Cayenne
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Capsicum spp.
Capsicum annuum L. var. annuum; C. annuum L. var. glabriusculum
(Dunal) Heiser & Pickersgill [syn. C. frutescens L.]; C. baccatum L.; C. chinense
Jacq.
[Fam. Solanaceae]
Overview
Cayenne is
marketed in the U.S. as a food, spice, and dietary supplement (in tablets,
capsules, and occasionally, as a tincture). Common names for cayenne include
cayenne pepper, chili pepper, paprika, red pepper, tabasco pepper, bird pepper,
African bird pepper, piquin, aji pepper, Brown’s pepper, Peruvian pepper,
piris, habañero pepper, and bonnet pepper. Cayenne is one of the fastest
growing botanical imports, accounting for approximately 12% of the total annual
value of U.S. spice imports. New Mexico alone produces approximately 100
million pounds of dried peppers annually (Buzzanell and Gray, 1999).
Twenty-three percent of natural food store consumers purchased cayenne at least
once during the first half of 1999 (Richman and Witkowski, 1999). Preparations
made from the oleoresin in cayenne and oleoresin’s isolated constituent,
capsaicin, are used in topical, over-the-counter (OTC) drug products. Capsicum
oleoresin topical analgesic lotions and creams, containing the pure compound
capsaicin, are available OTC in three strengths, 0.025%, 0.075%, and 0.25%
(Palevitch and Craker, 1995; Rosenstein, 1999) for the following uses:
inflammation and pain due to shingles, postherpetic neuralgia, rheumatoid
arthritis, osteoarthritis, diabetic neuropathy, and post-surgical pain. Other
uses for these lotions and creams that are not specified on the labels are to
relieve pain associated with psoriasis, chronic neuralgia unresponsive to other
forms of therapy, and intractable pruritus (Turkoski et al., 1998).
Description
Cayenne
preparations consist of the dried, ripe fruit, usually removed from the calyx,
of various capsaicin-rich Capsicum
species, such as C. annuum L. [Fam. Solanaceae], including a large number of
varieties (Blumenthal, et al., 2000).
In Germany, pharmacopeial grade cayenne must contain no less than 0.4% total
capsaicinoids, as determined by liquid chromatography (DAB, 1999). [Note: This herb was described under the
monograph heading “Paprika (Cayenne)” in the German Commission E monographs
(Blumenthal et al., 1998).]
Primary Uses
External
Capsaicin preparations
Neuralgia
Significant reduction of postherpetic neuralgia
(Watson et al., 1993; Peikert et al., 1991; Bernstein et al., 1989)
Neuropathy
Improved pain relief for diabetic neuropathy
(Capsaicin Study Group, 1991, 1992; Chad et
al., 1990)
Psoriasis
Improvement in global evaluation, pruritus relief and
combined psoriasis severity scores (Krogstad et al., 1999; Ellis et al.,
1993)
Osteoarthritis
Significant reduction in pain and joint tenderness
(Altman et al.,1994; Schnitzer et al., 1994; Weisman et al., 1994; McCarthy and McCarty,
1992; Deal et al., 1991)
Other Potential Uses
Internal
Cayenne preparations
Gastrointestinal
Cytoprotective effect (Yeoh et al., 1995)
Peptic ulcer, prevention (Kang et al., 1995; Yeoh et al., 1995)
External
Capsaicin preparations
Fibromyalgia (McCarty et al., 1994)
Cluster headache (Marks et al., 1993)
Chronic rhinopathy (Eberle and Gluck, 1994)
Dosage
Internal
Crude Preparations
Dried
fruit: 30–120 mg,
3 times daily, (BHP, 1983). As a digestive aid, 120–450 mg, 2–3 times daily
with meals (McKenna et al., 1998). In
a clinical study, 10 g powdered fruit was administered one time with meals to
stimulate carbohydrate oxidation (Lim et
al., 1997). However, this dose is probably too high for regular
consumption.
Infusion:
240 ml boiling
water is poured over 0.5–1.0 teaspoon of cayenne and steeped for 10 minutes; 1
tablespoon is drunk, diluted with hot water when needed (Hoffmann, 1992; Lust,
1974).
Tincture: 1:20 (g/ml), 60% ethanol: 0.3–1.0 ml, 3 times daily, or when needed (Boon
and Smith, 1999; BPC, 1968; Hoffmann, 1992; Karnick, 1994).
Standardized Preparations
Oleoresin:
1.2 mg (maximum
dose) (MD), 1.8 mg (maximum daily dose) (MDD) (GSL, 1984–1994).
