in one aspect , the invention relates to a medicinal ointment including 1 - 50 % ( e . g ., about 1 - 10 %, about 10 - 20 %, about 20 - 30 %, about 30 - 40 %, about 40 - 50 %) by weight kavalactone , ( e . g ., active kavalactone that is kawain , dihydrokawain , dihydromethysticin , methysticin , yangonin , desmethoxyyangonin , or a combination thereof ), about 0 . 001 - 4 % ( e . g ., about 0 . 001 - 0 . 01 %, about 0 . 01 - 0 . 1 %, about 0 . 1 - 0 . 5 %, about 0 . 5 - 1 %, about 1 - 2 %, about 2 - 3 %, about 3 - 4 %) capsaicinoid , and a pharmaceutically acceptable carrier . a kavalactone is any lactone - containing compound derived from the kava kava root . the term “ active kavalactone ” herein refers only to kawain , dihydrokawain , dihydromethysticin , methysticin , yangonin , desmethoxyyangonin , or a combination of them . the amount of kavalactone or active kavalactone can be an effective amount of compound to produce the desired effect ( e . g ., mediation of irritation , or burning sensation of capsaicin ). capsaicinoids are compounds derived from an extract of a capsicum from the solanaceae family , including capsicum frutescens linne and capsicum annum linne , and chemical derivatives thereof . in one embodiment , the capsaicinoids are compounds derived from an extract of a capsicum from the solanaceae family ( e . g ., capsaicin , dihydrocapsaicin , nordihydrocapsaicin , homocapsaicin , homodihydrocapsaicin ). in another embodiment , the capsaicinoids are 8 - methy - n - vanillyl - 6 - nonenamide , 8 - methyl - n - vanillyl - nonamide , or a combination thereof . capsaicinoids can be obtained as an extract from the fruit of plants in the capsicum genus ( e . g ., hot pepper , chili pepper , cayenne ) or can be of synthetic origin . capsaicinoids that are derivatives of those compounds found in the plants or plant extracts described above , are made synthetically from natural or synthetic sources using synthetic chemistry reagents and methods known in the art . the amount of capsaicinoid can be an effective amount of compound to produce the desired effect ( e . g ., modulation , reduction , or relief from pain ). a pharmaceutically acceptable carrier can include mineral oil , liquid petroleum , white petroleum , propylene glycol , polyoxyethylene polyoxypropylene compound , emulsifying wax , water , sorbitan monostearate , polysorbate 60 , cetyl esters wax , cetyl alcohol , 2 - octyldodecanol , and stearyl alcohol . an acceptable carrier can include water , a solvent , an emollient , a surfactant , a preservative , or a combination thereof . water , when present , can be in an amount of 5 to 80 % by weight . other than water , the acceptable carrier can also contain a relatively volatile solvent such as a monohydric c1 - c3 alkanol ( e . g ., methyl alcohol or ethyl alcohol ) in an amount of 1 to 70 % by weight , and an emollient such as those in the form of silicone oils and synthetic esters in an amount of 0 . 1 to 30 % by weight . other solvents that are acceptable carriers include any suitable for administration of kavalactones and capsaicinoids , for example , dimethyl sulfoxide , c1 - c20 alcohols , glycols , and ethers . anionic , nonionic , or cationic surfactants can also be included in the acceptable carrier . the concentration of total surfactants can be from 0 . 1 to 40 % by weight . examples of anionic surfactants include soap , alkyl ether sulfate and sulfonate , alkyl sulfate and sulfonate , alkylbenzene sulfonate , alkyl and dialkyl sulfosuccinate , c8 - c20 acyl isethionate , acyl glutamate , c8 - c20 alkyl ether phosphate , and a combination thereof . examples of nonionic surfactants include c10 - c20 fatty alcohol or acid hydrophobe condensed with from 2 to 100 moles of ethylene oxide or propylene oxide per mole of hydrophobe ; c2 - c10 alkyl phenol condensed with from 2 to 20 moles of alkylene oxide ; mono and di - fatty acid ester of ethylene glycol ; fatty acid monoglyceride ; sorbitan , mono - and di - c8 - c20 fatty acid ; block co - polymer ( ethylene oxide / propylene oxide ); polyoxyethylene sorbitan , and a combination thereof . preservatives can also be included in the biological acceptable carrier to prevent growth of potentially harmful microorganisms , and can be employed in an amount of 0 . 