FDA approves treatment for pain relief of post-herpetic neuralgia

The FDA has approved the approval of a capsaicin 8% medicated skin patch (Qutenza, Neurogesx) to treat pain associated with post-herpetic neuralgia.

Capsaicin is a compound found in chili peppers.

Medications containing lower concentrations of capsaicin were previously available over the counter. The current product is the first pure, concentrated, synthetic capsaicin-containing prescription drug to undergo FDA review.

The label requires the patch to be applied to the skin by a health care professional to reduce the possibility of associated adverse events, which included pain, swelling, itching, redness and bumps at the application site. Incidence of these events may require the use of a local topical anesthetic or other pain relief measures such as ice or use of opioid pain relievers.

Due to the potential for a significant rise in blood pressure, patients are required to be monitored for at least one hour following application of the patch.

Here, finally, is a treatment for those patients who suffer true agony from post-herpetic neuralgia. I would guess that most such patients find their way to neurologists, and are not treated for this condition by ID physicians. The pain relief it offers seems to be modest, at best, but for those with severe neuralgic pain, it seems well worth undertaking. Further, it is not at all an easy topical drug to use; it requires exceeding care, and can be applied and subsequently removed only once per 3-month interval. If interested, you can view the package insert at the FDA website. It is well worth knowing about, however, since there is now some help for those patients who are really suffering.

- Theodore C. Eickhoff, MD

Infectious Disease News Chief Medical Editor