External
Crude Preparations
Liniment:
Hot oil emulsion
containing dried cayenne powder or alcoholic tincture is applied locally by
friction method (Blumenthal et al.,
2000).
Standardized Preparations
Ointment
or cream: Semiliquid
preparation containing 0.02–0.05% capsaicinoids in an emulsion base, is applied
to affected area (Blumenthal et al.,
2000).
Oleoresin: 2.5% maximum strength (GSL, 1984–1994 from Newall et al., 1996) is applied locally.
Poultice:
Semisolid paste or
plaster which, when applied locally, produces 10–40 mcg capsaicinoids per cm2
(Blumenthal et al., 2000).
Tincture: 1:10 (g/ml), 90% ethanol, aqueous-alcoholic preparation containing
0.005–0.01% capsaicinoids, is applied locally (Blumenthal et al., 2000).
Pure Capsaicin Preparations
For diabetic
neuropathy, 0.075% capsaicin cream or ointment is applied 4 times daily. For
postherpetic neuralgia, 0.025%
capsaicin cream or ointment is applied 4 times daily (Boon and Smith, 1999;
Pizzorno and Murray, 1999).
Duration of Administration
External
Crude Preparations
Commission E
recommends no longer than two days; 14 days must pass before a new application
can be used in the same location. Longer use on the same area may cause damage
to sensitive nerves (Blumenthal et al.,
1998).
Preparations Containing Pure Capsaicin
Three to four
applications daily for 2–6 weeks may be required (Kruse and Eland, 1999).
Warning: Preparations made from cayenne
irritate the mucous membranes even in very low concentrations and cause a
painful burning sensation. Patients should avoid the contact of cayenne
preparations with mucous membranes, especially the eyes (Blumenthal et al., 1998).
Chemistry
Cayenne
contains up to 1.5% pungent principles known as capsaicinoids (usually
0.1–1.0%), composed of 49–69% capsaicin, 22–36% dihydrocapsaicin, 7.0–7.4%
nordihydrocapsaicin, 1–2% homodihydrocapsaicin, and 1–2% homocapsaicin (Bennet
and Kirby, 1968; Duke, 1985; Wood, 1987). Other constituents of cayenne include
carotenoids and ascorbic acid (vitamin C) (Bruneton, 1999).
Pharmacological Actions
Internal
Human
Crude
Preparations
Dried powder
can protect against aspirin-induced gastroduodenal mucosal injury when taken
1/2 hour prior to aspirin (Brinker, 2001; Yeoh et al., 1995); protects against peptic ulcer (Kang et al., 1995); increases fibrinolytic
activity (Visudhiphan et al., 1982);
stimulates carbohydrate oxidation (Lim et
al., 1997); gastrointestinal stimulant (Osol and Farrar, 1955).
Animal
Antigenotoxic
and anticarcinogenic (Surh et al.,
1998).
External
Crude Preparations
Local hyperemic
and local nerve-damaging activity (Blumenthal et al., 1998); rubefacient and vasostimulant (BHP, 1996; Kapoor,
1990). Capsicum oleoresin does not uniformly induce neuropeptide activity as
reliably as purified capsaicin. Clinical efficacy studies have shown purified
capsaicin depletes the neuropeptide-active agent substance P, which is stored
in sensory neurons, though no similar studies have been done on capsicum
oleoresin. Capsascin also further blocks resynthesis of substance P (Cordell
and Araujo, 1993).
Pure Capsaicin Preparations
Block pain
neurotransmitter, substance P (Ellison et
al., 1997); dilate blood vessels, release histamine and reduce perfusion in
lesional skin (Krogstad et al.,
1999); reduce and relieve pain; cause activation followed by desensitization of
the sensory neurons on short- and long-term treatments (Ellison et al., 1997; Munn et al., 1997; Vickers et al.,
1998).
Mechanism of Action
Internal
Intragastric capsaicin stimulates afferent
nerve endings in animal tests, suggesting that its gastroprotective effects may
be caused by increased mucosal blood flow rather than by prostaglandin
production (Yeoh et al., 1995).
Cayenne affects the cardiovascular system,
reducing trigylceride levels and platelet aggregation, and increasing
fibrinolytic activity (Pizzorno and Murray, 1999).
Reduces serum triglyceride levels without
an alteration in serum cholesterol or pre--lipoproteins, and stimulates lipid mobilization from adipose
tissue (Boon and Smith, 1999).
Increases catecholamine (plasma epinephrine
and norepinephrine concentration) levels (Barna and Sreter, 1986; Lim et al., 1997).
