White pepper grows in tropical Asian countries. Black pepper and white pepper both come from the same plant. But they are prepared differently. Black pepper is made by cooking the dried unripe fruit. White pepper is made by cooking and drying the ripe seeds.
People take white pepper by mouth to treat upset stomach, diarrhea, and many other conditions, but there is no good scientific evidence to support these uses.
White pepper is added to foods and drinks to add flavor.
White pepper essential oil is used in aromatherapy.
Is It Effective?
NatMed Pro rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
- Diarrhea.
- Cancer.
- A bacterial infection that causes diarrhea (cholera).
- Malaria.
- Pain.
- Upset stomach.
- Other conditions.
More evidence is needed to rate white pepper for these uses.
Is it Safe?
White pepper contains a chemical called piperine. This chemical seems to have many effects in the body. It seems to reduce pain, improve breathing, and reduce inflammation. Piperine also seems to improve brain function, but it is not clear how.
When taken by mouth: White pepper is LIKELY SAFE when taken in amounts commonly found in foods.
White pepper is POSSIBLY SAFE when taken appropriately as medicine. White pepper might cause an allergic reaction in some patients, although this is rare. White pepper might also cause a burning aftertaste. Piperine, a component of white pepper, has been reported to cause fast heart rate, nausea, headache, coughing, sneezing, and runny nose when used as a nasal spray.
Special Precautions & Warnings:
Pregnancy: White pepper is LIKELY SAFE when taken by mouth in amounts commonly found in foods. There isn't enough reliable information to know if taking white pepper as medicine or applying white pepper oil to the skin is safe while pregnant. Stay on the safe side and stick to food amounts.
Breast-feeding: White pepper is LIKELY SAFE when taken by mouth in amounts commonly found in foods. There isn't enough reliable information to know if taking white pepper as medicine is safe while breast-feeding. Stay on the safe side and stick to food amounts.
Children: White pepper is LIKELY SAFE when taken by mouth in amounts commonly found in foods. It is POSSIBLY UNSAFE when taken by mouth in large amounts. Deaths have been reported in children.
Bleeding conditions: Piperine, a chemical in white pepper, might slow blood clotting. In theory, taking white pepper in amounts greater than those in food might increase the risk of bleeding in people with bleeding disorders.
Diabetes: White pepper might affect blood sugar levels. In theory, taking white pepper in amounts greater than those in food might affect blood sugar control in people with diabetes. Dosing adjustments for diabetes medications might be needed.
Surgery: Piperine, a chemical in white pepper, might slow blood clotting and affect blood sugar levels. In theory, white pepper might cause bleeding complications or affect blood sugar levels during surgery. You should stop taking white pepper in amounts greater than those in food at least 2 weeks before surgery.
Amoxicillin (Amoxil, Trimox)
Interaction Rating=Minor Be watchful with this combination.
White pepper contains a chemical called piperine. Piperine might increase levels of amoxicillin in the blood. In theory, taking white pepper with amoxicillin might increase the effects and side effects of amoxicillin. However, there is not enough known about this potential interaction to know if it is a big concern.
Carbamazepine (Tegretol)
Interaction Rating=Minor Be watchful with this combination.
White pepper might increase the amount of carbamazepine (Tegretol) absorbed by the body. It might also decrease how quickly the body breaks down and gets rid of carbamazepine. This could increase how much carbamazepine is in the body and potentially increase the chance of side effects. However, there is not enough known about this potential interaction to know if it is a big concern.
Cefotaxime (Claforan)
Interaction Rating=Minor Be watchful with this combination.
White pepper contains a chemical called piperine. Piperine might increase levels of cefotaxime in the blood. In theory, taking white pepper with cefotaxime might increase the effects and side effects of cefotaxime. However, there is not enough known about this potential interaction to know if it is a big concern.
Cyclosporine (Neoral, Sandimmune)
Interaction Rating=Moderate Be cautious with this combination.
White pepper contains a chemical called piperine. Piperine might increase levels of cyclosporine in the body. In theory, taking white pepper with cyclosporine might increase the effects and side effects of cyclosporine.
Lithium
Interaction Rating=Moderate Be cautious with this combination.
White pepper might have an effect like a water pill or "diuretic." Taking white pepper might decrease how well the body gets rid of lithium. This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.
Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Interaction Rating=Moderate Be cautious with this combination.
