Drugs for the Treatment of Soft-Tissue Disorders and Topical Pain Relief

NHSL Medicines Guidance
NHS Lanarkshire

Rubefacients, Topical NSAIDs, Capsaicin, and Poultices

Preferred list (P)

IBUPROFEN 5% gel

 

Total list (T)

CAPSAICIN 0.025% cream

Both strengths of Capsaicin cream are currently out of stock and are not expected to be available until mid-2026 at the earliest.

Prescribing Notes:

  • Initial drug treatments for osteoarthritis include PARACETAMOL and topical non-steroidal anti-inflammatory (NSAID) gel if needed, provided there are no contraindications. NSAID gels are particularly useful for hand and knee involvement.
  • If treatment with PARACETAMOL and/or topical NSAIDs are ineffective, the use of topical CAPSAICIN can be considered.
  • Topical CAPSAICIN should be considered as an adjunct to core treatments for knee or hand osteoarthritis.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 30/06/2026

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.