camphor

Camphor is an aromatic flammable substance originally distilled from the bark and wood of the camphor tree, Cinnamomum camphora, but now produced primarily from turpentine oil.

Camphor is used as an active ingredient in ointments, camphorated oils and gels, which are topically applied on the skin to relieve local itching (pruritus) or pain, applied on the chest or throat to relieve cough and congestion, or added to steam inhalations to relieve cough.

Camphor works by counterirritation. Camphor initially irritates the nerve endings under the skin or mucous membranes, but continued exposure desensitizes the nerve endings and decreases their sensitivity to pain and itching, and reduces the urge to cough when inhaled.

Animal studies indicate that camphor desensitizes transient receptor potential vanilloid-1 (TRPV1) and transient receptor potential ankyrin (TRPA)1 ion channels on nerve cell (neuron) membranes. These ion channels on neuronal membranes detect environmental irritants and induce protective responses such as pain, heat or itching sensations, cough and tears.

Camphor has traditionally been used as an ingredient in many over-the-counter (OTC) cough and cold remedies, for fragrance in cosmetics and perfumes, and as a flavoring agent in food. Camphor balls are used as insect repellents and camphor was used as a fumigant during the Black Death, a plague that spread through Europe in the 14th century. In India, camphor pellets are burnt in temples during religious rituals. 

Suggested topical uses of camphor include:

• Minor pains and itching from insect bites, minor burns and scrapes, and itching and rash from poison ivy, poison oak or sumac.
• Warts and cold sores
• Muscle aches
• Joint aches
• Backache
• Cough and congestion (also as steam inhalations)

Camphor is highly toxic when orally ingested or when products with high camphor content are applied for too long on the skin, particularly on infants. In 1983, the FDA evaluated the use of camphor because of many reports of camphor poisoning.

The FDA recognized camphor as a safe and effective topical antitussive, analgesic, anesthetic, and antipruritic agent, and set a product limit of 11% of camphor concentration. The FDA completely banned products labeled as camphorated oil, camphor oil, camphor liniment and camphorated liniment.

• Do not apply camphor products on infants.
• Do not ingest products containing camphor, it is toxic and can cause serious adverse effects including refractory seizure, respiratory depression and death. Children are at greater risk for seizure and serious reactions.
• Use inhalation products with caution in patients with chronic or persistent cough such as from smoking or lung diseases.
• Camphor is flammable. Handle with care and keep away from flame or fire.

Common side effects of topical camphor include:

• Skin irritation and redness

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Topical

• 3-11% ointment

Adult:

Topical

• Itching and pain: 3-11% ointment applied three to four times daily
• Cough: Thick layer of 4.7-5.3% ointment applied to throat and chest
• Osteoarthritis: Topical combo product containing camphor (32 mg/g), glucosamine sulfate (30 mg/g), and chondroitin sulfate (50 mg/g) applied as needed for 8 weeks

Inhalation

• 1 tablespoon solution per quart of water in a steam vaporizer three times daily

Pediatric:

• American Academy of Pediatrics recommends that topical camphor products not exceed 11% camphor AND
• Recommend that camphor not be used in treating children orally
• Ingestion of camphor can cause significant toxicity including death

• Overdose of topical camphor is rare, but can occur if products with high camphor concentration are applied on the skin for prolonged periods, particularly in children. Oral overdose mostly occurs because of accidental ingestion by children.
• Orally ingested camphor is rapidly absorbed and can result in serious symptoms including gastrointestinal irritation, nausea, vomiting, abdominal pain, refractory seizure and other central nervous system effects.
• Camphor use may have a risk for addiction, according to one study conducted in India.
• Camphor overdose is treated with symptomatic and supportive care and the patient may be monitored for 4 to 6 hours. Severe overdose with seizure will require hospitalization and treatment for seizure with antiepileptic drugs, until symptoms are completely resolved.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Camphor has no known severe, serious, moderate, or mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Topical use of camphor may be acceptable during pregnancy and breastfeeding.

• Camphor products are only for external use, never take orally.
• Store safely out of reach of children. Most cases of camphor poisoning are because of accidental ingestion by children.
• In case of oral ingestion or overdose, seek medical help immediately or contact Poison Control.
• Do not apply camphor on wounds, damaged or broken skin, and avoid contact with eyes and mucous membranes.
• If you use OTC camphor products for cough, seek medical help if cough lasts more than 7 days, recurs, or is accompanied by a fever, rash, or persistent headache.
• The FDA has evaluated camphor and has set a limit of 11% concentration in camphor topical products. Check labels and choose only products from reliable manufacturers.
• The FDA has completely banned products labeled as camphorated oil, camphor oil, camphor liniment and camphorated liniment, because of safety concerns.