What is it used for?

• Nerve pain in people with diabetes (diabetic peripheral neuropathy).
• Nerve pain following an attack of shingles (post-herpetic neuralgia).

How does it work?

• Axsain cream contains the active ingredient capsaicin, which is the substance found naturally in red chilli peppers that gives them their heat. The cream is applied to the skin to relieve nerve pain associated with shingles and with nerve damage caused by poorly controlled diabetes.
• Capsaicin works by desensitising nerve cells to pain. It does this by binding to sensory receptors called nociceptors that are found at the end of the nerves. When stimulated, these receptors normally send nerve signals to the spinal cord and brain that result in the perception of pain. When capsaicin binds to these pain receptors it initially causes a painful burning sensation. However, with continued application of the capsaicin, the pain receptors become overloaded and desensitised and this makes them less responsive to painful stimulation. This relieves the nerve pain.
• A small amount of Axsain cream should be applied to the area of skin affected by the nerve pain three to four times a day during waking hours, as directed by your doctor.

Warning!

• You should not have a hot bath or shower before or after applying the cream, as this may enhance the burning sensation it causes.
• Wash your hands immediately after applying the cream, unless the hands are the area that is being treated. If the hands are the area being treated wash them 30 minutes after applying the cream.
• Avoid contact of this medicine with the eyes. Do not apply it near the eyes.
• Avoid breathing in any vapour from the cream, as this can irritate the airways and eyes.
• Do not apply any tight bandages over the treated area.
• Do not apply the cream more frequently than every four hours.
• If the condition worsens, seek medical advice.

Not to be used in

• Broken or irritated skin. (If you are using the cream for nerve pain following shingles you should only apply it after the skin sores have healed.)
• Children.
• This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

• Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
• The safety of this medicine during pregnancy and breastfeeding has not been established. However, as only small amounts of the medicine are absorbed into the bloodstream it is unlikely to be harmful. Seek medical advice from your doctor before using this medicine if you are pregnant or breastfeeding.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Temporary burning sensation on application. This will be worse if too much cream is applied or if it is used too frequently.
• Irritation of the eyes or airways from vapour off the cream may rarely occur. This may cause watering eyes, coughing, sneezing, wheezing or worsening of asthma.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

• This medicine is not known to affect any other medicines. However, you should tell your doctor what other medicines you are taking before starting treatment with this medicine and, likewise, check with your doctor or pharmacist before using any new medicines once you have started treatment. This includes medicines bought without a prescription and herbal medicines.

References:

https://www.medicines.ie/printfriendlydocument.aspx?documentid=4616&companyid=28

https://www.netdoctor.co.uk/medicines/aches-pains/a6260/axsain-cream-capsaicin/

https://www.medicines.org.uk/emc/product/887/smpc

https://www.webmd.com/drugs/2/drug-61855/axsain-topical/details

https://www.hey.nhs.uk/patient-leaflet/capsaicin-cream-zacin-0-025-axsain-0-075/

https://www.drugs.com/cdi/axsain.html