Capsici fructus acer

Capsici fructus acer, also known as cayenne pepper fruitsor hot paprika fruits, are paprika-like red fruits, native to tropical South and Central America. They grow on a perennial, bushy semi-shrub that grows up to 1 m high. The name comes from the structure similar to a "capsule", capsa in Latin. There are numerous varieties of cayenne pepper; the fruits of Capsicum annuum L. var. minimum and Capsicum frutescens L. are used for medicinal purposes.

The quality is defined in the European Pharmacopoeia (Ph. Eur.).

HMPC mon ograph: well-established use: Muscle pain in the lower back, only in adults aged 18 years and over, not longer than 3 weeks.

ESCOP monograph: Muscle pain, e.g. back pain, and for the treatment of pain in degenerative joint diseases(osteoarthritis) and rheumatoid arthritis, nerve pain, e.g. after herpes zoster or painful diabetic neuropathy, itching of various causes (e.g. in psoriasis, dialysis).

Commission E-monograph: painful muscle tension in the shoulder-arm and spine area (adults and schoolchildren).

Capsici fructus acer contains 0.3 to 1 % capsaicinoids, including capsaicin as the main component), the colouring carotenoids (e.g. capsorubin, capsanthin), fatty oil and flavonoids.

A minimum content of 0.4% total capsaicinoids must be present!

Cayenne pepper fruits have a local hyperemic, nerve-damaging and local analgesic effect. Furthermore, they alleviate an existing itching, have an antiphlogistic effect.

For cutaneous nociception, capsaicin receptors (note: the term "capsaicin receptor" has now been abandoned in favour of TRPV1 receptor) play an essential role. These belong to the receptor family of the "Transient Receptor Potential" receptor group (TRP receptors; see below TRP channels).

Cayenne pepper fruit is used for hard muscle tension, arthrosis and prurigo diseases. Other indications are rheumatic diseases, prurigo, diabetic polyneuropathy, osteoarthritis and postzoster neuralgia. In addition, Capsici fructus acer is used in adult non-diabetic patients complaining of peripheral neuropathic pain.

HMPC: as a medicinal patch for adults and elderly people:

Patch (22 x 14 cm) containing soft extract of Capsici fructus corresponding to 11 mg of capsaicinoids expressed as capsaicin (= 35 µg / cm2).

Patch (12 x 18 cm) containing soft extract of Capsici fructus, corresponding to 4.8 mg of capsaicinoids expressed as capsaicin (= 22 µg/cm2).

Daily dose: A maximum of 1 patch per day should be applied to the affected area for at least 4 and up to 12 hours. An interval of at least 12 hours should be observed before applying a new patch to the same application site. Use in children and adolescents under 18 years of age is not recommended

HMPC as a semisolid dosage form (gels, creams, ointments) for adults and the elderly:

40-53 mg capsaicinoids / 100 g. Apply thinly to the affected area 2-4 times a day.

The use in children and adolescents under 18 years is not recommended.

Preparations of hot pepper are intended for external use only. The duration of application should not exceed two days. Before repeated application period at the same place of application must be a 14-day break.

In rare cases, hypersensitivity reactions, such as a urticarial exanthema, may occur. A longer period of application at the same place (over 6 weeks, or in high dosage or as a patch already after 4 days) can cause damage to sensitive nerves, dermatitis up to the formation of blisters and ulcers.

In the case of an existing hypersensitivity to paprika preparations, the use of Capsici fructus acer should be avoided. It should also not be used on damaged mucous membranes and skin.

Children and adolescents under 18 years of age.

There are no data on use in pregnant women; animal studies show reproductive toxicity following high subcutaneous doses of capsaicin. Capsaicin crosses the placental barrier and may pass into breast milk.

Qutenza® plaster, Capsagamma dolor® pain ointment, Finalgon® CPD heat cream, 26.5 mg/50 g cream , Thermo® Bürger cream

Dolenon® ointment, Kneipp Rheumatism Ointment®, Capsamol® ointment,

Since capsaicin-containing preparations, even in small quantities, strongly irritate the mucous membranes and cause a painful burning sensation, contact with the mucous membranes and especially with the eyes should be avoided.

1. https://www.ema.europa.eu/en/medicines/herbal/capsici-fructus
2. https://arzneipflanzenlexikon.info/cayennepfeffer.php
3. Wenigmann M. (2017) Phytotherapy medicinal drugs, phytopharmaceuticals, application. Urban & Fischer, pp. 93-94