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Capsaicin is a chili pepper extract, genus Capsicum, with analgesic properties. Since its discovery, it is used as a homeopathic remedy to treat burning pain using the concept of "treating like with like" or counter-irritant. Since the first reports, various preparations of capsaicin are used to treat various chronic painful conditions. Systematic reviews have shown that capsaicin is efficacious in treating a variety of conditions. This activity reviews the mechanism of action, indications, and latest research pertinent for clinicians and other interprofessional team members in the clinical setting. Objectives: Identify the purported indications for using capsaicin. Review the mechanism of action of capsaicin. Summarize the potential adverse effects of capsaicin. Explain interprofessional team strategies for improving care coordination and communication to determine the appropriateness of capsaicin in the clinical setting. Access free multiple choice questions on this topic.

From a review of the literature, it appears the acute toxicity of capsaicin is determined only in animal species. A study in mice has shown that application of capsaicin based on LD50 values greater than 9 mg/kg (subcutaneous) or 190 mg/kg (by mouth), the likely mechanism of toxicity involves respiratory paralysis. There is no known reported case of an overdose in humans, and there is no known antidote. Acute Toxicity Capsaicin is a potent irritant, and if exposed to the mucous membranes, it can cause severe irritation, pain, and burning. When it gets in the eye, capsaicin can cause prolonged burning pain with tearing, photophobia, and blurry vision. When inhaled, it can cause dry coughing spells, wheezing, and dyspnea. Most people who present to the emergency department after acute exposure to capsaicin complain of burning pain on the skin. Children have reported side effects of nausea, vomiting, diarrhea, and abdominal cramps. Some people who have used capsaicin to lose weight have presented to the emergency department with profuse diaphoresis and chest pain. In these patients, reports of myocardial ischemia have been reported. If acute exposure has occurred, first remove the patient from further exposure. All contaminated clothing should be removed and placed in an airtight container. If the eyes or nose have been exposed, one should bathe the mucous membrane with oils like petroleum jelly or vegetable oil. To relieve the abdominal symptoms, polyethylene glycol or cold milk has been recommended. Skin exposure can be limited by washing the area with detergent followed by a thorough rinse with water. Just plain water alone is not effective at removing capsaicin from the skin. If the patient has wheezing, one may need to use intravenous corticosteroids and nebulizer therapy. It is highly recommended that healthcare workers wear gloves and goggles when handling and applying topical capsaicin on the skin of patients.

Managing drug side effects requires an interprofessional team of healthcare professionals, including clinicians, mid-level practitioners, nurses, and pharmacists. Without proper instruction on use, capsaicin can cause burning or stinging pain to the skin and, if ingested in large amounts by adults or small amounts by children, can produce nausea, vomiting, abdominal pain, and burning diarrhea. Eye exposure produces intense tearing, pain, conjunctivitis, and blepharospasm. Proper use of capsaicin under interprofessional guidance can be beneficial to patient outcomes. [Level 5]