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peppermint (generic name)

an herbal product - treats Urinary tract infection, Abdominal distention, Cough, Asthma, Bad breath, Antispasmodic, Irritable bowel syndrome, V...
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Alternate Title

Mentha x piperita L., Menthol

Category

Herbs & Supplements

Synonyms

Balm mint, black peppermint, brandy mint, curled mint, Feullis de menthe, Japanese peppermint, Katzenkraut (German), lamb mint, menta prima (Italian), Mentha arvensis L. var piperascens, Menthae piperitae aetheroleum (peppermint oil), Menthae piperita var officinalis, Menthae piperitae folium (peppermint leaf), Menthe anglaise, Menthe poivre, Menthe poivree, Mentha piperita var vulgaris, Our Lady's mint, pebermynte (Danish), peppermint oil, Pfefferminz (German), Porminzen, Schmecker, spearmint (Mentha spicata L.), water mint (Mentha aquatica), white peppermint, WS(R) 1340.

Note: Mentha x villosa L. is a different species of mint with a similar appearance, used primarily as a flavoring agent.

Background

Peppermint is a flowering plant that grows throughout Europe and North America. Peppermint is widely cultivated for its fragrant oil. Peppermint oil has been used historically for numerous health conditions, including common cold symptoms, cramps, headache, indigestion, joint pain, and nausea. Peppermint leaf has been used for stomach/intestinal disorders and for gallbladder disease.

Mint plants such as peppermint and spearmint have a long history of medicinal use, dating to ancient Egypt, Greece, and Rome. The scientific name for peppermint (Mentha x piperita) is derived from the name Mintha, a Greek mythological nymph who transformed herself into the plant, and from the Latin piper meaning "pepper." Peppermint is believed to be a cross (hybrid) between spearmint and water mint.

Peppermint oil is available in bulk herb oil, enteric-coated capsules, soft gelatin capsules, and in liquid form. In small doses, such as in tea or chewing gum, peppermint is generally believed to be safe in healthy, non-pregnant, non-allergic adults. The United States is a principal producer of peppermint, and the largest markets for peppermint oil are manufacturers of chewing gum, toothpaste, mouthwash, and pharmaceuticals.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Antispasmodic (colonic, esophageal, gastric spasm): Peppermint oil may be beneficial in reducing intestinal spasm during and after endoscopic procedures. However, more research is needed before a firm recommendation can be made.
Grade: B

Cough: There is currently insufficient evidence available to determine the efficacy of peppermint oil in the management of cough.
Grade: B

Indigestion (non-ulcer dyspepsia): There is preliminary evidence that a combination of peppermint oil and caraway oil may be beneficial for dyspepsia (heartburn) symptoms. It should be noted that heartburn can actually be a side effect of taking oral peppermint oil. Patients with chronic heartburn should be evaluated by a qualified healthcare provider.
Grade: B

Irritable bowel syndrome (IBS): Peppermint may improve irritable bowel syndrome (IBS) symptoms. Additional study is necessary before a strong recommendation can be made.
Grade: B

Tension headache: Application of diluted peppermint oil to the forehead and temples has been tested in people with headache. It is not clear if this is an effective treatment.
Grade: B

Abdominal distention: There is not enough available scientific evidence in this area.
Grade: C

Asthma: There is not enough available scientific evidence in this area.
Grade: C

Bad breath: Early research suggests that cleaning the mouth with an essential oil mixture of diluted tea tree, peppermint, and lemon may improve bad breath in intensive care unit patients.
Grade: C

Breast tenderness (preventing cracked nipples): Using peppermint gel during breastfeeding may help prevent cracked nipples. Additional research is needed to confirm these early findings.
Grade: C

Functional bowel disorders: Early research suggests that peppermint oil taken by mouth may improve gastric emptying. Therefore, peppermint oil may help treat digestive disorders. However, this research is early, and additional studies are needed.
Grade: C

Nasal congestion: Menthol, a constituent of peppermint oil, is sometimes included in inhaled preparations for nasal congestion, including "rubs" that are applied to the skin and inhaled. High quality research is lacking in this area.
Grade: C

Nausea: There is not enough evidence to recommend for or against the use of peppermint oil in the treatment of nausea. Further research is needed before a strong recommendation can be made.
Grade: C

Post-herpetic neuralgia (herpes zoster pain): There is currently insufficient research available to determine if there are benefits of peppermint oil in the treatment of post-herpetic neuralgia.
Grade: C