Inhibits lipid peroxidation and
myeloperoxidase activity in ethanol-induced gastric mucosal lesions; thereby
demonstrating gastroprotective activity, which may be useful in chemoprevention
(Park et al., 2000).
Vanilloid
(capsaicin) receptors act in nonspecific manner (not specifically as previously
believed) to activate sensory neurons. Capsaicin and the protons lower the heat
threshold of the receptor, while it is the heat (<48°C) that opens the
channel pore of the vanilloid receptor neurons (Szallasi and Blumberg, 1999).
External
Capsaicin Preparations
Activate nociceptive fibers, which induces
the release of excitatory neurotransmitters (substance P, N-methyl-D-asparic
acid), bind to specific vanilloid (capsaicin) receptors, and its effects are
reversible (Szallasi and Blumberg, 1999; Fusco and Giacovazzo, 1997; Lotz,
1994).
Induce a selective analgesic effect by
depleting substance P, a neuropeptide of 11 amino acids that mediates the
transmission and modulation of pain impulses from the peripheral nerves to the
spinal column. Capsaicin initially stimulates substance P release from
peripheral sensory, C-type nerve fibers, then prevents its reuptake, and also
blocks its transport within the neuron, which causes its eventual depletion,
resulting in analgesia. The depletion of substance P initially takes one to three
days, though with continued use the analgesic effect may last for weeks (Boon
and Smith, 1999; Fusco and Giacovazzo, 1997; Tyler, 1992).
Contraindications
Internal
Crude Preparations
Inhalation is
contraindicated due to immediate bronchoconstriction caused by capsaicin
(Fuller et al., 1985). Ingestion is
contraindicated in cases of chronic irritable bowel due to neural irritant and
intestinal contraction properties of capsaicin (Buck and Burks, 1986),
gastroduodenal ulcers, acute gastritis, pulmonary tuberculosis, and hemorrhoids
(But et al., 1997). However, a
randomized, comparison clinical study did not find gastric mucosal damage in
patients with duodenal ulcers who consumed cayenne (Kumar et al., 1984).
External
Cayenne
preparations are contraindicated for application on injured skin, allergies to
cayenne preparations (Blumenthal et al.,
1998), or use near the eyes (Brinker, 2001).
Pregnancy
and Lactation: No
known restrictions (McGuffin et al., 1997).
Adverse Effects
Commission E
noted that in rare cases, a hypersensitivity reaction (urticaria) can occur
(Blumenthal et al., 1998).
Capsaicinoids are strongly irritating to mucosal membranes and inhalation of
cayenne can produce a form of allergic alveolitis.
Drug Interactions
External
Commission E
reported no drug interactions are
known, but included the following note:
“No additional heat application” (Blumenthal et al., 1998). Angiotensin-converting enzyme (ACE) inhibitors can
predispose patients to coughing with application of topical preparations
containing capsaicin according to human case reports (Brinker, 2001).
Internal
Crude
herb: Capsicum may interfere with monoamine oxidase inhibitors
(MAOIs) and antihypertensive therapy (increased catecholamine secretion), and
may increase the hepatic metabolism of drugs (glucose-6-phosphate dehydrogenase
and adipose lipoprotein lipase activity elevated) (Newall et al., 1996). In an animal study (rabbits), theophylline
absorption was enhanced when administered before or simultaneously with cayenne
(Bouraoui et al., 1988).
American Herbal Products Association (AHPA) Safety Rating
Class
2d: External:
Contraindicated on injured skin or near eyes.
Class
1: Internal: Can
be safely consumed when used appropriately. Note: Excessive doses may cause gastrointestinal irritation in sensitive
individuals (McGuffin et al., 1997).
Regulatory Status
Austria:
Official in the Austrian Pharmacopoeia, ÖAB 1991
(Wichtl, 1997).
Canada:
Topical liniments,
lotions, and plasters containing capsicum oleoresin or purified capsaicin are
schedule OTC (over-the-counter) drugs requiring pre-market authorization and
assignment of a Drug Identification Number (DIN) (Health Canada, 2001).
France:
Topical
preparations are approved for relieving minor articular pain in French Pharmacopoeia, Ph.Fr. X (Bradley,
1992; Reynolds et al., 1993).
Germany: Topical preparations are approved
nonprescription drugs of the Commission E monographs (Blumenthal et al., 1998). Dried ripe fruit is
official in the German Pharmacopoeia (DAB,
1999). Dried ripe fruit for preparation of hydro-alcoholic mother tincture and
liquid dilutions is an official drug of the German
Homoeopathic Pharmacopoeia (GHP, 1993).
Italy:
Official in Italian Pharmacopoeia (Newall et al., 1996).
