Latin Name: Capsicum species Pharmacopeial Name: capsici fructus, capsici fructus acer Other Names: Capsicum annuum L. var. annuum: bell pepper, chili pepper, red pepper, sweet pepper, paprika; Capsicum annuum var. conoides Irish: Mexican chili, pimiento; Capsicum annuum var. glabriusculum (Dunal) Heiser & Pickersgill: bird pepper; Capsicum annuum var. longum Sendtner: Louisiana long pepper or hybridized to the Louisiana sport pepper; Capsicum frutescens L.s.l.: Tabasco pepper, African capsicum, African chili, capsicum, chili pepper, hot pepper.
[Note: This herb was published under the monograph heading 'Paprika (Cayenne)' in the original book of Commission E monographs.]
Capsicum annuum is an annual or biennial plant (Iwu, 1990), while C. frutescens is a perennial shrub. Both species are native to tropical America, now cultivated worldwide in tropical and subtropical zones (Leung and Foster, 1996; Whistler, 1992). The degree of pungency, calculated in heat units, of dried Capsicum and/or the oleoresin extractive, is what determines its value and end use (Wood, 1987). The material of commerce comes mainly from tropical Africa, China, and India (BHP, 1996).
Chili is the Aztec name for cayenne pepper. It has been used by Native Americans as food and medicine for at least nine thousand years. Based on archeological evidence, its cultivation in Mexico is believed to have begun around seven thousand years ago. It was first introduced to Europe by Dr. Diego Alvarez Chanca, who accompanied explorer Cristoforo Colombo (ca. 1451-1506 C.E.) to the West Indies (Lembeck, 1987; Palevitch and Craker, 1995). From Europe, it was then transported to most tropical, subtropical, and temperate zones around the world (Palevitch and Craker, 1995).
Cayenne was introduced into traditional Indian Ayurvedic medicine as well as traditional Chinese, Japanese, and Korean medicines, respectively. In Ayurvedic medicine, a combination of cayenne, garlic, and liquid amber are used externally in paste or plaster form as a rubefacient (agent which reddens the skin) and local stimulant. It is also combined with mustard seed in a paste form used as a counterirritant (Kapoor, 1990; Nadkarni, 1976). The dried fruit and/or tincture are also used internally to treat flatulent dyspepsia and atony of digestive organs (Karnick, 1994; Nadkarni, 1976). In Chinese medicine, cayenne is considered to have digestive stimulant action and is sometimes used to cause diaphoresis (Shih-Chen et al., 1973). Topically, it is used in China in an ointment form to treat myalgia and frostbite. In Japan, the tincture form is used topically to treat the same conditions (But et al., 1997).
In Germany, cayenne pepper is official in the German Pharmacopeia and approved in the Commission E monographs as a topical ointment for the relief of painful muscle spasms in the upper torso (DAB, 1997). In the United States, capsicum tincture and oleoresin were formerly official in the United States Pharmacopeia and National Formulary. Capsicum USP was used as a carminative, stimulant, and rubefacient (Leung and Foster, 1996; Taber, 1962). Capsaicin, isolated from Capsicum, is recognized by the U.S. FDA as a counterirritant for use in OTC topical analgesic drug products (Palevitch and Craker, 1995). It is used as a component in various counterirritant preparations (Leung and Foster, 1996), including ArthriCare (Del Pharmaceuticals, Inc.) arthritis pain relieving rub, which contains Capsicum oleoresin (0.025% capsaicin) in combination with menthol USP and Aloe vera gel (Arky et al., 1999). Capsicum ointments, such as Zostrix cream (GenDerm Corp.), containing 0.025% or 0.075% capsaicin, are used topically to treat shingles (herpes zoster) and post-herpetic neuralgia (Bernstein et al., 1987; Der Marderosian, 1999; Palevitch and Craker, 1995).
