Scientific Name: Capsicum
Other Names: African Pepper, Bird Pepper, Capsicum annuum, Capsicum frutescens, Chili Pepper, Goat's Pod, Mexican Chillies, Paprika, Red Pepper, Tabasco Pepper, Zanzibar Pepper

Who is this for?

Uses

Although capsicum may cause heartburn for many individuals, its most common oral use is to treat digestive complaints such as colic, gas, indigestion, and poor appetite. Chemicals in capsicum have been shown to increase not only the amount of acid the stomach produces, but also the blood flow in the lining of the stomach and intestines. Both these effects may improve digestion, but they may also irritate the stomach.

In folk medicine, oral capsicum has been used for relieving colds, fever, and headaches. Because it causes the eyes and nose to run, it may indeed help to relieve congestion and associated headaches. Recently, several studies in animals and a few studies in humans show that taking capsicum by mouth may increase the body's production of heat and energy for about a half hour after it is taken or eaten. This effect may make capsicum useful for treating obesity. Because capsicum may also affect the breakdown of carbohydrates in food, blood sugar levels may not fluctuate widely after meals. This effect may be beneficial in helping to control diabetes. However, none of these possible uses for capsicum has been proved by clinical research.

Capsicum contains several active ingredients, including oily substances called oleoresins. One of the main oleoresins, capsaicin, is used topically as a counterirritant. Substances that cause relatively minor surface irritation, counterirritants increase the flow of blood at the areas where they are applied, producing warmth on the skin surface and using up local supplies of a neurotransmitter known as substance P. Neurotransmitters are chemicals that carry messages from nerve cells to other cells. Substance P is responsible primarily for conducting pain signals. Because counterirritants such as capsicum reduce the amount of substance P, signals from more serious pain are interrupted. Topical capsaicin has been used to treat arthritis pain and it may also be useful for relieving pain from fibromyalgia and shingles. Because chemicals in capsicum have shown some antifungal properties in laboratory studies, they may be useful for treating fungal skin conditions such as athlete's foot, Some scientific evidence also supports the topical use of capsicum for itching associated with conditions such as psoriasis, but this use is less common.

Individuals with allergies to hot peppers of any kind should avoid using capsicum products.

Pregnant women should also avoid taking capsicum because studies have not been performed to test the safety of supplemental capsicum for pregnant women or developing babies. Women who are breastfeeding should not take capsicum by mouth because it passes into breast milk. Cases have been reported of infants who developed reddened or irritated skin after their mothers ate large amounts of capsicum while breastfeeding.

Individuals with gastrointestinal (GI) conditions caused by irritation or infection should not use capsicum orally because it can further irritate the GI tract.

Topical forms of capsicum should be used only on unbroken skin--never on cuts or scraped areas. Skin treated with capsicum should be protected from excessive heat and direct sunlight and it should be left open--not bandaged. If a rash or burning sensation develops, capsicum should be washed off with cool water and not reapplied.

Precautions

For reasons that are not clear, individuals who have allergies to latex or to tropical fruits such as bananas or kiwi may also be allergic to capsicum.

Topical capsicum has not been tested in very young children. Because it may irritate sensitive skin, it should not be used for children under 2 years old and used with caution for older children.

Handling fresh or dried capsicum fruits can result in red, irritated, itchy hands. Inhaling it can cause coughing, sneezing, or breathing problems. Individuals who work in growing or packing capsicum or in cooking with it are advised to wear gloves and face masks.

Topical capsicum may be irritating if it is allowed to remain on the hands after application to other parts of the body. Hands should be washed thoroughly after application. Individuals who use their hands to apply capsicum should avoid touching their faces and eyes even after their hands are washed, because traces of the oily chemicals in capsicum may remain on the skin. Some manufacturers of capsicum topical forms provide disposable applicators or recommend using disposable plastic gloves to apply the cream.

What side effects should I watch for?

Major Side Effects

The eyes and mucous tissues (such as inside the mouth and in the genital areas) are especially sensitive to capsicum. It can cause irritation, temporary blindness, and visual disturbances, if it gets into the eyes. The nose, mouth, and throat can also be irritated by exposure to capsicum.

