Black Pepper And White Pepper

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What other names is Black Pepper known by?

Black Peppercorn, Extrait de Poivre, Grain de Poivre, Hu Jiao, Kali Mirchi, Kosho, Marich, Maricha, Miris, Peber, Peper, Pepe, Peppar, Pepper, Pepper Extract, Peppercorn, Pfeffer, Pimenta, Pimienta, Pimienta Negra, Pipar, Piper, Piper nigrum, Piperine, Pippuri, Poivre, Poivre Noir, Poivrier, Schwarzer Pfeffer, Vellaja.

What is Black Pepper?

Black pepper grows in India and other tropical Asian countries. Black pepper is one of the most commonly used spices in the world. Black pepper and white pepper both come from the same plant species. 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 black pepper by mouth for arthritis, asthma, upset stomach, bronchitis, a bacterial infection that causes diarrhea (cholera), colic, depression, diarrhea, gas, headache, sex drive, menstrual pain, stuffy nose, sinus infection, dizziness, discolored skin (vitiligo), weight loss, and cancer.

People apply black pepper to the skin for measles, nerve pain, itchy skin caused by mites (scabies), and to treat pain.

People inhale black pepper oil to prevent falls, to help quit smoking, and for trouble swallowing.

In foods, black pepper and black pepper oil are used as a spice.

Insufficient Evidence to Rate Effectiveness for...

  • Fall prevention. Early research shows that applying black pepper oil near the right side of the nose improves stability when the eyes are closed in older people. But it does not seem to improve stability better than lavender oil.
  • To help quit smoking. Early research shows that puffing on a vapor device using black pepper oil over 3 hours may reduce cigarette cravings and anxiety in men who smoke.
  • Trouble swallowing. Early research shows that applying black pepper oil to the nostrils or nasal cavity for one minute before meals improves swallowing in children with brain disorders who have been fed through a feeding tube for long periods of time. However, the black pepper oil did not eliminate the need for the feeding tube. Other early research shows that applying black pepper oil near the nostrils for one minute before meals improves swallowing movements in post-stroke residents at long-term care nursing homes.
  • A bacterial infection that causes diarrhea (cholera).
  • Arthritis.
  • Asthma.
  • Bronchitis.
  • Cancer.
  • Colic.
  • Depression.
  • Diarrhea..
  • Discolored skin (vitiligo).
  • Dizziness.
  • Gas.
  • Headache.
  • Itchy skin caused by mites (scabies).
  • Measles.
  • Menstrual pain.
  • Nerve pain.
  • Pain.
  • Sex drive.
  • Stuffy nose.
  • Sinus infection.
  • Upset stomach.
  • Weight loss.
  • Other conditions.
More evidence is needed to rate black pepper for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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How does Black Pepper work?

Black 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.

Are there safety concerns?

Black pepper is LIKELY SAFE when taken by mouth in amounts commonly found in foods.

Black pepper is POSSIBLY SAFE when taken by mouth appropriately as medicine and when the oil is applied to the skin. Black pepper oil typically does not cause side effects. Black pepper might have a burning aftertaste. Taking large amounts of black pepper by mouth, which can accidentally get into the lungs, has been reported to cause death. This is especially true in children.

Special Precautions & Warnings:

Pregnancy: Black pepper is LIKELY SAFE when taken by mouth in amounts commonly found in foods. It is LIKELY UNSAFE when taken by mouth in large amounts during pregnancy as it might cause an abortion.
There isn't enough reliable information available to know if applying black pepper to the skin is safe while pregnant.

Breast-feeding: Black pepper is LIKELY SAFE when taken by mouth in amounts commonly found in foods. There isn't enough reliable information available to know if taking black pepper as medicine is safe while breast-feeding.

Children: Black 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 as deaths have been reported. There isn't enough reliable information available to know if applying black pepper oil to the skin is safe for children.