Japan:
Dried fruit and
powdered dried fruit are both official in the Pharmacopoeia of Japan (JSHM, 1993).
Sweden:
Topical
capsaicin cream is an approved non-prescription drug (MPA, 1997). No capsicum
products are listed in the Medical Products Agency (MPA) “Authorized Natural
Remedies” (MPA, 2001).
Switzerland:
Official in Swiss Pharmacopoeia, Ph.Helv.VII
(Wichtl, 1997). External-use plasters containing cayenne and cayenne extract
are nonprescription drugs, with sale limited to pharmacies and drugstores (Morant
and Ruppanner, 2001).
U.K.:
Capsicum oleoresin
and water-soluble capsicum oleoresin are herbal medicines specified in the General Sale List, Schedule 1 (medicinal
products requiring a full product license), Table B (external use only) (GSL,
1995).
U.S.: Generally recognized as safe (GRAS)
(US FDA, 1998). Dietary supplement (USC, 1994). Capsicum oleoresin and purified
capsaicin are safe and effective for use as OTC external analgesics (US FDA,
1979; US FDA, 1983).
Clinical Review
A total of 26
clinical trials conducted on cayenne and capsaicin are summarized in the
following tables, “Clinical Studies on Cayenne” and “Clinical Studies on
Capsaicin Preparations.” All but one of these studies (López-Carrillo et al., 1994), demonstrated positive
effects for indications including gastrointestinal and metabolic conditions.
Five studies investigated gastrointestinal effects related to the regular
dietary intake of cayenne powder vs. non-ingestion of cayenne including a
protective effect against peptic ulcer (Kang et al., 1995), a gastroprotective effect following ingestion of
aspirin (Yeoh et al., 1995), risk of
gastric cancer (Lopez-Carrillo et al.,
1994), gastric or duodenal mucosal damage (Graham et al., 1988; Kumar et al.,
1984), and elevated metabolic rate (Henry and Emery, 1986). A hematology study
found significantly higher fibrinolytic activity in Thai subjects who consumed
cayenne regulary, compared with American subjects (Visudhiphan et al., 1982).
Table 2,
“Clinical Studies on Capsaicin Preparations,” summarizes 18 studies involving a
total of 1,326 participants, evaluating the external use of preparations
containing pure capsaicin. All but one of the studies (Low et al., 1995) demonstrated positive effects for indications
including neuralgia, neuropathy, psoriasis, arthritis, and fibromyalgia. The
table includes 14 double-blind, placebo-controlled (DB, PC) studies involving a
total of 1,036 participants. Two DB, PC studies investigated topical capsaicin
in painful diabetic neuropathy, with statistically significant results related
to pain status (Capsaicin Study Group, 1992; Chad et al., 1990). Osteoarthritis was the subject of four DB, PC
studies, all with statistically significant results confirming capsaicin’s
efficacy in pain reduction (Altman et al.,
1994; Deal et al., 1991; McCarthy and
McCarty, 1992; Schnitzer et al.,
1994). Three DB, PC studies focused on the treatment of rheumatoid arthritis,
with two studies reporting significant reduction in pain (Deal et al., 1991; Weisman et al., 1994). One study reported a
significant reduction in primary osteoarthritis pain, but no significant
reduction in rheumatoid arthritis pain (McCarthy and McCarty, 1992). Other
topics investigated with topical capsaicin in DB, PC studies include notalgia
paresthetica (Wallengren and Klinker, 1995), fibromyalgia (McCarty et al., 1994), psoriasis (Ellis et al., 1993), and postherpetic
neuralgia (Watson et al., 1993). Only
one study did not demonstrate a trend in favor of treatment with capsaicin.
This was a 12-week, DB, PC study investigating chronic distal painful
polyneuropathy (Low et al., 1995).
Creams containing low concentrations (0.025–0.075%) of capsaicin have been
shown in clinical trials to be effective in the treatment of postherpetic
neuralgia (Bernstein et al., 1987; Bernstein et al., 1989; Menke and Heins, 1999;
Peikert et al., 1991; Watson et al., 1988; Watson et al., 1993), diabetic neuropathy
(Basha and Whitehouse, 1991; Tandan et al.,
1992), and other pain syndromes, including cluster headache (Marks et al., 1993).
Branded Products
Axsain®:
GenDerm Corporation / 4343 East Camelback Road / Phoenix, Arizona 85012 /
U.S.A. Cream product with 0.075% capsaicin. This product is no longer
available.
Capsig®:
Schering-Plough / 2000 Galloping Hill Road / Kenilworth, NJ 07033 / U.S.A. /
Tel: (908) 298-4000 / www.sch-plough.com. Cream with 0.025% capsaicin. This
product is no longer available.
