Frequently Asked Questions

Below are answers to the most frequently asked questions (FAQs) concerning Zostrix. For additional information on using Zostrix, we recommend that you consult the package insert and Drug Facts information on the carton. You may also find MEDLINEplus Health Information to be a useful resource.

QUESTIONS:

I heard topical analgesic creams don't work on relieving arthritis pain. Is Zostrix any different?


I take an oral pain reliever, such as acetaminophen (Tylenol®), ibuprofen (Advil®), naproxen sodium (Aleve®), or a COX-2 inhibitor (Celebrex®, Vioxx®), to manage my arthritis pain. Can I use Zostrix as well?


How does Zostrix differ from other capsicum products on the market?


I heard from some of my friends that Zostrix "burns." Is that true? If so, is it safe?


One day last week the arthritis in my knee flared. I put Zostrix on that morning, and when I went to bed that night the pain was still there. Why didn't Zostrix work for me?


How many times a day should I apply Zostrix? And how long do I need to use it before I feel some results?


I'm getting good results from Zostrix, but I'm worried that I may be using it for too long. Also, will Zostrix interfere with my oral medications?


How do I remove Zostrix from my hand (or knee or elbow or hip)?


I got Zostrix in my eye (or contact lens). What should I do?

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ANSWERS:

I heard topical analgesic creams don't work on relieving arthritis pain. Is Zostrix any different?

Yes. Many topical analgesics use counterirritants such as menthol, methyl salicylate, and camphor, which temporarily "mask" the sensation of pain by causing the skin to feel hot or cold. A number of other topical analgesics contain no active ingredients whatsoever and instead tout additives like emu oil, eucalyptus oil, MSM, lanolin, and glucosamine that have no proven effectiveness in relieving pain. By contrast, Zostrix contains purified capsaicin, a powerful natural pain reliever that has been shown to reduce levels of a neurotransmitter called Substance P. By depleting Substance P, Zostrix gradually relieves pain.

In addition, no other topical arthritis pain reliever has been tested as extensively as Zostrix in large, well-controlled clinical studies. The proven effectiveness of Zostrix in treating arthritis pain is one reason why doctors have recommended Zostrix for arthritis pain more than all other topical analgesics combined.
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I take an oral pain reliever, such as acetaminophen (Tylenol®), ibuprofen (Advil®), naproxen sodium (Aleve®), or a COX-2 inhibitor (Celebrex®, Vioxx®), to manage my arthritis pain. Can I use Zostrix as well?

Yes. When oral medicines do not completely relieve your arthritis pain, you can use Zostrix for additional pain relief. In well-controlled clinical studies, arthritis sufferers who used Zostrix as directed along with their existing oral pain medications typically obtained relief above and beyond that provided by oral medicines alone. People who used Zostrix as directed along with oral pain medications for arthritis had significantly greater mobility and were better able to perform daily activities, such as walking and driving, relative to those who used only oral pain medications.

In addition, Zostrix has no known drug interactions, contraindications, or systemic side effects. You can be comfortable knowing that Zostrix will not interfere with your oral medications; Zostrix works along with oral pain relievers to relieve arthritis pain more effectively.
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How does Zostrix differ from other capsicum products on the market?

Zostrix contains purified capsaicin, while many other creams contain capsicum, capsicum oleoresin or capsaicin oleoresin. The last three ingredients are not the same as purified capsaicin. Capsicum and its oleoresin variants contain only small amounts of capsaicin, and they also contain noxious chemicals that work against the pain-relieving effects of purified capsaicin.

Zostrix also differs from other “knock-off” capsaicin products in that only Zostrix has been tested in large, well-controlled clinical studies. With a topical product, the vehicle delivery system makes a significant difference in the release properties of the active ingredient. Thus, only Zostrix has a vehicle delivery system proven to release the active ingredient in a therapeutically effective manner.
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I heard from some of my friends that Zostrix "burns." Is that true? If so, is it safe?