Stroke recovery: Aromatherapy with peppermint oil, lavender, and rosemary has been used to reduce shoulder pain and improve motor power in patients recovering from strokes. Although treatment appeared to have beneficial effects, it is unclear if this was caused by peppermint oil or the other two herbs. Additional studies using peppermint oil alone are needed.
Grade: C

Tuberculosis: There is not enough available scientific evidence in this area.
Grade: C

Urinary tract infection: Peppermint tea added to other therapies has been used in the treatment of urinary tract infections. It is not clear if this is an effective treatment, and it is not recommended to rely on peppermint tea alone to treat this condition.
Grade: C

Vigilance improvement in brain injury (aromatherapy): There is currently a lack of sufficient evidence to recommend for or against the use of peppermint oil to affect vigilance following brain injuries.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Anorexia, antacid, antiviral, arthritis, asthma, bile duct disorders, cancer, chicken pox, cholelithiasis (gallstones), common cold, cramps, dysmenorrhea (menstrual pain), enteritis, fever, fibromyositis, gallbladder disorders, gas (flatulence), gastritis, gonorrhea, ileus (post-operative), inflammation of oral mucosa, influenza, intestinal colic, lice, liver disorders, local anesthetic, morning sickness, motility disorders, mouth and throat inflammation, mosquito repellant, mouthwash, musculoskeletal pain, neuralgia (nerve pain), pruritus (itching), respiratory infections, rheumatic pain, sun block, tendonitis, toothache, tuberculosis, urticaria (hives), vomiting.

Dosing

Adults (18 years and older)

Peppermint oil should be used cautiously, as doses of the constituent menthol over 1 gram per kilogram of body weight may be deadly. For intestinal/digestion disorders, doses of 0.2 to 0.4 milliliters of peppermint oil in enteric-coated capsules, dilute preparations, or suspensions taken three times daily by mouth have been used or studied. Lozenges containing 2 to 10 milligrams of peppermint oil have been used. 10% peppermint oil (in methanol) has been applied to the skin (forehead and temples) multiple times per day for headache relief. Some sources recommend using peppermint oil preparations on the skin no more than 3 to 4 times per day. For inhalation, 3 to 4 drops of oil added to 150 milliliters of hot water and inhaled up to three times per day or 1% to 5% essential oil as a nasal ointment has been used to relieve congestion.

As an infusion, 3 to 6 grams of peppermint leaf has been used daily. Doses of other liquid preparations depend on concentration, for example, 2 to 3 milliliters of tincture (1:5 in 45% ethanol) three times daily or 1 milliliter of spirits (10% oil and 1% leaf extract, mixed with water) has been taken. Various doses of dried herb extract have also been used, ranging from 0.8 gram daily up to 4 grams taken three times daily, although safety is not clear.

Children (younger than 18 years)

There is not enough scientific information available to recommend the safe use of peppermint leaf or oil in children.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Allergic/hypersensitivity reactions may occur from using peppermint or menthol by mouth or on the skin, including throat closing (laryngeal spasm), breathing problems (bronchial constriction/asthma symptoms), or skin rash/hives/contact dermatitis. People with known allergy/hypersensitivity to peppermint leaf or oil should avoid peppermint products.

Side Effects and Warnings

Peppermint oil may be safe in small doses, although multiple adverse effects are possible. When used on the skin, peppermint oil has been associated with allergic/hypersensitivity reactions, skin rash/hives/contact dermatitis, mouth ulcers/sores, chemical burn, and eye irritation. Lung injury has occurred following an injection of peppermint oil. Peppermint oil taken by mouth may cause headache, dizziness, heartburn, anal burning, slow heart rate, or muscle tremor. Very large doses of peppermint oil taken by mouth have resulted in muscle weakness, brain damage, and seizure.

Peppermint oil should be used cautiously by people with G6PD deficiency or gallbladder disease. Use in infants or children is not recommended due to potential toxicity.

Menthol, a constituent of peppermint oil that is included in mouthwashes, toothpastes, mentholated cigarettes, and decongestant "rubs" or lozenges, has been associated with multiple adverse effects, such as serious breathing difficulties, asthma, skin bruising (purpura), and mouth sores. Although small amounts may be safe in non-allergic adults, higher doses may be deadly in humans or cause brain damage. Use on the skin may also cause rash, severe skin damage (necrosis), or kidney damage (interstitial nephritis). Inhalation of large doses of menthol may lead to dizziness, confusion, muscle weakness, nausea, or double vision.