Bleeding conditions: Piperine, a chemical in black pepper, might slow blood clotting. In theory, taking black pepper in amounts greater than those in food might increase the risk of bleeding in people with bleeding disorders.

Diabetes: Black pepper might affect blood sugar levels. In theory, taking black 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 black pepper, might slow blood clotting and affect blood sugar levels. In theory, taking black pepper in amounts treater than those found in food might cause bleeding complications or affect blood sugar levels during surgery. You should stop taking black pepper in amounts greater than those in food at least 2 weeks before surgery.

Are there any interactions with medications?



Cyclosporine
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Black pepper contains a chemical called piperine. Piperine might increase levels of cyclosporine in the body. In theory, taking black pepper with cyclosporine might increase the effects and side effects of cyclosporine. However, there is not enough known about this potential interaction to know if it is a big concern.



Lithium
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Black pepper might have an effect like a water pill or "diuretic." Taking black 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 1A1 (CYP1A1) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Black pepper might decrease how quickly the liver breaks down some medications. Taking black pepper along with some medications that are broken down by the liver might increase the chance of side effects from some medications. Before taking black 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 chlorzoxazone, theophylline, and bufuralol.



Medications changed by the liver (Cytochrome P450 2B1 (CYP2B1) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Black pepper might decrease how quickly the liver breaks down some medications. Taking black pepper along with some medications that are broken down by the liver might increase the chance of side effects from some medications. Before taking black 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 cyclophosphamide, ifosfamide, barbiturates, bromobenzene, and others.



Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Black pepper might decrease how quickly the liver breaks down some medications. Taking black pepper along with some medications that are broken down by the liver might increase the chance of side effects from some medications. Before taking black 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.
Talk with your health provider.

Some medications are changed and broken down by the liver. Black and white pepper might decrease how quickly the liver breaks down some medications. Taking pepper along with some medications that are broken down by the liver can increase the chance of side effects from some medications. Before taking black or 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 lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.



Medications for diabetes (Antidiabetes drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Black pepper contains a chemical called piperine. Some research shows that piperine might decrease blood sugar levels. In theory, black 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 black 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.
Talk with your health provider.

Some medications are moved by pumps in cells. Black and white pepper might make these pumps less active and increase how much of some medications get absorbed by the body. 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.
Talk with your health provider.

Black pepper contains a chemical called piperine. Piperine might slow blood clotting. In theory, taking black 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
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Black pepper contains a chemical called piperine. Piperine might increase levels of nevirapine in the body. In theory, taking black 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.
Talk with your health provider.

Black pepper contains a chemical called piperine. Piperine might increase sleepiness caused by pentobarbital. In theory, taking black pepper with pentobarbital might increase the sedative side effects of pentobarbital.



Phenytoin (Dilantin)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Black and white pepper might increase how much phenytoin (Dilantin) the body absorbs. Taking black and white pepper along with phenytoin (Dilantin) might increase the effects and side effects of phenytoin (Dilantin).



Propranolol (Inderal)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Black and white pepper might increase how much propranolol (Inderal) the body absorbs. Taking black and white pepper along with propranolol (Inderal) might increase the effects and side effects of propranolol (Inderal).



Rifampin
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Black and white pepper might increase how much rifampin the body absorbs. Taking black and white pepper along with rifampin might increase the effects and side effects of rifampin.



Theophylline
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Black pepper can increase how much theophylline the body can absorb. This might cause increased effects and side effects of theophylline.



Amoxicillin (Amoxil, Trimox)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Black pepper contains a chemical called piperine. Piperine might increase levels of amoxicillin in the blood. In theory, taking black 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 cautious with this combination.
Talk with your health provider.

Black 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 cautious with this combination.
Talk with your health provider.

Black pepper contains a chemical called piperine. Piperine might increase levels of cefotaxime in the blood. In theory, taking black 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.

Dosing considerations for Black Pepper.

The appropriate dose of black 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 black 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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Reviewed on 3/29/2011 12:35:40 PM

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