Nicoboxil/Nonivamide

Topical application of nonivamide-nicoboxil cream to resting legs has been shown to enhance the level of oxygenated haemoglobin in leg muscles 15 min later. Here, we examined whether such application improves the performance of experienced cyclists in a subsequent 4-km time-trial.

Nine male cyclists [26 ± 8 years; 176 ± 9 cm; 73.5 ± 12.8 kg; peak oxygen uptake: 50.7 ± 4.0 mL min(-1) kg(-1) (mean ± SD)] performed three 4-km time-trials on an ergometer with either topical application of nonivamide-nicoboxil cream (CREAM) or cream without active components (SHAM) to both their thigh muscles or no application (CONTROL).

Only the skin temperature immediately before and after the time-trial was higher with cream than SHAM and CONTROL (best p < 0.001, best d = 1.16). All other parameters evaluated, i.e., the average power output during the time-trial (p > 0.05, best d = 0.08), the tissue saturation index of the m. vastus lateralis (p > 0.05, best d = 0.57), cardiac output, heart rate, oxygen uptake, blood lactate concentration, and perceived exertion (p > 0.05, best d = 1.1) were similar under all three conditions.

Our present findings reveal that topical application of cream containing nonivamide and nicoboxil to the thighs of cyclists prior to a 4-km time-trial does not improve their power output, saturation of the m. vastus lateralis with oxygen, oxygen uptake, heart rate, cardiac parameters, or perceived level of exertion.

Topical capsaicin is an established treatment option for various pain conditions. In a randomized double‐blind multi‐centre study, 281 patients suffering from chronic soft tissue pain were treated either with a cream containing capsaicin 0.05% (‘Finalgon® CPD Wärmecreme’, n = 140) or placebo (n = 141). Of these, 151 were excluded from the ITT analysis, as they had in addition to their soft‐tissue pain, pain of other origin. The primary outcome measure was a positive treatment response, defined as a pain sum score reduction of 30% or more. After 3 weeks of treatment, the median pain sum score had decreased by 49% (capsicum group) and 23% (placebo group) (ITT analysis, p = 0.0006). The odds ratio of the responders in favour for capsaicin was 4.3 (CI 97.5% lower limit 1.9, p < 0.0001). Improvements in the secondary efficacy measures confirmed the results. Likewise, all outcome measures had significantly more improved in the capsaicin‐treated compared with the placebo‐treated chronic back pain sufferers. All patients were included in the safety assessments. More adverse events occurred in the capsicum group (n = 13) than in the placebo group (n = 6). The capsaicin cream was generally well tolerated. The results indicate that capsaicin cream is useful in patients with chronic soft tissue pain and is also efficacious in patients with chronic back pain for which effectiveness was already demonstrated in earlier clinical trials.