Injectable capsaicin
The present invention is directed to compositions and methods for relieving pain at a site in a human or animal by administering at a discrete site in a human or animal a dose of capsaicin in an amount effective to denervate the discrete site without eliciting an effect outside the discrete location.
1. A method for attenuating pain in a joint in a human or animal, comprising:
injecting into an intraarticular space or intrasynovially in the joint of a human or animal in need thereof an effective amount of a capsaicinoid at a joint afflicted with osteoarthritis in a pharmaceutically acceptable carrier for injection in an amount effective to attenuate pain emanating from the joint for at least one month, the effective amount being from about 1 μg to about 5000 μg of capsaicin or a therapeutically equivalent dose of a capsaicinoid other than capsaicin.
2. The method of claim 1 , wherein from about 10 to about 3000 μg of capsaicin is administered per injection.
3. The method of claim 1 , wherein from about 300 to about 1500 μg of capsaicin is administered per injection.
4. The method of claim 1 , wherein from about 400 to about 1200 μg of capsaicin is administered per injection.
5. The method of claim 1 , wherein the pharmaceutically acceptable carrier comprises an agent selected from the group consisting of antimicrobial agents, isotonic agents, buffers, antioxidants, local anesthetics, suspending and dispersing agents, emulsifying agents, sequestering agents, chelating agents and any combinations thereof.
6. The method of claim 1 , wherein the capsaicin is injected into the articular space or synovial fluid of a joint selected from the group consisting of knee, elbow, hip, sternoclavicular, temporomandibular, shoulder, hand, foot, spinal, carpal, tarsal, wrist, ankle, and intervertebral disk.
7. The method of claim 1 , wherein the capsaicinoid is injected in the form of injectable microparticles.
8. The method of claim 1 , further comprising administering a local anesthetic prior to or concurrently with the capsaicinoid in an amount and location effective to attenuate an initial hyperalgesic effect of the capsaicinoid.
9. The method of claim 8 , wherein the local anesthetic is administered by direct injection into the site where the capsaicinoid is injected.
10. The method of claim 1 , further comprising administering phenol prior to or concurrently with the capsaicinoid in an amount and location effective to attenuate an initial hyperalgesic effect of the capsaicinoid.
11. The method of claim 1 , wherein said capsaicinoid is selected from the group consisting of resiniferatoxin, N-vanillylnonanamides, N-vanillylsulfonamides, N-vanillylureas, N-vanillylcarbamates, N[(substituted phenyl)methyl]alkylamides, methylene substituted N[(substituted phenyl)methyl]alkanamides, N[(substituted phenyl)methyl]-cis-monosaturated alkenamides, N[(substituted phenyl)methyl]diunsaturated amides, 3-hydroxyacetanilide, hydroxyphenylacetamides, pseudocapsaicin, dihydrocapsaicin, nordihydrocapsaicin anandamide, piperine, zingerone, warburganal, polygodial, aframodial, cinnamodial, cinnamosmolide, cinnamolide, isovelleral, scalaradial, ancistrodial, β-acaridial, merulidial, scutigeral, and any combinations thereof.
12. The method of claim 1 , wherein said capsaicinoid is capsaicin.
13. The method of claim 12 , wherein said capsaicin consists essentially of trans-capsaicin.
14. The method of claim 1 , wherein said capsaicinoid comprises a mixture of capsaicinoids in a total amount equivalent to a capsaicin dose from about 1 μg to about 5000 μg of capsaicin.
15. The method of claim 1 , further comprising administering to the human or animal an analgesically effective amount of an analgesic.
16. The method of claim 1 , wherein the pain is associated with osteoarthritis of the hip, comprising injecting capsaicin intraarticulary into the hip.
17. The method of claim 1 , wherein the pain is associated with osteoarthritis of the shoulder, comprising injecting capsaicin intraarticulary into the shoulder.
18. The method of claim 1 , wherein the pain is associated with osteoarthritis of the spine, comprising injecting capsaicin intraarticulary into the spine.
19. The method of claim 1 , wherein the pain is associated with osteoarthritis of the elbow, comprising injecting capsaicin intraarticulary into the elbow.
20. The method of claim 1 , wherein the pain is associated with osteoarthritis of the foot, comprising injecting capsaicin intraarticulary into the foot.
21. The method of claim 1 , wherein the pain is associated with osteoarthritis of the hand, comprising injecting capsaicin intraarticulary into the hand.
22. The method of claim 1 , wherein the dose of capsaicin is from about 1 to about 3000 μg.
23. The method of claim 1 , wherein the dose of capsaicin is from about 20 to about 300 μg.
24. The method of claim 1 , wherein the dose of capsaicin is from about 35 to about 200 μg.
25. The method of claim 1 , wherein the dose of capsaicin is 100 μg.
26. The method of claim 1 , wherein the injection of capsaicinoid intraarticularly into the joint attenuates pain emanating from the joint for at least 3 months.
27. The method of claim 1 , wherein the injection of capsaicinoid intraarticularly into the joint attenuates pain emanating from the joint for up to six months.
28. The method of claim 15 , wherein the analgesic is selected from the group consisting of sodium aurothiomalate, nonsteroidal anti-inflammatory agents (NSAID), opioid analgesics, paraminophenol derivatives and salicylates.