Peppermint

Peppermint is a plant also known as Brandy Mint, Extract of Mentha Piperita, Extract of Peppermint, Extrait de Feuilles de Menthe de Poivrée, Herba Menthae, Menta Piperita, Mentha arvensis, Mint, Mint Balm, Paparaminta, Peppermint Extract, Peppermint Leaf, Peppermint Leaf Extract, Peppermint Oil, Western Peppermint, and other names.

Peppermint has been used in alternative medicine as a possibly effective aid in treating irritable bowel syndrome, breast feeding discomfort, heartburn, migraines, tension headache and to reduce spasms during endoscopy and colon exams.

Peppermint has also been used to treat nausea and recovery after surgery. However, research has shown that peppermint may not be effective in treating these conditions.

Other uses not proven with research have included dental plaque, bad breath, hot flashes, pain caused by shingles, itchy skin, toothaches, infections, muscle pain, and others.

It is not certain whether peppermint is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Peppermint should not be used in place of medication prescribed for you by your doctor.

Peppermint is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Peppermint may also be used for purposes not listed in this product guide.

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before using peppermint, talk to your healthcare provider. You may not be able to use peppermint if you have certain medical conditions.

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have:

• diarrhea; or
• a condition in which the stomach does not produce acid.

Peppermint is considered likely safe to use during pregnancy in amounts normally found in food. However, it is not known if it can harm a baby in larger amounts. Do not use this product in large amounts, without medical advice if you are pregnant.

Peppermint is considered likely safe to use while breast-feeding if it is in amounts normally found in food. Do not use this product in large amounts, without medical advice if you are breast-feeding a baby..

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use peppermint, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Do not use different formulations of peppermint (such as tablets, liquids, and others) at the same time, unless specifically directed to do so by a health care professional. Using different formulations together increases the risk of an overdose.

Call your doctor if the condition you are treating with peppermint does not improve, or if it gets worse while using this product.

Store at room temperature away from moisture and heat.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra peppermint to make up the missed dose.

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use peppermint, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Do not use different formulations of peppermint (such as tablets, liquids, and others) at the same time, unless specifically directed to do so by a health care professional. Using different formulations together increases the risk of an overdose.

Call your doctor if the condition you are treating with peppermint does not improve, or if it gets worse while using this product.

Store at room temperature away from moisture and heat.

Peppermint oil may influence metabolism of certain drugs, including felodipine and simvastatin, via inhibition of the cytochrome P450 (CYP-450) enzyme system, increasing pharmacologic and adverse reactions. Absorption of caffeine may be delayed by menthol. Decreased cyclosporine levels have been reported with consumption of a tea containing peppermint and 8 other herbs.

Several comprehensive reviews of peppermint's therapeutic activity have appeared in the literature. 14 , 15

The relative safety of peppermint and the availability of randomized clinical trials in humans render data from animal trials largely irrelevant. 2 , 16

Animal models support the ability of peppermint oil to reduce nausea, but trials in humans have used poor methodology. 17 Trials have shown that menthol and peppermint oil are more effective than placebo, 18 , 19 but they are not more effective than standard treatments. 17 , 19 An allosteric effect of menthol and peppermint oil on the 5-HT 3 receptor may explain its antiemetic action; however, the effect was weak and may not be clinically relevant. 20

Peppermint oil has been used traditionally in the management of gallstones. A choleretic action of the oil has been described. 13

Peppermint oil alone and in combination with other herbs was more effective than placebo in reducing symptoms of dyspepsia in adults and children. 21 , 22 , 23 , 24 , 25 , 26 Gastric emptying was accelerated by peppermint oil added to a test meal. 27

Patients should be administered peppermint oil only after examination has definitely diagnosed IBS with no associated organic lesions and after other diagnoses have been eliminated. 20 Reviews of peppermint oil's role in IBS affirm its effectiveness compared with placebo and as standard treatment in patients with nonserious constipation or diarrhea to reduce global symptoms, pain, and bloating. 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 A comparison of 2 delayed-release preparations of peppermint oil found that Colpermin delivered the oil more effectively than Mintec . 39 Several studies of a combination product, Iberogast , which includes peppermint, have found effects on intestinal physiology in mice, 40 as well as antioxidant effects. 41

Peppermint oil exerts an antispasmodic action on smooth muscle, considered to be caused by calcium channel blockade. 13 , 42 , 43 The oil has been useful in patients with colonic 16 , 43 , 44 , 45 and esophageal spasm 46 , 47 , 48 and in endoscopy. 43 , 48 , 49 , 50

