What is the efficacy of topical anesthetics in the treatment of HIV-associated distal painful sensorimotor polyneuropathy?

Updated: Aug 08, 2019
  • Author: Florian P Thomas, MD, PhD, MA, MS; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Capsaicin and transdermal lidocaine have been used. A controlled trial of a high-concentration capsaicin dermal patch found that a single application was safe and provided at least 12 weeks of pain reduction. [31]

Repeated NGX-4010, a capsaicin 8% dermal patch, treatments were generally well tolerated and resulted in consistent reductions in HIV distal sensory polyneuropathy–associated pain. [32]  In patients that respond to the high-dose patch, relief begins within days and typically lasts on average for 5 months. [33]

A randomized controlled trial of 5% lidocaine gel found that it was well tolerated but no more effective than placebo. [34]

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