Cayenne preparations have demonstrated significant efficacy in the treatment of shingles, trigeminal neuralgia, and reduction of pain following surgical amputation (Tyler, 1993). For topical arthritis relief, capsaicin interferes with the pain of inflammatory joint disease. It may block pain fibers by destroying substance P, which normally would mediate pain signals to the brain (Garrett et al., 1997; Tyler, 1993). It may also interfere with oxygen radical transfers that are intrinsic to pain-producing prostaglandin pathways (Leung and Foster, 1996). While its exact mechanisms are not fully understood, capsaicin is regarded as a neuropathic pain reliever, and has recently been the subject of a phase 3 trial that demonstrated significant reductions in the long-term, postsurgical pain of cancer survivors (Ellison et al., 1997).
Numerous studies on topical preparations containing isolated capsaicin have been documented. Human trials have investigated its use as a treatment for chronic post-herpetic 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), its effects on normal skin and affected dermatomes in herpes zoster (Westerman et al., 1988), the somesthetic and electrophysiologic effects of topical capsaicin (Walker and Lewis, 1990), its use in the treatment of painful diabetic neuropathy (Basha and Whitehouse, 1991; Tandan et al., 1992), the effect of local capsaicin treatment for chronic rhinopathy (Eberle and Gluck, 1994), its use in the management of surgical neuropathic pain in cancer patients (Ellison et al., 1997), and the effect of topical capsaicin on substance P immunoreactivity (Munn et al., 1997). Additionally, a meta-analysis of trials of topical capsaicin for the treatment of diabetic neuropathy, osteoarthritis, post-herpetic neuralgia, and psoriasis has been published (Zhang and Li Wan Po, 1994).
Other studies on the anti-inflammatory action of capsaicin analogs suggest that the antioxidant nature of the methoxyphenol ring of capsaicin may interfere with the oxygen radical transfer mechanism common to lipoxygenase and cyclo-oxygenase. Cayenne is thought to cause a dose-related (1-100 nM) hemolysis of human red blood cells, and is associated with significant changes in erythrocyte membrane lipid components (decreasing phospholipid and cholesterol content), as well as an acetylcholinesterase activity. There are reported alterations in membranes including calcium homeostasis, lysosomal leakage, and alterations in antioxidant enzyme defense systems (Leung and Foster, 1996).
German pharmacopeial grade cayenne pepper consists of dried, ripe fruit of C. frutescens L. sensu latiore., usually removed from the calyx. It must contain not less than 0.4% capsaicinoids with reference to the dried drug. Determination of total capsaicinoids is carried out with liquid chromatography. Botanical identification must be confirmed by thin-layer chromatography (TLC), macroscopic and microscopic examinations, and organoleptic evaluation. Fruit from C. annuum L. var. longum (de Candolle) Sendtner may not be present (DAB, 1997). The German Homeopathic Pharmacopoeia, however, requires the dried ripe fruits of C. annuum L. and considers the fruits of C. frutescens L. to be foreign constituents (GHP, 1993).
Japanese pharmacopeial grade cayenne pepper consists of the fruit of C. annuum L. or its varieties. Identity is confirmed by TLC plus macroscopic and organoleptic evaluations. It must contain not less than 9.0% ether-soluble extractive (JSHM, 1993).
Description
Cayenne consists of the dried fruits of various capsaicin-rich Capsicum species [Fam. Solanaceae] and its preparations in effective dosage. Cayenne pepper consists of the dried, ripe, usually removed from the calyx, fruits of C. frutescens L., and its preparations in effective dosage. The preparations contain capsaicinoids.
Chemistry and Pharmacology
Cayenne pepper contains up to 1.5% capsaicinoids (pungent principles) including 0.11% capsaicin, 6,7-dihydrocapsaicin, nordihydrocapsaicin, homodihydrocapsaicin, and homocapsaicin; fixed oils (Budavari, 1996; Leung and Foster, 1996; Wood, 1987); carotenoid pigments including capsanthin, capsorubin, alpha- and beta-carotene (Budavari, 1996; But et al., 1997; Leung and Foster, 1996); steroid glycosides, including capsicosides A, B, C, and D (But et al., 1997); 9-17% fats; 12-15% proteins; vitamins A and C; trace of volatile oil (Leung and Foster, 1996; Newall et al., 1996).
The Commission E reported local hyperemic and local nerve-damaging activity.
