camphor + capsicum oleoresin (capsicin) + menthol + methyl salicylate: clinical use

Prescribing considerations

• Confirm that the pain is suitable for symptomatic topical treatment and investigate persistent symptoms.
• Consider systemic salicylate exposure when large skin areas, prolonged use or concurrent salicylates are involved.
• Use during pregnancy or lactation only when no safer alternative is suitable.
• Counsel about hand washing, accidental ingestion and fabric flammability.

Contraindications and cautions

• Children younger than 6 years
• Skin abrasions or irritated skin
• Hypersensitivity to salicylates or another ingredient
• Discontinue if local irritation develops

Monitoring

• Review persistent or worsening pain rather than continuing unsupervised treatment.
• Assess local burning, dermatitis, eczema or hypersensitivity.
• For patients taking warfarin, consider whether closer anticoagulation monitoring is needed.
• Assess urgently for toxicity after ingestion or extensive excessive application.

Clinical pharmacology

Menthol produces vasodilatation, cooling and subsequent analgesia. Camphor, white camphor oil and capsicum provide rubefacient or counter-irritant effects. Methyl salicylate is absorbed through skin and contributes salicylate and counter-irritant activity; product-specific pharmacokinetic data are unavailable.

Formulation and product differences

• The selected product is an off-white topical cream, also described in the SmPC as Radian Massage Cream.
• Lanolin, cetostearyl alcohol and sodium laurilsulfate may cause or intensify local skin reactions.
• Cream transferred to clothing, bedding or dressings creates a serious fire hazard.