Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for CAPSICUM are as follows:

Likely effective for…

• Nerve pain in people with diabetes (diabetic neuropathy). A specific cream containing 0.075% capsaicin (Zostrix-HP, Link Medical Products Pty Ltd.) 4 times daily is approved for treating this condition. Another patch containing 8% capsaicin (Qutenza, NeurogesX, Inc.), which is available by prescription only, is also approved for treating this condition. Creams or gels that contain smaller amounts of capsaicin (less than 0.075%) don’t seem to work.
• Chronic pain. Applying creams and lotions containing capsaicin, the active chemical in capsicum, can temporarily relieve chronic pain from several conditions. It’s FDA approved for this use.
• Nerve damage caused by shingles (postherpetic neuralgia). Applying a patch containing 8% capsaicin (Qutenza, NeurogesX Inc.), the active chemical in capsicum, reduces pain over 24 hours in people with this condition. This capsaicin patch is available by prescription only.

Possibly effective for…

• Back pain. Applying capsicum or capsaicin to the skin seems to help reduce back pain.
• Cluster headache. Applying capsaicin, the active chemical in capsicum, inside the nose can reduce the number and severity of cluster headaches. It’s not clear if it helps treat cluster headaches.
• Runny nose not caused by allergies or infection (nonallergic rhinitis). Applying capsaicin, the active chemical in capsicum, inside the nose can reduce runny nose in people who do not have allergies or an infection. The benefits might last for 6-9 months.
• Osteoarthritis. Applying 0.025% capsaicin, the active chemical in capsicum, to the skin can improve symptoms of osteoarthritis.
• Acute pain. Applying capsaicin, the active chemical in capsicum, to the skin can reduce pain from trauma.
• Nausea and vomiting after surgery. Applying a plaster containing capsicum to specific points on the hand and forearm reduces nausea and vomiting after surgery.
• Pain after surgery. Applying a plaster containing capsicum to specific points on the hand and forearm reduces the need for painkillers within the first 24 hours after surgery.

There is interest in using capsicum for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

When taken by mouth: Capsicum is likely safe when consumed in amounts typically found in food. Capsaicin, the active chemical in capsicum, is possibly safe when used short-term. Side effects can include stomach irritation, sweating, and runny nose. Capsicum is possibly unsafe to take in large doses or for long periods of time.

When applied to the skin: Lotions and creams that contain capsicum extract are likely safe for most adults. Capsaicin is approved by the FDA as an over-the-counter medication. Side effects can include skin irritation and itching. Capsicum can also be very irritating to the eyes, nose, and throat. Don’t use capsicum on sensitive skin or near the eyes.

When used in the nose: Capsicum is possibly safe. But, application in the nose can be painful and cause burning pain, sneezing, watery eyes, and runny nose.

Special precautions & warnings:

Pregnancy: Capsicum is likely safe when applied to the skin during pregnancy. Capsicum is possibly safe when taken by mouth as a medicine during the second half of the second trimester and during the third trimester.

Breast-feeding: If you are breast-feeding, using capsicum on your skin is likely safe. But it is possibly unsafe for your baby if you take capsicum by mouth. Skin problems (dermatitis) have been reported in breast-fed infants when mothers eat foods heavily spiced with capsicum peppers.

Children: Applying capsicum to the skin of children under two years of age is possibly unsafe. There isn’t enough reliable information to know if it is safe for children to use capsicum by mouth as a medicine. Stay on the safe side and stick with the amounts found in foods.

Bleeding disorders: While conflicting results exist, capsicum might increase the risk of bleeding in people with bleeding disorders.

Damaged skin: Don’t use capsicum on damaged or broken skin.

High blood pressure: Taking capsicum or eating a large amount of chili peppers might cause a spike in blood pressure. In theory, this might worsen the condition for people who already have high blood pressure.

Surgery: Capsicum might increase bleeding during and after surgery. Stop using capsicum at least 2 weeks before a scheduled surgery.

Moderate

Be cautious with this combination.

Aspirin

Capsicum might decrease how much aspirin the body can absorb. Taking capsicum along with aspirin might reduce the effects of aspirin.

Ciprofloxacin (Cipro)

Capsicum might increase how much ciprofloxacin the body can absorb. Taking capsicum along with ciprofloxacin might increase the effects and side effects of ciprofloxacin.

Medications for diabetes (Antidiabetes drugs)

Capsicum might lower blood sugar levels. Taking capsicum along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Capsicum might slow blood clotting. Taking capsicum along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Theophylline

Capsicum can increase how much theophylline the body can absorb. Taking capsicum along with theophylline might increase the effects and side effects of theophylline.

Minor

Be watchful with this combination.

Medications for high blood pressure (ACE inhibitors)

Some medications for high blood pressure might cause a cough. There is one report of someone whose cough worsened when using a cream with capsicum along with these medications for high blood pressure. But it isn’t clear if this interaction is a big concern.

Herbs and supplements that might lower blood sugar

Capsicum might lower blood sugar. Taking it with other supplements with similar effects might lower blood sugar too much. Examples of supplements with this effect include aloe, bitter melon, cassia cinnamon, chromium, and prickly pear cactus.

Herbs and supplements that might slow blood clotting

Capsicum might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.

Iron

There is some concern that using capsicum might reduce how much iron the body can absorb.

There are no known interactions with foods.

In adults, capsicum has been taken by mouth as extracts, chili, fermented red pepper, red pepper powder, lozenges, nectar, and capsaicin. In both adults and children, capsicum has been applied to the skin in creams, plasters, and gels. It’s also used in nasal sprays and solutions. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.