Chili powder
(no product name specified): KNP Trading Pte Ltd, 50 Senoko Drive / Singapore
758 232 / Tel: 65-257 6916 / Fax: 65-753 6916 / www.knp-housebrand.com. Chili
powder containing 478 ppm capsaicin.
Saemaul
Kongjang 1: No product information available.
Zostrix®-HP:
GenDerm Corporation. Cream product with 0.075% capsaicin.
References
Altman R, Aven A, Holmberg C et al.
Capsaicin cream 0.025% as monotherapy for osteoarthritis: a double-blind study.
Semin Arthritis Rheum 1994;23(No. 6
Suppl 3):25–33.
Barna J, Sreter F. Effect of chronically administered large amount of
“sweet” paprika on some muscle characteristics. Acta Aliment 1986;15:299–305.
Basha K, Whitehouse F. Capsaicin: a therapeutic option for painful diabetic
neuropathy. Henry Ford Hosp Med J
1991; 39(2):138–40.
Bennet D, Kirby G. Constitution and biosynthesis of capsaicin. J Chem Soc C 1968;442–6.
Berger A, Henderson M, Nadoolman W, et
al. Oral capsaicin provides temporary relief for oral mucositis pain
secondary to chemotherapy/radiation therapy. J Pain Symptom Manage 1995;10(3):243–8.
Bernstein J, Bickers D, Dahl M, Roshal J. Treatment of chronic postherpetic
neuralgia with topical capsaicin. A preliminary study. J Am Acad Dermatol 1987; 17(1):93–6.
Bernstein J, Korman N, Bickers D, Dahl M, Millikan L. Topical capsaicin
treatment of chronic postherpetic neuralgia. J Am Acad Dermatol 1989; 21(2 Pt 1):265–70.
BHP. See: British Herbal
Pharmacopoeia.
Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister
RS (eds.). Klein S, Rister RS (trans.). The
Complete German Commission E
Monographs—Therapeutic Guide to Herbal Medicines. Austin, TX: American
Botanical Council; Boston: Integrative Medicine Communication; 1998; 178.
Blumenthal M, Goldberg A, Brinckmann J (eds.). Herbal Medicine: Expanded Commission E Monographs. Newton, MA:
Integrative Medicine Communications; 2000; 52–6.
Boon H, Smith M. The Botanical
Pharmacy: The Pharmacology of 47 Common Herbs. Kingston, Ontario, Canada:
Quarry Health Books; 1999;56–61.
Bouraoui A, Toumi A, Mustapha H, Brazier J. Effects of capsicum fruit on
theophylline absorption and bioavailability in rabbits. Drug-Nutrient Interact 1988;5:345–50.
BPC. See: British Pharmaceutical
Codex.
Bradley P (ed.). British Herbal
Compendium, Vol. 1. Dorset, UK: British Herbal Medicine Association
1992;174–6.
Brinker F. Herb Contraindications and
Drug Interactions, 3rd ed. Sandy, OR: Eclectic Medical Publications;
2001;57–59.
British Herbal Pharmacopoeia
(BHP). Cayenne monograph. Exeter, U.K.: British Herbal Medicine Association;
1996;55–6.
British Herbal Pharmacopoeia (BHP).
Cayenne monograph. Keighley, UK: British Herbal Medicine Association; 1983.
British Pharmaceutical Codex (BPC).
London, UK: The Pharmaceutical Press; 1968.
Bruneton, J. Pharmacogonosy,
Phytochemistry, Medicinal Plants, 2nd ed. Hatton, C.K (trans.). Paris:
Intercept, Ltd.; 1999.
Buck S, Burks T. The neuropharmacology of capsaicin: review of some recent
observations. Pharmacol Rev 1986;38(3):179–226.
But P, Kimura T, Guo J, Sung C (eds.). International
Collation of Traditional and Folk Medicine, Vol. 2, Northeast Asia, Part
II. River Edge, NJ: World Scientific Publishing, Co; 1997;138–9.
Buzzanell P, Gray F. The spice market in the United States: Recent
developments and prospects. Economic Research Service, U.S. Department of
Agriculture; Agricultural Information Bulletin No. 709. 1999.
Capsaicin Study Group. Effect of treatment with capsaicin on daily
activities of patients with painful diabetic neuropathy. Diabetes Care 1992;15(2):159–65.
Capsaicin Study Group. Treatment of painful diabetic neuropathy with
topical capsaicin. Arch Intern Med
1991;151:2225–9.
Chad D, Aronin N, Lundstrom R et al.