Taken in a very high amount or for extensive periods of time, capsicum may also cause inflammation of the stomach or intestines. In rare cases, liver damage, kidney damage, or both has been reported from excessive oral use.

Eating large amounts of capsicum may damage taste buds and reduce the ability to taste foods and beverages.

Less Severe Side Effects

Chemicals in capsicum are irritating to the mouth, so many individuals cannot eat individuals cannot eat capsicum comfortably. Oral capsicum may also cause:

• Reddened face
• Runny nose
• Sweating
• Upset stomach
• Watery eyes

Individuals using topical capsicum may feel heat at the application site. Some users report stinging or burning pain--especially during the first few days of treatment. If irritation is intense, if a rash develops, or if pain lasts longer than a day or two, the capsicum preparation should be stopped.

What interactions should I watch for?

Prescription Drugs

Eating or taking capsicum by mouth causes an increase in the production of stomach acid that could interfere with drugs used to suppress stomach acid. Examples of acid-suppressing drugs are:

• H2 blockers such as cimetidine, famotidine, nizatidine, and ranitidine
• Proton pump inhibitors such as Nexium and omeprazole

In clinical studies and case reports, oral capsicum has been shown to increase the time blood needs to clot. When it is taken with antiplatelet or anticoagulant drugs, the effect of the drug may be increased, resulting in uncontrolled bleeding.

• Antiplatelet drugs include clopidogrel and Ticlid
• Anticoagulants include heparin and warfarin

When topical capsicum was used at the same time that some patients were also taking a type of high blood pressure medication known as an ACE Inhibitor, the tendency to have a cough was increased. ACE inhibitors include benazepril, captopril, enalapril, fosinopril, lisinopril and quinapril.

In theory, capsicum may interfere with some of the neurotransmitters that are also affected by a type of antidepressant drugs known as MAO inhibitors (MAOIs). Altered drug effects may result. MAOIs include:

• Marplan
• Nardil
• tranylcypromine (Parnate)

Selegiline (Eldepryl) and rasagiline (Azilect), drugs which are related to the MAOI antidepressants and which are used to treat Parkinson's disease, also should not be taken with capsicum.

When oral capsicum is used with prescription drugs that promote sleepiness, the effects of the drug may be exaggerated, resulting in sedation or mental impairment. Prescription drugs that can cause sleepiness include:

• Anticonvulsants such as carbamazepine (Tegretol), phenytoin (Dilantin), and valproic acid (Depakote)
• Barbiturates such as phenobarbital
• Benzodiazepines such as alprazolam, diazepam, and lorazepam
• Drugs for insomnia such as Lunesta, Rozerem, zaleplon, and zolpidem
• Tricyclic antidepressants such as amitriptyline, amoxapine, doxepin, and nortriptyline

While a single dose of capsicum had little effect on theophylline levels, some animal studies have shown that capsicum taken orally on a daily basis may increase blood levels of the drug theophylline. Used to treat asthma and chronic obstructive pulmonary disease (COPD), theophylline may cause problems if blood levels are too high. Symptoms of high theophylline levels may include nausea, shakiness, and a fast heartbeat. . Individuals who take theophylline should check with a doctor before starting to take capsicum.

Non-prescription Drugs

Eating or taking capsicum by mouth causes an increase in the production of stomach acid that could interfere with drugs used to suppress stomach acid. Examples of non-prescription acid-suppressing drugs are:

• Antacids such as Maalox, Rolaids, or Tums
• H2 blockers such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac-75)
• The proton pump inhibitor, omeprazole (Prilosec-OTC)

In studies, blood levels of aspirin were much less than expected in laboratory animals given capsicum chronically and then given aspirin. As a result, aspirin may not be effective in relieving pain. In addition, both capsicum and aspirin may decrease the blood's ability to clot. If they are taken together on a regular basis, uncontrolled bleeding may occur.

The sleep-producing effects of over-the-counter products containing diphenhydramine or doxylamine can be enhanced by taking oral capsicum at the same time. Diphenhydramine and doxylamine are contained in many over-the-counter sleep aids as well as in some cough and cold products, therefore caution should be used when taking these medications with oral capsicum because excessive drowsiness may result.

