Black Pepper

Black pepper, also known as Piper nigrum, has been used to treat upset stomach, bronchitis, and even cancer. Some have used black pepper to treat pain associated with neuralgia and skin irritation when used topically and may also possess antimicrobial and diuretic properties (Leung and Foster 1996, Gruenwald et al. 1998). The putative compounds include volatile oils (sabinene, limonene, caryophyllene, P-pinene, a-pinenes), acid amines (e.g., piperines), and fatty acids.

The compound is not without side effects. Eye contact may lead to redness and/or swelling. Large amounts have even been reported to cause death secondary to aspiration (Cohle et al. 1988).

Black pepper may decrease the activity of the CYP3A4 enzyme, thereby increasing levels of drugs such as phenytoin, propranolol, and theophylline metabolized by the enzyme. The piperine constituent of pepper seems to inhibit CYP3A4 in vitro (Bhardwaj et al. 2002). Other drugs that may be affected include calcium channel blockers, chemotherapeutic agents, antifungals, glucocorticoids, cisapride, alfentanil, fentanyl, losartan, fluoxetine, mida-zolam, omeprazole, and ondansetron. Caution is advised if patients are taking these drugs concomitantly as their doses may need to be decreased.

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