Does capsaicin relieve the pain of diabetic neuropathy? Pain 1990;42:387–8.
Cordell G, Araujo O. Capsaicin: identification, nomenclature, and
pharmacotherapy. Ann Pharmacother
1993;27:330–6.
DAB. See: Deutsches Arzneibuch.
Deal C, Schnitzer T, Lipstein E, et
al. Treatment of arthritis with topical capsaicin: a double-blind trial. Clin Therapeut 1991;13(3):383–395.
Desai H et al. Effect of red
chilli powder on DNA content of gastric aspirates. Gut 1973;14:974–6.
Deutsches Arzneibuch (DAB).
Stuttgart, Germany: Deutscher Apotheker Verlag. 1999.
Duke J. CRC Handbook of Medicinal
Herbs. Boca Raton, FL: CRC Press, Inc; 1985;98–9.
Eberle L, Gluck U. Clinical experiences with local capsaicin treatment of
chronic rhinopathy. [in German]. HNO
1994;42(11):665–9.
Ellis C, Berberian B, Sulica V, et al.
A double-blind evaluation of topical capsaicin in pruritic psoriasis. J Am Acad Dermat 1993;29:438–42.
Ellison N, Loprini C, Kugler J, et al.
Phase III placebo-controlled trial of capsaicin cream in the management of
surgical neuropathic pain in cancer patients. J Clin Oncol 1997;15(8):2974–80.
Fuller R, Dixon C, Barnes P. Bronchoconstrictor response to inhaled
capsaicin in humans. J Appl Physiol 1985;58(4):1080–4.
Fusco B, Alessandri M. Analgesic effect of capsaicin in idiopathic
trigeminal neuralgia. Anest Analg
1992;74:375–377.
Fusco BM Giacovazzo M. Peppers and pain: The promise of capsaicin. Drugs 1997;53(6):909–14.
General Sale List (GSL).
Statutory Instrument 1995 No. 3216 The Medicines (Products Other Than
Veterinary Drugs) Amendment Order 1995. London, U.K.: Her Majesty’s Stationery
Office (HMSO). 1995.
General Sale List (GSL).
Statutory Instrument (S.I.). The Medicines (Products other than Veterinary
Drugs). London, UK: Her Majesty’s Stationery Office; 1984; S.I. No. 769, as
amended 1985; S.I. No. 1540, 1990; S.I. No. 1129, 1994; S.I. No. 2410.
German Homeopathic Pharmacopoeia (GHP),
1st ed. 1978 with 5 supplements through 1991. Translation of the German “Homöopathisches Arzneibuch (HAB 1)
Amtliche Ausgabe.” Stuttgart, Germany: Deutscher Apotheker Verlag; 1993;275–7.
GHP. See: German Homeopathic
Pharmacopoeia.
Graham D, Smith J, Opekum A. Spicy food and the stomach: Evaluation by
videoendoscopy. JAMA 1988;260(23):3473–5.
GSL. See: General Sale List.
Health Canada. Drug Product Database
(DPD) Product Information. Ottawa, Ontario: Health Canada Therapeutic
Products Programme; 2001.
Henry C, Emery B. Effect of spiced food on metabolic rate. Human Nutr Clin Nutr 1986;40(2):165–8.
Hoffmann D. The New Holistic Herbal.
Rockport, MA: Element, Inc;. 1992;189.
Japanese Standards for Herbal
Medicines (JSHM). Tokyo, Japan: Yakuji Nippo, Ltd; 1993;59–60.
JSHM. See: Japanese Standards for
Herbal Medicines.
Kang J, Yeoh K, Chia H, et al.
Chili – protective factor against peptic ulcer? Dig Dis Sci 1995;40(3)576–9.
Kapoor L. CRC Handbook of Ayurvedic
Medicinal Plants. Boca Raton, FL: CRC Press; 1990; 98.
Karnick C. Pharmacopoeial Standards
of Herbal Plants, Vol. 1. Delhi, India: Sri Satguru Publications;
1994;79–80.
Krogstad A, Lönnroth P, Larson G, Wallin B. Capsaicin treatment induces
histamine release and perfusion changes in psoriatic skin. Brit J Derm 1999;141:87–93.
Kruse L, Eland J. Capsaicin (Axsain®,
Capsaicin-P, Zostrix® HP, Dolorac): Healthcare Professional Version. Iowa
City, IA: The University of Iowa College of Nursing; 1999 available at:
<http://www.nursing.uiowa.edu/sites/PedsPain/Topicals/ CAPSAIte.htm>.
Kumar N, Vij C, Sarin S, Anand B. Do chilies influence healing of duodenal
ulcer? Br Med J 1984;288:1803–1804.