Herbal Products

Theoretically, if oral capsicum is used with other herbs that affect blood clotting, excessive bleeding may occur. Some of the most common herbal products that might inhibit blood clotting are:

• Danshen
• Devil's claw
• Garlic
• Ginger
• Gingko
• Ginseng
• Horse chestnut
• Papain
• Red clover
• Saw palmetto

Oral capsicum may cause excessive sleepiness if taken with other sedating herbs such as:

• Catnip
• Hops
• Kava
• St. John's wort
• Valerian

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how capsicum interacts with drugs, other herbals, and foods and the severity of those interactions, please use our Drug Interactions Checker to check for possible interactions.

Should I take it?

Capsicum is the general name given to several species of hot peppers believed to have originated in Central and South America. Now cultivated in most temperate and tropical areas, capsicum generally grows as small bushes with hollow, seedy fruits. The plants cross pollinate easily, so many different hybrid species have adapted for different environments. The fruits, or peppers, have varying degrees of hotness depending on the type of capsicum and the growing conditions. Capsicum is common as a spicy flavoring for foods, and the peppers--often with the seeds removed--are eaten as a vegetable in many parts of the world. Among other nutrients, capsicum contains potassium and vitamin C.

Usually, the peppers are dried and ground into powder for medicine. The active ingredients include oily compounds called oleoresins, which temporarily irritate the eyes, so they are used in self-defense sprays. Interestingly, birds do not have the ability to taste capsicum. Therefore, it may be added to birdseed or feed for commercially-raised birds as a way to keep small mammals from eating the bird feed.

Dosage and Administration

In the United States, oral supplemental capsicum is available mostly as capsules. Oral dosing of capsicum varies considerably according to the condition being treated. In studies, daily doses of supplemental oral capsicum ranged from about 30 mg to 400 mg. Amounts of capsicum obtained from the diet may be much higher. Individuals who choose to take an oral capsicum product should follow the package directions for the condition being treated.

The U. S. Food and Drug Administration (FDA) has approved creams and ointments containing up to 0.075% of capsaicin as over-the-counter remedies for arthritis pain and muscle soreness. Generally, topical capsicum preparations must be used several times a day to be effective, and their full effectiveness may take up to 4 weeks to develop. The individual manufacturer's directions for doses and scheduling of doses should be followed carefully.

Summary

In the United States, capsicum is used mainly as a topical product to relieve pain and sometimes itching. By mouth, it may have some usefulness in relieving digestive conditions such as indigestion. Also taken orally to treat nasal congestion and headaches, it may have a role as add-on treatment for diabetes and obesity.

Risks

Individuals who are allergic to hot peppers, those with GI conditions, children, and women who are pregnant or breastfeeding should avoid taking supplemental amounts of capsicum by mouth. Individuals with allergies to latex or tropical fruits may be sensitive to capsicum, as well. After handling capsicum plants or applying topical forms of capsicum, the hands should be washed carefully and the eyes and face should not be touched. If a rash or intense pain occurs, topical capsicum should be stopped.

Side Effects

In rare reports, very large amounts of capsicum or capsicum taken by mouth for very long amounts of time have been associated with liver or kidney damage. Orally, capsicum may irritate the stomach, worsening inflammatory or infective stomach conditions. The eyes, mouth, nose, and throat may also be irritated, producing results such as a runny nose and watering eyes. Topical forms of capsicum may cause burning or itching at the places they are applied. They should be applied only to unbroken skin.

Interactions

Oral capsicum can interfere with prescription and non-prescription drugs and other herbal products that:

• Cause sedation
• Delay or reduce blood clotting
• Inhibit monoamine oxidase
• Lower blood pressure
• Suppress stomach acid

Last Revised July 16, 2008

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Last Revised July 16, 2008

Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.

In general, herbal products are not subject to review or approval by the U.S. Food and Drug Administration (FDA). They are not required to be standardized, meaning that the amounts of active ingredients or contaminants they contain may vary between brands or between different batches of the same brand. Not all of the risks, side effects, or interactions associated with the use of herbal products are known because few reliable studies of their use in humans have been done.

This information is provided for your education only. Please share this information with your healthcare provider and be sure that you talk to your doctor and pharmacist about all the prescription and non-prescription medicines you take before you begin to use any herbal product.

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