For patients suffering from neuropathic pain, quality of life can be a real issue. Traditional over-the-counter remedies have often not been enough to combat the effects of diabetic neuropathy or postherpetic neuralgia. However, with the introduction of Axsain^™ (capsaicin 0.25%), doctors now have a new weapon in their armamentarium to fight pain.

   Used alone or as an adjunctive therapy to supplement oral medications, Axsain contains three times as much capsaicin as other brands currently on the market. It works by depleting sensory nerves of the neurotransmitter Substance P, which is involved in the transmission of pain. Axsain’s patented Lidocare vehicle also reduces the stinging side effects often associated with capsaicin treatment, according to the product’s manufacturer, Winston Laboratories.

   Alexander Reyzelman, DPM, who has used Axsain for six months, points to many conditions that would necessitate the use of Axsain. He says these conditions include peripheral neuropathy secondary to diabetes, alcohol-induced neuropathy or any condition that results in hyperesthesia and allodynia of the extremities.

   While he notes that some patients could not tolerate the initial burning they experienced from the product, Dr. Reyzelman says the majority of the patients were pleased with Axsain.

    “Most of the patients who were able to overcome the burning pain for the first three to four days have reported a decrease in pain and were happy with the results,” notes Dr. Reyzelman, the Chairman of the Department of Medicine and an Assistant Professor at the California School of Podiatric Medicine at Samuel Merritt College.

Emphasizing Patient Education On Expectations

   Doctors prescribing Axsain should inform their patients that they can expect results after repeated use. The stinging associated with the product should also lessen over time.

    “Patients need to be patient and have realistic expectations when using capsaicin cream,” explains Stephanie Wu, DPM, an Assistant Professor in the Department of Surgery at the Dr. William N. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science. “Because of Axsain’s mechanism of action, the patient needs to apply it a minimum of two to four times daily and it may take some time before the patient sees results.”

   Dr. Wu says patients often expect instantaneous results with topical medications and are quick to dismiss their effectiveness before giving them an opportunity to work.

    “Axsain is a product where patient education and awareness do play a significant role,” comments Dr. Wu, a Fellow at Scholl’s Center for Lower Extremity Ambulatory Research. “Patients should be aware that burning sensations often occur initially but generally diminish with regular use as directed.”

How The Lidocare Vehicle Helps Axsain Stand Out Over Other Topical Modalities

   Dr. Reyzelman likes the fact that Axsain delivers capsaicin via the Lidocare vehicle, thus reducing the burning sensation that often accompanies capsaicin use.

    “It makes sense that the anesthetic property of lidocaine would be of benefit when combined with capsaicin,” notes Dr. Reyzelman. “In my experience, this product appears to be tolerated better by patients compared to previous similar products. If I am going to use a topical counter-irritant product, I would choose Axsain over other existing products.”

   Dr. Wu agrees. “With respect to the presently available topical preparations for painful neuralgia, Axsain stands out from the rest because of its Lidocare vehicle system,” she asserts. “Axsain is ideal in that it has minimal, if any, systemic side effects and can provide symptomatic relief in some patients.”

   Dr. Wu notes treating one patient in particular, a diabetic and kidney transplant recipient, who preferred a topical preparation over an oral medication for relief of his neuropathic pain.

    “The patient has been using Axsain for about a month and a half now and it has decreased his neuralgia from an 8 to a 2 (on the) analog pain scale,” reveals Dr. Wu, “In cases like this in which the patient is either unwilling or unable to tolerate oral medications for painful neuralgia, Axsain offers a low-risk alternative for symptomatic relief.”