Lim K, Yoshioka M, Kikuzato S, et al.
Dietary red pepper ingestion increases carbohydrate oxidation at rest and
during exercise in runners. Med Sci
Sports Exerc 1997 March;29(3):355–61.
Locock R. Capsicum. Can Pharm J
1985;118:517–9.
López-Carrillo L, Avila M, Dubrow R. Chili pepper consumption and gastric
cancer in Mexico: A case-control study. Am
J Epidem 1994;139(3):264–71.
Lotz M. 1994. Experimental models of arthritis: Identification of substance
P as a therapeutic target and use of capsaicin to manage joint pain and
inflammation. Semin Arthritis Rheum
1994; 23(6)Suppl 3:10–17.
Low P, Opfer-Gehrking T, Dyck P, Litchy W, O’Brien P. Double-blind,
placebo-controlled study of the application of capsaicin cream in chronic
distal painful polyneuropathy. Pain 1995;62:163–8.
Lust J. The Herb Book. New York,
NY: Bantam Books; 1974;151–2.
Marks D, Rapoport A, Padla D, et al.
A double-blind placebo-controlled trial of intranasal capsaicin for cluster
headache. Cephalalgia
1993;13(2):114–6.
McCarthy G, McCarty D. Effect of topical capsaicin in the therapy of
painful osteoarthritis of the hands. J
Rheumatol 1992;19:604–7.
McCarty D, Csuka M, McCarthy G, Trotter D. Treatment of pain due to
fibromyalgia with topical capsaicin: a pilot study. Semin Arthritis Rheum 1994;23(No. 6, Suppl 3):41–7.
McGuffin M, Hobbs C, Upton R, Goldberg A (eds.). American Herbal Products Association’s Botanical Safety Handbook.
Boca Raton, FL: CRC Press; 1997;23.
McKenna D, Hughes K, Jones K (eds.). Natural
Dietary Supplements: A Desktop Reference. Marine on St. Croix, MN:
Institute for Natural Products Research; 1998.
Medical Products Agency (MPA). Läkemedelsmonografi:
Capsina (kapsaicin). Uppsala, Sweden: Medical Products Agency; 1997.
Medical Products Agency (MPA). Naturläkemedel:
Authorised Natural Remedies (as of January 24, 2001). Uppsala, Sweden:
Medical Products Agency; 2001.
Menke J, Heins J. Treatment of postherpetic neuralgia. J Am Pharm Assoc (Wash) 1999; 39(2):217–21.
Morant J, Ruppanner H (eds.). Patienteninformation: Democal Kreuz-Pflaster
D. In: Arzneimittel-Kompendium der
Schweiz® 2001. Basel, Switzerland: Documed AG. 2001.
MPA. See: Medical Products Agency.
Munn S, Burrows N, Abadia-Molina F. The effect of topical capsaicin on
substance P immunoreactivity: a clinical trial and immunohistochemical analysis
[letter]. Acta Derm Venereol (Stockh)
1997; 77(2):158–9.
Newall C, Anderson L, Phillipson J. Herbal
Medicines: A Guide for Health-care Professionals. London, UK: The Pharmaceutical
Press; 1996;60–61.
Osol A, Farrar G. The Dispensatory of
the United States of America, 25th edition. Philadelphia, PA: Lippincott;
1955;239–42.
Paice J, Ferrans C, Lashley F, et al.
Topical capsaicin in the management of HIV-associated peripheral neuropathy. J Pain Symptom Manage 2000;19(1):45–52.
Palevitch D, Craker L. Nutritional and medical importance of red peppers (Capsicum spp.). J Herbs Spices Med Plants 1995; 3(2):55–83.
Park JS, Choi MA, Kim BS, et al.
Capsaicin protects against ethanol-induced oxidateive injury in the gastric
mucosa of rats. Life Sci 2000;67:
3087–93.
Peikert A, Hentrich M, Ochs G. Topical 0.025% capsaicin in chronic
post-herpetic neuralgia: efficacy, predictors of response and long-term course.
J Neurol 1991; 238(8):452–6.
Pimparkar B et al. Effects of
commonly used spices on human gastric secretion. J Assoc Physicians India 1972;20:901–10.
Pizzorno JE, Murray MT, editors. Capsicum frutescens. In: Textbook of Natural Medicine, Vol. 1,
2nd ed. New York: Churchill Livingstone; 1999;629–32.
Reynolds JEF, Pafitt K, Parsons AV, Sweetman SC (eds.). Martindale: The Extra Pharmacopoeia,
30th edition. London, U.K.: The Pharmaceutical Press. 1993;899.