Pregnancy and Breastfeeding

Peppermint oil and menthol should be avoided during pregnancy and breastfeeding due to insufficient information and potential for toxicity.

Interactions

Interactions with Drugs

Peppermint oil by mouth may increase blood levels of the drugs felodipine (Plendil®) and simvastatin (Zocor®). Peppermint oil increases levels of cyclosporine in the blood. Peppermint oil used on the skin with 5-fluorouracil (5-FU) may increase the rate of absorption of 5-FU.

Peppermint oil may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. Patients using these medications should check the package insert and speak with a qualified healthcare provider including a pharmacist about possible interactions.

Peppermint may also interact with antacids, other calcium channel blockers, or drugs that lower high blood pressure. Caution is advised.

Interactions with Herbs and Supplements

Peppermint oil may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may be too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system. Patients using these medications should check the package insert and speak with a qualified healthcare provider including a pharmacist about possible interactions.

Peppermint may also interact with herbs and supplements that raise or lower blood pressure or have antacid properties. Caution is advised.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Rae Abrams, PharmD (University of Rhode Island); Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Nicole Giese, MS (Natural Standard Research Collaboration); Mary Giles, PharmD (University of Rhode Island); David Keifer, MD (University of Arizona); Catherine DeFranco Kirkwood, MPH, CCCJS-MAC (MD Anderson Cancer Center); Michelle Miranda, PharmD (University of Rhode Island); Adrianne Rogers, MD (Harvard Medical School); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Northeastern University).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Behrends M, Beiderlinden M, Peters J. Acute lung injury after peppermint oil injection. Anesth Analg 2005;101(4):1160-1162.

Cappello G, Spezzaferro M, Grossi L, et al. Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial. Dig Liver Dis 2007 Jun;39(6):530-6.

Hiki N, Kurosaka H, Tatsutomi Y, et al. Peppermint oil reduces gastric spasm during upper endoscopy: a randomized, double-blind, double-dummy controlled trial. Gastrointest Endosc 2003;57(4):475-482.

Hur MH, Park J, Maddock-Jennings W et al. Reduction of mouth malodour and volatile sulphur compounds in intensive care patients using an essential oil mouthwash. Phytother Res 2007 Jul;21(7):641-3.

Inamori M, Akiyama T, Akimoto K, et al. Early effects of peppermint oil on gastric emptying: a crossover study using a continuous real-time 13C breath test (BreathID system). J Gastroenterol 2007 Jul;42(7):539-42. Epub 2007 Jul 25.

Kalavala M, Hughes TM, Goodwin RG, et al. Allergic contact dermatitis to peppermint foot spray. Contact Dermatitis. 2007 Jul;57(1):57-8.

Kline RM, Kline JJ, Di Palma J, et al. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J Pediatr 2001;138(1):125-128.

Liu JH, Chen GH, Yeh HZ, et al. Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol 1997;32(6):765-768.

Madisch A, Heydenreich CJ, Wieland V, et al. Treatment of functional dyspepsia with a fixed peppermint oil and caraway oil combination preparation as compared to cisapride. A multicenter, reference-controlled double-blind equivalence study. Arzneimittelforschung 1999;49(11):925-932.

Melli MS, Rashidi MR, Nokhoodchi A, et al. A randomized trial of peppermint gel, lanolin ointment, and placebo gel to prevent nipple crack in primiparous breastfeeding women. Med Sci Monit 2007 Sep;13(9):CR406-411.

Pittler MH, Ernst E. Peppermint oil for irritable bowel syndrome: a critical review and meta-analysis. Am J Gastroenterol 1998;93(7):1131-1135.

Shin BC, Lee MS. Effects of aromatherapy acupressure on hemiplegic shoulder pain and motor power in stroke patients: a pilot study. J Altern Complement Med 2007 Mar;13(2):247-51.

Shkurupii VA, Kazarinova NV, Ogirenko AP, et al. [Efficiency of the use of peppermint (Mentha piperita L) essential oil inhalations in the combined multi-drug therapy for pulmonary tuberculosis]. Probl Tuberk 2002;(4):36-9.

Tate S. Peppermint oil: a treatment for postoperative nausea. J Adv Nurs 1997;26(3):543-549.

Veal L. The potential effectiveness of essential oils as a treatment for headlice. Pediculus humanus capitis. Complement Ther Nurs Midwifery 1996;2(4):97-101.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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