Rub A535 is a rubefacient used for the relief of muscle pain. Its 3 medicinal ingredients – Methyl Salicylate, Camphor, and Capsaicin – aim to increase blood circulation, reducing pain caused from overuse of muscles. Manufactured by the Canadian company Church & Dwight, it’s been relieving pain since 1919.
Rub A535 Antiphlogistine has been used for over a century as a household pain reliever and is known to provide a “tingly relief” sensation while it relaxes muscles and increases blood flow when muscles and joints are sore. It is used sporadically as an on-the-spot treatment rather than an ongoing or daily-use medicine.
Fast Fact: Antiphlogistine is another word for a mass (usually plant or clay-based material) found in nature that is applied to the skin as a remedy to relieve muscle and joint pain.
But does A535 actually work to “rub the pain away”? The effectiveness of its pain-relieving medicinal ingredients is up for debate, so should you bother using it? We’ve outlined everything you need to know about Rub A535 below, including:
- How does Rub A535 work to relieve pain?
- Rub A535 ingredients
- Rub A535 side effects
- Rub A535 review: can you “rub” the pain away?
- How safe is Rub A535?
- The bottom line: will Rub A535 work, and is it worth it?
Let’s jump in with the basics of how exactly Rub A535 relieves pain.
How does Rub A535 work to relieve pain?
Rub A535 is a topical analgesic (pain reliever) designed to decrease muscle pain. Its medicinal ingredients are absorbed into the skin and converted into salicylic acid, which reduces the sensation of pain. While rubbing, it also stimulates the nerves in your skin, providing a sensation that distracts you from the pain.
Rub A535 mainly advertises as a relief for muscle stiffness and soreness caused by physical activity, overuse, and arthritis. It comes in many different forms including lotions, gels, rub-on sticks, and medicated wraps. Each contains a series of active ingredients that suggest they can provide pain relief.
Rub A535 ingredients
Rub A535 contains ingredients that have been used individually to reduce muscle pain. The wide variety of products offered contain many different ingredients, but the most common ingredients in the Rub A535 formula are the ones that primarily help with pain relief. There are also over 50 other ingredients you might not have realized.
Medicinal ingredients in Rub A535
- Methyl salicylate (12.5%-21%): Absorbed into the skin and converted by the body into salicylic acid. The release of salicylic acid leads to a reduction in the molecules contributing to pain sensations. This process helps relieve muscle pain, but it can take up to 8 hours to work.1
- Capsaicin (<1%): Stimulates the nerves in the skin responsible for pain. This stimulation masks the pain in the muscles by providing a burning sensation to the nerves. This tingling and burning sensation can take your mind off the pain until the capsaicin wears off.2
- Menthol/Camphor (1%-4%): Stimulates the nerves in the skin by masking the pain with a cooling effect. Many people find this cooling sensation to provide relief of muscle and joint pain, and cause muscle relaxation. Although menthol can be cooling, it does not have a direct effect on the pain3 and inflammation in the muscles.
Other common ingredients in A535 cream
- Alcohols: Acetylated Lanolin Alcohol / Cetyl alcohol / Isopropyl Alcohol / Polyvinyl Alcohol
- Natural Ingredients: Beeswax / Zingiber officinale (ginger) root extract
- Minerals: Charcoal / Salt / Vermiculite
- Cholesterol / Gelatin / Glycerin
- FD & C Blue 1 / Fragrance / Perfume
- Iron oxide brown / Iron Powder
- Water / Purified Water
Synthetic and organic chemical compounds present in A535
Acrylates/C10-30 alkyl acrylatecrosspolymer, Butylatedhydroxyoluene, Caprylic/Capric Triglyceride, Carbomer/Carbomer 934, Cyclomethicone, Dea-Cetyl Phosphate, Diazolidinyl Urea, Dimethicone/Dimethiconecopolyol phosphate, Disodium EDTA/Calcium disodium EDTA/Edetate calcium disodium, Glyceryl stearate, Isobornyl Acetate / Tocopherol Acetate, Isopropyl Palmitate, Menthyl Lactate, Methylparaben, Oxacyclohexadecan-2-one, PEG-75 sterate/PEG-400, Polyethylene Glycol/Polyethylene glycol 400, Polysorbate 20 / Potassium sorbate, Propylparaben, Sodium Lauryl, Steric Acid, Sulfate/Sodium Polyacrylate, Tartaric Acid, Titanium dioxide, Triethanolamine, Vanillyl butyl ether
Note: Not every A535 rub, cream, or other product contains all these ingredients. This is a complete list of all the ingredients used in all formulations of Rub A535.