The British Herbal Pharmacopoeia reported rubefacient and vasostimulant actions (BHP, 1996). The Merck Index reported the therapeutic category of capsaicin, a pungent principle isolated from cayenne or paprika, as topical analgesic (Budavari, 1996). Cayenne has been shown to have counterirritant, antiseptic, diaphoretic, rubefacient, and gastric stimulating properties (Newall et al., 1996; Stecher, 1968).
Uses
The Commission E approved cayenne for painful muscle spasms in areas of shoulder, arm, and spine of adults and children. Preparations are used to treat arthritis, rheumatism, neuralgia, lumbago, and chilblains. It is also used as a deterrent for thumb sucking or nail biting in children (Leung and Foster, 1996). Human studies on cayenne have found different results in duodenal ulcer patients. One study administered 10 g of red chilies in wheatmeal to the control group and duodenal ulcer sufferers and found no significant effect on acid or pepsin secretion, or on sodium, potassium, and chloride concentrations in the gastric aspirate (Pimparkar et al., 1972). In contrast, a study on capsicum showed that it increased acid concentration and DNA content of gastric aspirates in control subjects as well as in patients with duodenal ulcers (Locock, 1985).
Contraindications
Application on injured skin, allergies to cayenne preparations.
Side Effects
In rare cases hypersensitivity reaction may occur (urticaria).
Use During Pregnancy and Lactation
No restrictions known.
Interactions with Other Drugs
None known.
Note:No additional heat application.
Dosage and Administration
Unless otherwise prescribed: Preparations of cayenne exclusively for external uses.
Liniment: Hot oil emulsion containing dried cayenne powder or alcoholic tincture, applied locally by friction method.
Ointment or cream: Semi-liquid preparation containing 0.02-0.05% capsaicinoids in an emulsion base, applied to affected area.
Poultice: Semi-solid paste or plaster containing 10-40 µg capsaicinoids per cm2, applied locally.
Duration of administration: Not 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.
Warning: Cayenne preparations irritate the mucous membranes even in very low concentrations and cause a painful burning sensation. Avoid contact of cayenne preparations with mucous membranes, especially the eyes.
References
Arky, R. et al., 1999. Physicians' Desk Reference for Nonprescription Drugs and Dietary Supplements. Montvale, NJ: Medical Economics Company, Inc. 642.
Basha, K.M. and F.W. Whitehouse. 1991. Capsaicin: a therapeutic option for painful diabetic neuropathy. Henry Ford Hosp Med J 39(2):138-140.
Bernstein J.E., D.R. Bickers, M.V. Dahl, J.Y. Roshal. 1987. Treatment of chronic postherpetic neuralgia with topical capsaicin. A preliminary study. J Am Acad Dermatol 17(1):93-96.
British Herbal Pharmacopoeia (BHP). 1996. Exeter, U.K.: British Herbal Medicine Association. 55-56.
Budavari, S. (ed.). 1996. The Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals, 12th ed. Whitehouse Station, N.J.: Merck & Co, Inc. 287-289.
But, P.P.H. et al. (eds.). 1997. International Collation of Traditional and Folk Medicine. Singapore: World Scientific. 138-139.
Der Marderosian, A. (ed.). 1999. The Review of Natural Products. St. Louis: Facts and Comparisons.
Deutsches Arzneibuch (DAB 1997). 1997. Stuttgart: Deutscher Apotheker Verlag.
Eberle L. and U. Gluck. 1994. Klinische Erfahrungen mit lokaler Capsaicinbehandlung bei chronischer Rhinopathie [Clinical experiences with local capsaicin treatment of chronic rhinopathy]. HNO 42(11):665-669.
Ellison, N. et al. 1997. Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients. J Clin Oncol 15(8):2974-2980.
Garrett, N.E., S.C. Cruwys, B.L. Kidd, D.R. Tomlinson. 1997. Effect of capsaicin on substance P and nerve growth factor in adjuvant arthritic rats. Neurosci Lett 230(1):58.
The German Homeopathic Pharmacopoeia (GHP). 1993. Translation of Homopathisches Arzneibuch (HAB 1), 5th suppl. 1991 to the first edition 1978. Stuttgart: Deutscher Apotheker Verlag. 275-277.