Some medications are changed and broken down by the liver. White pepper might decrease how quickly the liver breaks down some medications. Taking white pepper along with some medications that are broken down by the liver might increase the chance of side effects from some medications. Before taking white pepper, talk to your healthcare provider if you are taking any medications that are changed by the liver.
Some medications changed by the liver include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), haloperidol (Haldol), imipramine (Tofranil), metoprolol (Lopressor, Toprol XL), ondansetron (Zofran), paroxetine (Paxil), risperidone (Risperdal), tramadol (Ultram), venlafaxine (Effexor), and others.
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Interaction Rating=Moderate Be cautious with this combination.
Some medications are changed and broken down by the liver. White pepper might decrease how quickly the liver breaks down some medications. Taking white pepper along with some medications that are broken down by the liver might increase the chance of side effects from some medications. Before taking white pepper, talk to your healthcare provider if you are taking any medications that are changed by the liver.
Some medications changed by the liver include some calcium channel blockers (diltiazem, nicardipine, verapamil), chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), glucocorticoids, cisapride (Propulsid), alfentanil (Alfenta), fentanyl (Sublimaze), losartan (Cozaar), fluoxetine (Prozac), midazolam (Versed), omeprazole (Prilosec), ondansetron (Zofran), propranolol (Inderal), fexofenadine (Allegra), and many others.
Medications for diabetes (Antidiabetes drugs)
Interaction Rating=Moderate Be cautious with this combination.
White pepper contains a chemical called piperine. Some research shows that piperine might decrease blood sugar levels. In theory, white pepper might cause an interaction with diabetes medications resulting in blood sugar levels going too low. Until more is known, monitor your blood sugar closely if you take white pepper. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
Medications moved by pumps in cells (P-Glycoprotein Substrates)
Interaction Rating=Moderate Be cautious with this combination.
Some medications are moved by pumps in cells. White pepper might make these pumps less active and increase how much of some medications get absorbed by the body. In theory, this might cause more side effects from some medications.
Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, digoxin, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating=Moderate Be cautious with this combination.
White pepper contains a chemical called piperine. Piperine might slow blood clotting. In theory, taking white pepper along with medications that also slow clotting might increase the chances of bruising and bleeding.
Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Nevirapine (Viramune)
Interaction Rating=Moderate Be cautious with this combination.
White pepper contains a chemical called piperine. Piperine might increase levels of nevirapine in the body. In theory, taking white pepper with nevirapine might increase the effects and side effects of nevirapine. However, there is not enough known about this potential interaction to know if it is a big concern.
Pentobarbital (Nembutal)
Interaction Rating=Moderate Be cautious with this combination.
White pepper contains a chemical called piperine. Piperine might increase sleepiness caused by pentobarbital. In theory, taking white pepper with pentobarbital might increase the sedative side effects of pentobarbital.
Phenytoin (Dilantin)
Interaction Rating=Moderate Be cautious with this combination.
White pepper might increase how much phenytoin the body absorbs. Taking white pepper along with phenytoin might increase the effects and side effects of phenytoin.
Propranolol (Inderal)
Interaction Rating=Moderate Be cautious with this combination.
White pepper might increase how much propranolol the body absorbs. Taking white pepper along with propranolol might increase the effects and side effects of propranolol.
Rifampin (Rifadin)
Interaction Rating=Moderate Be cautious with this combination.
White pepper might increase how much rifampin the body absorbs. Taking white pepper along with rifampin might increase the effects and side effects of rifampin.
Theophylline
Interaction Rating=Moderate Be cautious with this combination.
White pepper can increase how much theophylline the body can absorb. This might cause increased effects and side effects of theophylline.
Herbs and supplements that might lower blood sugar: White pepper might lower blood sugar. Using it along with other herbs and supplements that have the same effect might cause blood sugar to drop too low in some people. Some of these products include devil's claw, fenugreek, guar gum, Panax ginseng, Siberian ginseng, and others.
Herbs and supplements that might slow blood clotting: White pepper might slow blood clotting. Using white pepper with other herbs that can slow blood clotting might increase the risk of bleeding in some people. These other herbs include angelica, danshen, garlic, ginger, ginkgo, red clover, turmeric, willow, Panax ginseng, and others.
Rhodiola: White pepper contains a chemical called piperine. Piperine might reduce the effects of rhodiola in the body.
Sparteine: White pepper contains a chemical called piperine. Piperine might increase the effects of sparteine in the body. Sparteine is a chemical in scotch broom.
There are no known interactions with foods.
The appropriate dose of white pepper depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for white pepper (in children/in adults). Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
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