Potency and Stability of Intradermal Capsaicin: Implications for Use as a Human Model of Pain in Multicenter Clinical Trials

Intradermally injected capsaicin has been used extensively both as a human pain model and to assess analgesic efficacy. Factors such as dose, formulation, route, and site are known to affect its sensitivity. We determined whether potency and stability of capsaicin solutions were further sources of variability when following strict manufacturing guidelines. Capsaicin solution (1.0 mg/mL) was prepared according to Current Good Manufacturing Practice (cGMP) guidelines and aseptically filled into sterile amber borosilicate vials and stored at 5°C, 25°C, and 30°C. All samples were analyzed at one, three, six, and twelve months. Chemical stability was determined using HPLC and physical stability was evaluated by visual inspection of color changes, clarity, particulate matter, and product/ container closure abnormalities during each sampling time. Capsaicin intradermal injection was found to be sterile and retained 95% of the initial concentration for at least one year, regardless of studied storage temperatures (P<0.0001). Visual inspection indicated no changes in color, clarity, particulate matter, and product/ container closure abnormalities in all samples. These data show that capsaicin solutions (1.0 mg/mL) maintain their potency and stability over one year when manufactured according to cGMP guidelines. These results suggest that in clinical trials manufacturing of capsaicin solutions is recommended over extemporaneous compounding.

[1]  Cornetto Test , 2020, ACM Transactions on Algorithms.

[2]  L. Thoma,et al.  Rapid Quantitative Evaluation of Amphotericin B in Human Plasma, by Validated HPLC Method , 2013 .

[3]  G. Wood,et al.  Development and Validation of a Spectrofluorimetric Method for the Determination of Erlotinib in Spiked Human Plasma , 2012, Journal of Fluorescence.

[4]  R. LaMotte,et al.  Sensory responses to injection and punctate application of capsaicin and histamine to the skin , 2011, PAIN.

[5]  L. Arendt-Nielsen,et al.  Increased Capsaicin-induced Secondary Hyperalgesia in Patients With Multiple Chemical Sensitivity , 2011, The Clinical journal of pain.

[6]  P. Rolan,et al.  A comparison of two formulations of intradermal capsaicin as models of neuropathic pain in healthy volunteers. , 2009, British journal of clinical pharmacology.

[7]  M. Yunus,et al.  Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. , 2008, Seminars in arthritis and rheumatism.

[8]  R. Irwin,et al.  The effects of Tween-80 on the integrity of solutions of capsaicin: useful information for performing tussigenic challenges , 2008, Cough.

[9]  M. Wallace,et al.  Intradermal Capsaicin Causes Dose-Dependent Pain, Allodynia, and Hyperalgesia in Humans , 2006, Journal of Investigative Medicine.

[10]  R. Dworkin,et al.  Effects of intradermal foot and forearm capsaicin injections in normal and vulvodynia-afflicted women , 2005, Pain.

[11]  R. Irwin,et al.  Chemical analysis of freshly prepared and stored capsaicin solutions: implications for tussigenic challenges. , 2002, Pulmonary pharmacology & therapeutics.

[12]  A. Hughes,et al.  Assessment of the reproducibility of intradermal administration of capsaicin as a model for inducing human pain , 2002, PAIN.

[13]  R. Sorelle US Department of Health and Human Services gives states wider latitude in choosing services to be covered by Medicaid. , 2001, Circulation.

[14]  C. Vierck,et al.  Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome , 2001, Pain.

[15]  M. Rowbotham,et al.  Capsaicin evoked pain and allodynia in post-herpetic neuralgia , 2000, Pain.

[16]  H. Handwerker,et al.  Patterns of hyperalgesia in complex regional pain syndrome , 1999, Pain.

[17]  V. Morris,et al.  Increased capsaicin-induced secondary hyperalgesia as a marker of abnormal sensory activity in patients with fibromyalgia , 1998, Neuroscience Letters.

[18]  R. Gracely,et al.  The human capsaicin model of allodynia and hyperalgesia: sources of variability and methods for reduction. , 1998, Journal of pain and symptom management.

[19]  D. Julius,et al.  The capsaicin receptor: a heat-activated ion channel in the pain pathway , 1997, Nature.

[20]  V. Morris,et al.  Characterisation of capsaicin-induced mechanical hyperalgesia as a marker for altered nociceptive processing in patients with rheumatoid arthritis , 1997, Pain.

[21]  W. Willis,et al.  The effects of G-protein and protein kinase inhibitors on the behavioral responses of rats to intradermal injection of capsaicin , 1997, Pain.

[22]  C. Kennedy,et al.  A Case Illustrating Proteus and Klippel-Trenaunay Syndrome Overlap , 1993, Journal of the Royal Society of Medicine.

[23]  R H LaMotte,et al.  Pain, hyperalgesia and activity in nociceptive C units in humans after intradermal injection of capsaicin. , 1992, The Journal of physiology.

[24]  R. LaMotte,et al.  Neurogenic hyperalgesia: psychophysical studies of underlying mechanisms. , 1991, Journal of neurophysiology.

[25]  B. Lynn Capsaicin: actions on nociceptive C-fibres and therapeutic potential , 1990, Pain.

[26]  J. Ochoa,et al.  Heat and mechanical hyperalgesia induced by capsaicin. Cross modality threshold modulation in human C nociceptors. , 1989, Brain : a journal of neurology.

[27]  Robert H. LaMotte,et al.  Dose-dependent pain and mechanical hyperalgesia in humans after intradermal injection of capsaicin , 1989, Pain.

[28]  N. Briggs,et al.  Intradermal capsaicin as a neuropathic pain model in patients with unilateral sciatica. , 2012, British journal of clinical pharmacology.