Rub A535 side effects
Rub A535 is known to have some minor side effects, though none that are cause for medical concern. In most cases, side effects are mild and occur only on the surface of the skin. In general, only people with sensitive skin or allergies to Rub A535 ingredients would experience any discomfort.
Here are the main side effects reported with use of Rub A535:
- Skin irritation: This is the most common side effect associated with antiphlogistine – causing an irritation of the skin,4 including redness, bumps, swelling, or rash. If you experience this, wash the cream off thoroughly and irritation should stop.
- Mild to severe burns: When used too often or in inappropriate amounts, Rub A535 has caused burning of the skin.5 To avoid this, always follow the instructions for use on the product, and never use the rub on broken skin, cuts, wounds, or thin skin (face and genitals).6
- Interaction with blood thinners: Methyl salicylate has been known to interact with blood thinners such as Aspirin or Warfarin. Therefore, concurrent use7 of these two products should be avoided.
- Harmful if ingested: Though the box warns you not to, if accidental ingestion of Rub A535 occurs, Health Canada has reported serious complications,4 and suggests you call a Poison Control Center immediately. It is particularly important to keep the product out of reach of children to prevent harmful ingestion.
If you experience any of these side effects, discontinue use of the product. If your symptoms do not go away within a couple of hours, seek medical attention. In addition, do not use A535 if you are allergic to any of the contents in the formulations, as hypersensitivity reactions have been reported.8 Though the side effects of muscle rubs are usually mild, it is always recommended that you talk to your pharmacist or doctor before starting any new therapies.
Rub A535 review: can you “rub” the pain away?
Rub A535 is an effective pain treatment and has been known to help create the sensation that muscles are more relaxed; however, there is no strong evidence to support the effectiveness of rub as a whole. The best way to determine whether it will help with your pain is to look at studies done on the main components of the rub.
Methyl salicylate
- Pro: Has been approved by Health Canada4 for temporary pain relief of still and sore muscles
- Pro: In 2010, a study found that participants who wore patches containing 10% methyl salicylate and 3% menthol (comparable to concentrations in Rub A535) had a significant reduction in mild to moderate muscle strain compared to those who didn’t wear the patch8
- Con: In 2004, a study9 found evidence that salicylate creams may reduce pain, but are only moderately effective for muscular, skeletal, and arthritic pain
- Con: Little evidence supports the efficacy of methyl salicylate
Capsaicin
- Con: There have only been two studies10 for low dose capsaisin (less than 1%) suggesting that capsaicin may relieve pain, but they were unreliable
- Pro: The same study shows there is insufficient data10 to draw conclusions on low-dose capsaicin creams for the treatment of nerve pain
Menthol/Camphor
- Pro: Is likely effective in reducing muscular pain in concentration from 3%-11%11 (resembling concentration in Rub A535), according to The Natural Medicines Comprehensive Database (NMCD)
- Pro: Health Canada has approved camphor and menthol4 for relief of muscle pains
- Con: There is not enough evidence to support menthol’s efficacy in reducing inflammation and local pain12
Most muscle rubs for pain relief have limited evidence, and they all seem to have similar effects on pain. Therefore, when choosing a product, it often comes down to personal preference.13
How safe is Rub A535?