01 to 2 % by weight . examples of preservatives include alkyl ester of para - hydroxybenzoic acid , hydantoin derivative , propionate salt , and a variety of quaternary ammonium compounds . each preservative should be selected based on its compatibility with other ingredients in the composition . an ointment of this invention can be applied to any particular surface area of the body ( including the skin , mouth , or gums ). eucerin crème is a suitable formulation for use in making the compositions herein . the invention also relates to methods of making any of the compositions herein comprising combining the materials , each added alone , or in combination . the components can be combined or added in a dry or liquid state , and mixed in suitable apparatuses ( e . g ., drum , bowl , containers ) compatible with the components of the composition . in another aspect , the invention is a patch ( see , for example , u . s . pat . no . 5 , 186 , 938 ) including a kavalactone / capsaicinoid - containing material layer . more specifically , the material layer , e . g ., a pad or a pressure - sensitive adhesive , serves as a substrate for receiving about 1 - 50 % ( alternatively about 1 - 10 %, alternatively about 10 - 20 %, alternatively about 20 - 30 %, alternatively about 30 - 40 %, alternatively about 40 - 50 %) by weight kavalactone or active kavalactone and about 0 . 001 - 4 % ( alternatively about 0 . 001 - 0 . 01 %, alternatively about 0 . 01 - 0 . 1 %, alternatively about 0 . 1 - 0 . 5 %, alternatively about 0 . 5 - 1 %, alternatively about 1 - 2 %, alternatively about 2 - 3 %, alternatively about 3 - 4 %) capsaicinioid . the composition can have 1 - 50 % ( alternatively about 1 - 10 %, alternatively about 10 - 20 %, alternatively about 20 - 30 %, alternatively about 30 - 40 %, alternatively about 40 - 50 %) by weight kavalactone or active kavalactone , and about 0 . 001 - 4 % ( alternatively about 0 . 001 - 0 . 01 %, alternatively about 0 . 01 - 0 . 1 %, alternatively about 0 . 1 - 0 . 5 %, alternatively about 0 . 5 - 1 %, alternatively about 1 - 2 %, alternatively about 2 - 3 %, alternatively about 3 - 4 %) capsaicinoid associated with the material layer ( e . g ., impregnated , embedded , or coated on the surface ). a patch optionally has a protective layer intimately adhered to one side of the material layer , which is resistant to passage of the kavalactone or active kavalactone and capsaicinoid . in other embodiments , the invention is a patch including any of the compositions herein , wherein the amounts of kavalactone ( e . g ., active kavalactone ) and capsaicinoids are any of those as delineated herein . an active kavalactone - containing composition can be administered using an implantable device . implantable devices and related technology are known in the art and are useful as delivery systems where a continuous , or timed - release delivery of pure kavalactone compounds or compositions delineated herein is desired . additionally , the implantable device delivery system is useful for targeting specific points of pure kavalactone compound or composition delivery ( e . g ., localized sites , organs ). negrin et al ., biomaterials , 22 ( 6 ): 563 ( 2001 ). timed - release technology involving alternate delivery methods can also be used in this invention . for example , timed - release formulations based on polymer technologies , sustained - release techniques and encapsulation techniques ( e . g ., polymeric , liposomal ) can also be used for delivery of the pure kavalactone compounds and compositions delineated herein . topical - patches having pure dihydrokawain , dihydromethysticin , kawain , methysticin , yangonin , desmethoxyyangonin , or a combination thereof , or a composition thereof ( e . g ., kavalactone / capsaicinoid combination ) are also included in this invention . also within the invention is a patch to deliver active kavalactone . a patch includes a material layer ( e . g ., polymeric , cloth , gauze , bandage ) and the kavalactone / capsaicinoid combination as delineated herein . one side of the material layer can have a protective layer adhered to it to resist passage of kavalactone / capsaicinoid compositions . the patch can additionally include an adhesive to hold the patch in place on a subject . an adhesive is a composition , including those of either natural or synthetic origin , that when contacted with the skin of a subject , temporarily adheres to the skin . it can be water resistant . the adhesive can be placed on the patch to hold it in contact with the skin of the subject for an extended period of time . the adhesive can be made of a tackiness , or adhesive strength , such that it holds the device in place subject to incidental contact , however , upon an affirmative act ( e . g ., ripping , peeling , or other intentional removal ) the adhesive gives way to the external pressure placed on the device or the adhesive itself , and allows for breaking of the adhesion contact . the adhesive can be pressure sensitive , that is , it can allow for positioning of the adhesive ( and the device to be adhered to the skin ) against the skin by the application of pressure ( e . g ., pushing , rubbing ,) on the adhesive or device . also included are peelable masks that can be formulated by placing the composition as a gel or paste on a protective layer made of a film - forming polymer ( e . g ., polyvinyl alcohol ) and an adhesive promoting polymer ( e . g ., hydrophobic acrylate or methacrylate polymer , such as pemulen tr2 . rtm . from the b . f . goodrich company ). alternatively , a hydrogel composition ( see , for example , u . s . pat . no . 5 , 961 , 479 or u . s . pat . no . 5 , 306 , 504 ) including any one or more of the kavalactone / capsaicinoid combinations can be used . another aspect of the invention relates to a packaged product including a container , a composition containing a kavalactone / capsaicinoid compositions herein disposed in the container and a label ( e . g ., sticker , product insert ) with the container and having instructions for application of the kavalactone / capsaicinoid compositions herein for treating a pain disorder , or modulating the irritant effects of capsaicinoids . the invention also covers a pharmaceutical composition having a pure active kavalactone that is kawain , dihydrokawain , dihydromethysticin , methysticin , yangonin , desmethoxyyangonin , or a combination thereof . the subject can be a human or an animal ( e . g ., dog , cat ). the term “ pure ” refers to a level of 90 % or higher . pure active kavalactone can be derived from natural ( e . g ., root extract and purification ) or synthetic ( e . g ., synthesis from natural or synthetic materials ) means , or a combination thereof . a crude extract of the kava roots ( obtained using various extraction methods ( e . g ., simple solvent soak , supercritical fluid extraction )) can be used as the source of kavalactones or active kavalactones for the preparation of a composition of this invention . if desired , the kavalactones or active kavalactones can be further purified by column chromatography . they can also be synthesized from readily available starting materials by conventional chemical methods . see , for example , kostermans , reclk . trav . chim . pays - bas ., 70 , 79 ( 1951 ); klohs et al ., j . org . chem ., 24 , 1829 ( 1959 ); spino , et al . tetrahedron lett ., 37 , 6503 ( 1996 ), and references cited in each . the kavalactones or active kavalactones present in a composition can be enriched by addition of those kavalactones ( from either natural or synthetic sources ). the kavalactones or active kavalactones contain one or more asymmetric centers and thus can occur as racemates and racemic mixtures , single enantiomers , individual diastereomers and diastereomeric mixtures . they can also occur in cis - or trans - or e - or z - double bond isomeric forms . the compositions herein are useful for ameliorating the burning or irritation ( e . g ., primary and secondary hyperalgesic effects ) associated with capsaicinoids and their use . as such , the compositions allow for more wide - spread use and improved patient compliance of treatment regimens involving capsaicinoids . the compositions herein are useful in treating ( e . g ., relieving , reducing , modulating ) pain ( e . g ., neuropathic , inflammatory , myofacial , osteoarthritic ), pain sensation , or symptoms thereof . in certain instances , as illustrated in the examples herein , the treatment protocols using the compositions herein provided relief in cases where multiple surgical interventions , and multiple medication regimens had previously given unsatisfactory results ( e . g ., insufficient relief from pain or pain symptoms ) or had failed . in addition to the masking effect against hyperalgesia of the kavalactone - capsaicinoid combination compositions delineated herein , the compositions have an additional benefit in that the undesirable pain or irritation effects attributable to capsaicin are modulated , while the efficacy effects of the capsaicin ( e . g ., pain relief , pain , reduction , analgesic effect ) are retained , or relatively unaffected as compared to capsaicin compositions without the kavalactones . the retention of analgesic effect can be measured using a variety