Zostrix has a long-established safety record. There are no known serious side effects with Zostrix or Zostrix-HP. However, some people do experience a burning sensation upon application, especially when they first begin to use Zostrix. This sensation is more common when using the triple-strength Zostrix-HP than the regular Zostrix cream. In most cases, any burning is transient and diminishes as Zostrix is used consistently as directed. As long as the burning sensation is tolerable and temporary, you should not be concerned.

Here are a few tips to help minimize any burning sensation:

• Do not apply Zostrix to broken, open, or irritated skin.
  
• Do not bandage or tightly wrap the Zostrix-treated area.
  
• Use only a small amount of Zostrix, enough to cover the painful area with a thin film of cream.
• Apply Zostrix regularly, 3 to 4 times daily. If you use Zostrix less often, you are more likely to feel burning upon each application.
• Avoid applying heat to the Zostrix-treated area, especially immediately before or after application of Zostrix. Avoid taking hot showers or baths, using a heating pad, and exposing the Zostrix-treated area to the sun.
  
• Avoid activities that will cause excessive perspiration after applying Zostrix.
• If you apply Zostrix cream by hand, wash hands thoroughly with soap and water after each application, in order to avoid spreading capsaicin to the eyes, nose, or other sensitive areas of the body. For the same reason, some Zostrix users find it helpful to wear a disposable glove when applying Zostrix.

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One day last week the arthritis in my knee flared. I put Zostrix on that morning, and when I went to bed that night the pain was still there. Why didn't Zostrix work for me?

You should expect gradual, not immediate, pain relief from Zostrix. Although some people notice a reduction in their pain within the first few days of using Zostrix, for most people it can take up to two weeks before they really feel significant pain relief.

Scientists believe that Substance P builds up around arthritic joints and sends pain signals along nerve pathways to the brain. By applying Zostrix regularly—three to four times a day, every day—you work to deplete the Substance P in the area. Over time, as Substance P levels fall, your pain diminishes.

Once relief occurs, it should be sustainable indefinitely as long as you continue to apply Zostrix three to four times daily.
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How many times a day should I apply Zostrix? And how long do I need to use it before I feel some results?

For maximum pain relief, Zostrix must be applied three to four times a day, every day. Relief may not occur, or may be delayed, if Zostrix is used less frequently than directed.

Because the depletion of Substance P takes time, you should expect gradual pain relief from Zostrix. The time required to achieve pain relief varies from individual to individual. Some people begin to feel the pain-relieving effects of Zostrix within the first few days, but most people have noticeable relief within two weeks of regular use. For optimal relief, Zostrix should be used as directed for four to six weeks.
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I'm getting good results from Zostrix, but I'm worried that I may be using it for too long. Also, will Zostrix interfere with my oral medications?

There are no time restrictions on how long you can use Zostrix. Indeed, to maintain its effectiveness in reducing pain, Zostrix must be applied regularly, three to four times each day. If you stop using Zostrix once its effects have started to work, Substance P may build up again and your pain may return.

Zostrix should not interfere with any oral medications. It has no known drug interactions or contraindications.
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How do I remove Zostrix from my hand (or knee or elbow or hip)?

First, try washing and rinsing the area thoroughly with cool water and soap. If this fails to remove all the residue, then soak a washcloth in cool water and apply periodic compresses to the area. It may be helpful to have a fan blow on the area while you are applying the compresses. If some residue still remains, then soak a washcloth in cold milk and apply periodic compresses to the area.
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I got Zostrix in my eye (or contact lens). What should I do?

Carefully flush the affected eye with water to remove any traces of Zostrix. Although your eye may burn from contact with capsaicin, Zostrix has not been reported to cause any lasting harm to the eye.

In using Zostrix, be especially careful not to get any cream residue on contact lenses. If this happens, clean the contact lenses in their usual cleaning solution. If this fails to remove all traces of residue, you should try soaking the contact lenses in milk and then recleaning them in their usual cleaning solution.
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