Richman A, Witkowski J. 17th annual consumer survey. Whole Foods 1999 Aug;33–8.
Rosenstein E. Topical agents in the treatment of rheumatic disorders. Complement Alternative Ther Rheum Dis I
1999;25(4):899–918.
Schnitzer T, Morton C, Coker S. Topical capsaicin therapy for osteoarthritis
pain: Achieving a maintenance regimen. Semin
Arthritis Rheum 1994;23(No. 6 Suppl 3):34–40.
Surh Y, Lee E, Lee J. Chemoprotective properties of some pungent
ingredients present in red pepper and ginger. Mut Res 1998;402:259–67.
Szallasi A, Blumberg, PM. Vanilloid (capsaicin) receptors and mechanisms. Pharmacol Rev 1999;51(2):159–95.
Tandan R, Lewis G, Krusinski PB, Badger GB, Fries TJ. Topical capsaicin in
painful diabetic neuropathy. Controlled study with long-term follow-up. Diabetes Care 1992; 15(1):8–14.
Turkoski B, Lance B, Janosik J. Drug
Information Handbook for Nursing. Hudson, Ohio: Lexi-Comp Inc. 1998;1475.
Tyler, VE. The Honest Herbal: A
Sensible Guide to the Use of Herbs and Related Remedies, 3rd ed. New York:
Pharmaceutical Products Press; 1992;79–80.
United States Congress (USC). Public Law 103–417: Dietary Supplement Health
and Education Act of 1994. Washington, DC: 103rd Congress of the United States;
1994.
United States Food and Drug Administration (U.S. FDA). Code of Federal Regulations, Title 21, Part 182 – Substances
Generally Recognized as Safe. Washington, DC: Office of the Federal Register
National Archives and Records Administration; 1998;427–33.
United States Food and Drug Administration (U.S. FDA). Code of Federal Regulations 21 (CFR 21). Proposed monographs on
analgesic drug products for over-the-counter (OTC) human use. Washington, D.C.:
Office of the Federal Register National Archives and Records Administration;
1979;44:69804–5; 1983;48:5852–69.
US FDA. See: United States Food and Drug Administration.
USC. See: United States Congress.
Vickers E, Cousins M, Walker S, Chisolm K. Analysis of 50 patients with
atypical odontalgia. Oral Surg Oral Med
Oral Pathol Oral Radiol Endod 1998;85:24–32.
Visudhiphan S, Poolsuppasit S, Piboonnukarintro S, et al. The relationship between high fibrinolytic activity and
daily capscium ingestion in Thais. Am J
Clin Nutr 1982;35:1452–58.
Wallengren J, Klinker M. Successful treatment of notalgia paresthetica with
topical capsaicin: Vehicle-controlled, double-blind, crossover study. J Am Academy Dermatol 1995;32(No. 2,
Part 1)287–9.
Watson C, Tyler K, Bickers D et al.
A randomized vehicle-controlled trial of topical capsaicin in the treatment of
postherpetic neuralgia. Clin Ther
1993; 15(3):510–26.
Watson C, Evans R, Watt V. Post-herpetic neuralgia and topical capsaicin. Pain 1988;33(3):333–40.
Watson C, Evans R. The postmastectomy pain syndrome and topical capsaicin:
a randomized trial. Pain
1992;51(3):375–9.
Weisman M, Hagaman C, Yaksh T, Lotz M. Preliminary findings on the role of
neuropeptide suppression by topical agents in the management of rheumatoid
arthritis. Semin Arthritis Rheum
1994;23(No 6, Suppl 3):18-24.
Westerman R, Roberts R, Kotzmann R, et
al. Effects of topical capsaicin on normal skin and affected dermatomes in Herpes zoster. Clin Exp Neurol 1988;25:71–84.
Wichtl M (ed.). Tea Derived Drugs and
Phytopharmaceuticals, 3rd Edition: A
pocket reference for the evidence-based clinical practice. [in German].
Stuttgart, Germany: Wissenschaftliche Verlagsgesellschaft GmbH; 1997;123–5.
Willard T. The Wild Rose Scientific
Herbal. Calgary, Alberta: Wild Rose College of Natural Healing; 1991;68–73.
Wood A. Determination of the pungent principles of chilies and ginger by
reversed-phase high-performance liquid chromatography with use of a single
standard substance. Flavour Fragrance J
1987;2:1–12.
Yeoh K, Kang J, Yap I, et al.
Chili protects against aspirin-induced gastroduodenal mucosal injury in humans.
Dig Dis Sci 1995;40(3):580–3.