of standard analgesia protocols , including , for example , the formalin test as essentially reported by tjolsen , et al ., pain , 51 , 13 ( 1992 ). depending on the dosages employed , the kavalactones may either potentiate the degree of analgesia beyond that obtainable using capsaicinoids alone , or it may induce analgesia at dosages where no analgesic effect is obtained from either component alone . all references cited herein , whether in print , electronic , computer readable storage media or other form , are expressly incorporated by reference in their entirety , including but not limited to , abstracts , articles , journals , publications , texts , treatises , technical data sheets , internet web sites , databases , patents , patent applications , and patent publications . embodiments are further described in the following representative examples , which do not limit the scope of the invention described in the claims . a 1 % capsaicin cream was prepared by mixing of 455 g of eucerin crème with 10 ml of etoh solution and 5 g natural capsaicin ( trans - 8 - methyl - n - vanilyl - 6 - noneamide ) ( purchased from aldrich chemical company , inc ., milwaukee , wis .). a 20 % kava + 1 % capsaicin crème was prepared as follows : 120 g of kava extract paste ( 84 % kavalactones , purchased from cosmopolitan trading , seattle , wash .) was converted to a homogeneous solution with the aid of 20 ml of etoh at 70 c . five grams ( 5 g ) of capsaicin was added to the solution . the solution was mixed with 395 g of eucerin crème and left overnight at room temperature to remove excess etoh . a chinese male ( 40 years old ) received 5 g of 1 % capsaicin crème on his right shin and 20 % kava + 1 % capsaicin crème on his left shin in a circular motion in a 5 cm diameter , respectively and the applied area was covered with a bandage , then the degree of hyperalgesia was monitored . after 5 - 10 min , the subject experienced significant pain on his right shin where 1 % capsaicin had been applied . in contrast , he did not feel pain on his left shin where 20 % kava and 1 % capsaicin had been applied . this effect lasted until the applied crème was removed . the same experiment as in example 3 was been conducted using three other subjects consisting of two caucasian males ( 45 years old and 40 years old ) and one japanese male ( 48 years old ). significant masking effect of hyperalgesis caused by capsaicin was observed in all subjects . capsaicin was applied topically at a concentration of 1 % in one extremity . a second extremity had topically applied 1 % capsaicin plus 30 % kava cream . both samples were blinded to the subjects . ten subjects had both mixtures applied . in all subjects the burning associated with 1 % capsaicin was blunted ( cut on average 60 - 80 %). four subjects experienced no burning with capsaicin . that evening secondary hyperalgesia was measured in several subjects and found to be markedly reduced in the subjects receiving kava plus capsaicin compositions . four subjects were exposed to topical capsaicin at 1 % in two extremities . after approximately 1 hour , when the burning became quite intense , either placebo or 30 % kava was applied to the effective area in a blinded fashion . all subjects reported a marked reduction in the burning associated with capsaicin in the side receiving capsaicin but not in the side receiving the placebo . this indicates that kava ( e . g ., kavalactones ) were able to counteract the burning ( secondary and primary hyperalgesia ) associated with capsaicin . a patient with intractable neuropathic and myofascial pain had topically applied 1 % capsaicin plus 30 % kava cream . she reported marked reduction in pain in the area applied . this effect lasted for 24 hours . this had previously failed multiple surgical interventions , multiple medications . she also reported a pleasant heat , with no burning associated with capsaicin . a number of embodiments of the invention have been described . nevertheless , it will be understood that various modifications may be made without departing from the spirit and scope of the invention . accordingly , other embodiments are within the scope of the following claims .
this invention relates to kavalactone - containing compositions , and more particularly to compositions having compounds derived from kavalactones and from capsaicinoids . the compositions are useful in modulating pain , and thus can be used to mediate , or eliminate , sensations of pain , thereby providing pain relief and reduction .