Karnick, C.R. 1994. Pharmacopoeial Standards of Herbal Plants, Vol. 1. Delhi: Sri Satguru Publications. 79-80.
Lembeck, F. 1987. Columbus, Capsicum and capsaicin: past, present and future. Acta Physiol Hung 69(34):265-273.
Leung, A.Y. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc.
Locock, R.A. 1985. Capsicum. Can Pharm J 118:517-519.
Menke, J.J. and J.R. Heins. 1999. Treatment of postherpetic neuralgia. J Am Pharm Assoc (Wash) 39(2):217-221.
Munn, S.E. et al. 1997. The effect of topical capsaicin on substance P immunoreactivity: a clinical trial and immunohistochemical analysis [letter]. Acta Derm Venereol(Stockh) 77(2):158-159.
Nadkarni, K.M. 1976. Indian Materia Medica. Bombay: Popular Prakashan. 268-271.
Newall, C.A., L.A. Anderson, J.D. Phillipson. 1996. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press.
Palevitch, D. and L.E. Craker. 1995. Nutritional and medical importance of red pepper (Capsicum spp.). J Herbs Spices Med Plants 3(2):55-83.
Peikert A., M. Hentrich, G. Ochs. 1991. Topical 0.025% capsaicin in chronic post-herpetic neuralgia: efficacy, predictors of response and long-term course. J Neurol 238(8):452-456.
Pimparkar, B.N.D. et al. 1972. Effects of commonly used spices on human gastric secretion. J Assoc Physicians India 20:901-910.
Shih-Chen, L., F.P. Smith, G.A. Stuart. 1973. Chinese Medicinal Herbs. San Francisco, CA: Georgetown Press.
Stecher, P.G. et al. 1968. The Merck Index: An Encyclopedia of Chemicals and Drugs, 8th ed. Rahway, N.J.: Merck & Co., Inc.
Taber, C.W. 1962. Taber's Cyclopedic Medical Dictionary, 9th ed. Philadelphia: F.A. Davis Company. C-11.
Tandan, R., G.A. Lewis, P.B. Krusinski, G.B. Badger, T.J. Fries. 1992. Topical capsaicin in painful diabetic neuropathy. Controlled study with long-term follow-up. Diabetes Care 15(1):8-14.
Tyler, V. 1993. The Honest Herbal, 3rd ed. New York: Pharmaceutical Products Press.
Walker, F.O. and S.F. Lewis. 1990. Somesthetic and electrophysiologic effects of topical 0.025% capsaicin in man. Reg Anesth 15(2):61-66.
Watson C.P. et al. 1993. A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia. Clin Ther 15(3):510-526.
Westerman, R.A. et al. 1988. Effects of topical capsaicin on normal skin and affected dermatomes in herpes zoster. Clin Exp Neurol 25:71-84.
Wood, A.B. 1987. 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 2:112.
Zhang, W.Y. and A. Li Wan Po. 1994. The effectiveness of topically applied capsaicin. A meta-analysis. Eur J Clin Pharmacol 46(6):517-522.
Additional Resources
British Herbal Pharmacopoeia (BHP).1983. Keighley, U.K.: British Herbal Medicine Association.
Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing.
Deutsches Arzneibuch, 10th ed. (DAB 10). 1991. (With subsequent supplements through 1996.) Stuttgart: Deutscher Apotheker Verlag.
Grieve, M. 1979. A Modern Herbal. New York: Dover Publications, Inc.
Wren, R.C. 1988. Potter's New Cyclopaedia of Botanical Drugs and Preparations. Essex: The C.W. Daniel Company Ltd.
This material was adapted from The Complete German Commission E Monographs—Therapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.
1) The Overview section is new information.
2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.
3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:
Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
Infusion: 2 g in 150 ml of water
Fluidextract 1:1 (g/ml): 2 ml
Tincture 1:5 (g/ml): 10 ml
4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.
This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.
Excerpt from Herbal Medicine: Expanded Commission E Monographs Copyright 2000 American Botanical Council Published by Integrative Medicine Communications Available from the American Botanical Council.