Rub A535 cream is typically considered safe as the active ingredients generally do not get absorbed into the bloodstream. Topical applications of the cream work locally and have less side effects, especially compared to oral pain relievers.14 If you experience irritation, washing the cream off will end it.
Can you use A535 when pregnant?
Rub A535 is generally acceptable to use while pregnant, as none of its main active ingredients (methyl salicylate, camphor, or capsaicin) are known to be harmful to the skin or other parts of the body while pregnant or breastfeeding. No additional or serious side effects have been reported.
Always check with your doctor before using a new ointment while pregnant or breastfeeding, and if you experience any irritation or your child has an unusual reaction, discontinue use and call your doctor immediately.
The bottom line: will Rub A535 work, and is it worth it?
Rub A535 may be effective in improving mild muscle pain for a short period of time, but the evidence isn’t strong enough to suggest that A535 can treat severe or ongoing pain. It is important to remember that painful muscle aches that have you limping require medical attention.
However, if you are experiencing some mild aches and pains due to overuse of muscles, sports activities, or arthritis, Rub A535 is an easy-to-use, safe option when used properly, and it is incredibly cost effective compared to other pain relievers. At the very least, you might enjoy the tingles!
Authors:
Nicole Gaudet, Priya Samuel, Stephanie Metzger, and Jillian Breen
BSc. Pharm Candidate(s)
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta
Edited and Reviewed by the Health Aisle Team
References:
1. Green, B. G., & Flammer, L. J. (1989). Methyl salicylate as a cutaneous stimulus: a psychophysical analysis. Somatosensory & Motor Research, 6(3), 253-274.
2. Anger, W. H. (2014). Low-concentration topical capsaicin for chronic neuropathic pain in adults. Clinical Journal Of Oncology Nursing, 18(1), 123-124.
3. Peier, A. M., Moqrich, A., Hergarden, A. C., Reeve, A. J., Andersson, D. A., Story, G. M., & … Patapoutian, A. (2002). A TRP channel that senses cold stimuli and menthol. Cell, 108(5), 705-715.
4. Health Canada: Drugs and Health Products. (2015). Counterirritants.
5. Food and Drug Association. (2012). FDA Drug Safety Communication: Rare cases of serious burns with the use of over-the-counter topical muscle and joint pain relievers.
6. Mayo Clinic. (2013). Arthritis pain: Treatments absorbed through your skin.
7. Yip, A. S., Chow, W. H., Tai, Y. T., & Cheung, K. L. (1990). Adverse effect of topical methyl salicylate ointment on warfarin anticoagulation: an unrecognized potential hazard. Postgraduate Medical Journal, 66(775), 367–369.
8. Higashi, Y., Kiuchi, T., & Furuta, K. (2010). Efficacy and safety profile of a topical methyl salicylate and menthol patch in adult patients with mild to moderate muscle strain: a randomized, double-blind, parallel-group, placebo-controlled, multicenter study. Clinical Therapeutics, 32(1), 34-43.
9. Mason, L., Moore, R. A., Edwards, J. E., McQuay, H. J., Derry, S., & Wiffen, P. J. (2004). Systematic review of efficacy of topical rubefacients containing salicylates for the treatment of acute and chronic pain. BMJ Clinical Research Ed., 328 (7446), 995.
10. Derry, S., & Moore, R. A. (2012). Topical capsaicin (low concentration) for chronic neuropathic pain in adults. The Cochrane Database Of Systematic Reviews.
11. Natural Medicines. (2014). Camphor product monograph.
12. Natural Medicines. (2014). Peppermint product monograph.
13. Jorge, L. L., Feres, C. C., & Teles, V. E. (2011). Topical preparations for pain relief: efficacy and patient adherence. Journal of Pain Research, 4, 11–24.
14. Martin, D., Valdez, J., Boren, J., & Mayersohn, M. (2004). Dermal absorption of camphor, menthol, and methyl salicylate in humans. Journal Of Clinical Pharmacology, 44(10), 1151-1157.