for 2 patches.
Anybody use this product yet? I've got an ideal patient for it, but would like to hear more before I use it on him. thanks.
We have used it a lot - mostly off label.
In my experience, it works great for allodynia, but not for neuropathic pain without allodynia (like post thoracotomy pain).
Why wouldn't it work? There are a billion studies showing that capsaicin works - there is no question there. But what is the problem? It is rare to find a patient that will actually use that crap. The advantage to Qutenza is you get all the benefit from capsaicin in a 1 hr treatment and supposedly it should last 3 months.
We have had some PHN patients get 3 months. I don't see much HIV patients, but I have heard it works well with their peripheral neuropathy.
Most tolerate it well. The studies show that it is the last 10 minutes of treatment that was the most uncomfortable.
Dr Wallace (UCSD) , who did a lot of the studies, told us he pretreats with some valium and percocet, and that almost everyone does great with that. He doesn't use EMLA.
When I use it peripherally, I do a nerve block first - then leave it on for 90 minutes instead of the recommended 60 minutes.
I used it on a guy with horrible allodynia from CRPS in his foot - and it got rid of the allodynia for a long time. he still had a lot of pain in the foot though.
epidural man, please let me know how you have found it financially responsible to use it a lot. We in priviate practice in the pacific NW have a hell of a hard time getting Qutenza approved by insurance, and even if it is, the reimbursement is really poor. Usually I have to have the patients pay cash out of pocket for it.
Obviously you've found some magic to make this work for you financially; please share as I think it is a great drug but the insurance coverage is horrible, reimbursement horrible, and dealing with the company a major PITA.
epidural man, please let me know how you have found it financially responsible to use it a lot. We in priviate practice in the pacific NW have a hell of a hard time getting Qutenza approved by insurance, and even if it is, the reimbursement is really poor. Usually I have to have the patients pay cash out of pocket for it.
Obviously you've found some magic to make this work for you financially; please share as I think it is a great drug but the insurance coverage is horrible, reimbursement horrible, and dealing with the company a major PITA.
does any one have any experience with qutenza that they'd be willing to share? i havent used it yet but just saw someone who it might be helpful for.
It works well imho but the business model is a scam
But does it work better than regular OTC capsacian (which is a first line treatment for PHN).
No it doesn't work better than regular OTC or even prescription capsacian....but NO ONE ever claimed that it did.
That isn't the point at all.
the problem with OTC capsaicin is compliance.
it does improve compliance tremendously.
No it doesn't work better than regular OTC or even prescription capsacian....but NO ONE ever claimed that it did.
That isn't the point at all.