Menthol is available in a variety of nonprescription products (eg, chest rubs, inhalations, lozenges, syrups) for the treatment of colds and related congestion and cough. A decrease in cough was demonstrated in children when inhalation of menthol was compared with placebo. 51 The mechanism by which menthol may act as an antitussive is still speculative 52 ; however, anion transporters in airway epithelial cells have been implicated. 53 Menthol inhalation can cause a subjective nasal decongestant effect without any objective decongestant action. 52 In lozenges, the main action of menthol appears to be a subjective sensation of improved nasal airflow. 52 No effect on forced expiratory volume was shown in patients with chronic mild asthma using nebulized menthol versus placebo. However, the menthol group used fewer bronchodilators and had fewer wheezing episodes. 54

In low concentrations, topical application of menthol causes a cooling sensation, while in higher concentrations it causes local anesthesia and irritation. 52 , 55 , 56 These attributes of menthol have been used to construct pain models. 55 , 56 The irritant effect of menthol causes local vasodilation. 52 , 56 , 57 This effect has been used to aid penetration of topical drugs; higher diffusion of tetracaine has been demonstrated with menthol-enhanced gel. 57 Menthol's sensory effects are utilized in commercial topical musculoskeletal products. 52 , 58

The cooling effect of menthol has been explained by its direct effect on the “cold receptor” TRPM8, a distant relative of the vanilloid receptors that sense pain and noxious high temperatures. 59 , 60 , 61 , 62 Binding of menthol to TRPM8 induces calcium release from the endoplasmic reticulum and Golgi apparatus in the cell. 60 Menthol is an agonist of TRPM8. 59

Peppermint oil possesses antibacterial activity in vitro. Different commercial preparations exhibit various activities. 5 The essential oil and its constituents (eg, menthol, menthone) displayed activity against Escherichia coli , Helicobacter pylori , methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus , Pseudomonas species, Enterobacter aerogenes , and Salmonella enteritidis . 63 , 64 , 65 Weak antifungal activity also has been shown in vitro. 65 Biofilm development and growth of Listeria was inhibited by peppermint extracts, as well as those of rosemary and tea tree. 66

Aqueous extracts of peppermint and several other Lamiaceae inhibited HIV through interference with viral entry without altering cell viability. Several other enveloped viruses were similarly affected. 67

Menthol was found to synergize with vitamin D in blocking the growth of prostate cancer cells by cooperatively modulating expression of bcl-2 and p21 proteins. 68 A reduction in incidence and multiplicity of induced lung cancer has been shown in mice. 69

Peppermint oil is being studied as aromatherapy for dementia by the Cochrane Dementia and Cognitive Improvement Group. 70 Peppermint oil in ethanol reduced pain sensitivity experienced with headaches. 71 Peppermint oil aroma has shown an antisoporific effect. 72 , 73 Memory performance was enhanced by peppermint oil, but not oil of ylang-ylang. 74 However, aromatherapy was no better than placebo in averting postoperative nausea. 19 Menthone promotes ambulation in mice; this effect is apparently mediated by the dopamine system, because it is additive with bupropion, which inhibits dopamine uptake, and is blocked by dopamine antagonists. 75 Neurochemical profiling of mint extracts in gamma–aminobutyric acid and antioxidant systems has been performed. 76

Peppermint oil protected mice against experimental hepatic injury by arsenic. 77

Head lice were successfully treated with a lotion incorporating peppermint and eucalyptus oil. 78 Giardia trophozoites were inhibited by peppermint extracts. 79

Peppermint water has been studied for prevention of nipple cracks in breast-feeding women. 80

Peppermint oil has been used as a carminative in clinical studies at doses of 0.1 to 0.24 mL. 16 , 81 , 82 , 83 Doses of peppermint oil of up to 1,200 mg in enteric-coated tablets have been used in treating IBS 45 , 46 ; 40 mL of peppermint oil has been added to barium suspension 23 ; and 8 mL of peppermint oil also has been administered intraluminally during colonoscopy. 22

Because of the oil's ability to relax GI smooth muscle, patients with hiatus hernia may experience worsening symptoms while ingesting peppermint-containing preparations. 42

Enteric-coated capsules should be swallowed whole and not crushed, broken, or chewed because peppermint oil can irritate the mouth, esophagus, and stomach. Tablets should be taken 30 to 60 minutes before meals on an empty stomach. 24 , 84

LactMed Record Number

935

Last Revision Date

20170411

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