A review of studies on the use of capsaicin cream for pain relief was conducted. Six studies (n=389) were identified examining low dose (0.075%) capsaicin cream versus placebo. Low dose topical capsaicin was ineffective for pain without significant effect beyond placebo. Studies showed skin reactions could result in withdrawal and were more common with capsaicin than placebo though this became better with time. Adverse effects were rare systemically. (47)
The high dose, 8% capsaicin patch was studied in a similar fashion on postherpetic neuralgia by Irving et al. The patch was also found to be effective at pain relief for 12 weeks. (48)
Diabetic peripheral arterial disease in patients with diabetes:
Carnitine is a supplement available in over the counter in health food stores and pharmacies as propionyl- L-carnitine, acetyl-L-carnitine, and L-carnitine. Propionyl-L-carnitine has been studied for use in peripheral arterial disease at a dose of 500-1000 mg oral 3 times daily with most trials showing a benefit in severe disease with improvement in walking distance of over 40%, but has been less effective for mild peripheral arterial disease. Minimal adverse effects have been reported (60).