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Peppermint


What is it?

Peppermint is a plant. The leaf and oil are used as medicine.

Peppermint is used for the common cold, cough, inflammation of the mouth and throat, sinus infections, and respiratory infections. It is also used for digestive problems including heartburn, nausea, vomiting, morning sickness, irritable bowel syndrome (IBS), cramps of the upper gastrointestinal (GI) tract and bile ducts, upset stomach, diarrhea, bacterial overgrowth of the small intestine, and gas.

Some people also use peppermint for menstrual problems, liver and gallbladder complaints, preventing spasms during endoscopy procedures, and as a stimulant.

Peppermint oil is applied to the skin for headache, muscle pain, nerve pain, toothache, inflammation of the mouth, joint conditions, itchiness, allergic rash, bacterial and viral infections, relaxing the colon during barium enemas, and for repelling mosquitoes.

Some people inhale peppermint oil for treating symptoms of cough and colds, and as a painkiller.

In foods and beverages, peppermint is a common flavoring agent.

In manufacturing, peppermint oil is used as a fragrance in soaps and cosmetics, and as a flavoring agent in pharmaceuticals.

In 1990, the FDA banned the sale of peppermint oil as an over-the-counter drug for use as a digestive aid because its effectiveness had not been proven. Today, peppermint is sold as a dietary supplement. Unlike over-the-counter medications, dietary supplements do not have to be proven effective to the satisfaction of the FDA in order to be marketed. Also, unlike over-the-counter medications, dietary supplements are not allowed to claim that they prevent or treat illness.

How effective is it?

Natural Medicines Comprehensive Database 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.

The effectiveness ratings for PEPPERMINT are as follows:

Likely effective for...

  • Irritable bowel syndrome (IBS). Although some older studies suggest that peppermint oil does not affect IBS, most research shows that taking peppermint oil by mouth reduces stomach pain, bloating, gas, and bowel movements in people with IBS.

Possibly effective for...

  • Relaxing the colon during medical exams, including barium enemas. Using peppermint oil as an ingredient in enemas seems to relax the colon during barium enema examinations. Also, taking peppermint oil by mouth before the start of a barium enema also seems to decrease spasms.
  • Breastfeeding discomfort. Research suggests that breastfeeding women who apply peppermint oil on their skin have less cracked skin and pain in the nipple area.
  • Heartburn (dyspepsia). Taking peppermint oil by mouth together with caraway oil seems to reduce feelings of fullness and stomach spasms. A specific combination product containing peppermint (Iberogast, Medical Futures, Inc) also seems to improve symptoms of heartburn, including severity of acid reflux, stomach pain, cramping, nausea, and vomiting. The combination includes peppermint leaf plus clown’s mustard plant, German chamomile, caraway, licorice, milk thistle, angelica, celandine, and lemon balm.
  • Spasms caused by endoscopy. Research shows that peppermint oil can reduce pain and spasms in people undergoing endoscopy, a procedure used to see within the gastrointestinal tract.
  • Migraine headache. Applying a peppermint solution to the skin at the start of a migraine and again 30 minutes later seems to increase the percentage of patients who experience headache resolution.
  • Tension headache. Applying peppermint oil to the skin seems to help relieve tension headaches.

Possibly ineffective for...

  • Nausea following surgery. Inhaling peppermint might relieve nausea by improving breathing patterns after surgery. However, inhaling peppermint oil does not seem to be more effective than inhaling alcohol or saline for reducing nausea after surgery.
  • Recovery following surgery. One study shows that taking a specific peppermint product (Copermin) three times daily for five days after surgery does not affect stomach bloating or heartburn. Another study shows that taking peppermint oil capsules does not relieve bloating or stomach pain following surgery.

Insufficient evidence to rate effectiveness for...

  • Bad breath. Early research shows that a specific combination of tea tree oil, peppermint, and lemon oil can improve breath smell when used for 3 minutes.
  • Mental function. Early evidence suggests that peppermint slightly improves memory and performance on mental tasks, but does not improve attention and speed of completing tasks.
  • Dental plaque. Early evidence shows that peppermint oil or extract combined with other herbs reduces dental plaque. However, peppermint does not seem to be better than standard treatments.
  • Spasm in the esophagus. Early evidence shows that drinking water containing five drops of peppermint oil stops spasms in the esophagus.
  • Hot flashes. Early evidence suggests that a combination peppermint and neroli hydrolat spray might relieve hot flashes in women receiving chemotherapy treatments for breast cancer.
  • Relieving pain caused by shingles. Early information suggests that applying peppermint oil to the skin might provide some relief for lingering pain caused by shingles.
  • Itchy skin (pruritus). Early evidence suggests that applying a specific product containing the peppermint constituent, menthol, along with camphor and phenol, can reduce scalp itching.
  • Stress. Early research shows that peppermint aromatherapy can reduce stress.
  • Tuberculosis. Early research suggests that inhaling peppermint for 20 minutes for 2 months improves the effectiveness of typical drug therapy for tuberculosis.
  • Toothaches.
  • Infections.
  • Morning sickness.
  • Nausea and vomiting.
  • Painful menstrual periods.
  • Bacteria overgrowth in the intestines.
  • Lung infections.
  • Cough and symptoms of cold.
  • Inflammation of mouth and respiratory tract lining.
  • Muscle or nerve pain.
  • Other conditions.
More evidence is needed to rate peppermint for these uses.

How does it work?

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Peppermint oil seems to reduce spasms in the digestive tract. When applied to the skin, it can cause surface warmth, which relieves pain beneath the skin.

Are there safety concerns?

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Peppermint and peppermint oil are LIKELY SAFE when taken by mouth in amounts commonly found in food, when taken in medicinal amounts, or when applied to the skin. The leaf is POSSIBLY SAFE when taken in amounts used for medicine short-term (up to 8 weeks). The safety of using peppermint leaf long-term is unknown.

Peppermint can cause some side effects including heartburn, and allergic reactions including flushing, headache, and mouth sores.

Peppermint oil, when taken by mouth in pills with a special (enteric) coating to prevent contact with the stomach, is POSSIBLY SAFE for children 8 years of age and older.

Special precautions & warnings:

Pregnancy and breast-feeding: It is LIKELY SAFE to take peppermint in amounts normally found in food during pregnancy and breast-feeding. However, not enough is known about the safety of taking larger amounts used for medicine. It’s best not to take these larger amounts if you are pregnant or breast-feeding.

A stomach condition in which the stomach is not producing hydrochloric acid (achlorhydria): Don’t use enteric-coated peppermint oil if you have this condition. The enteric coating might dissolve too early in the digestive process.

Diarrhea: Enteric-coated peppermint oil could cause anal burning, if you have diarrhea.

Are there interactions with medications?

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Moderate

Be cautious with this combination.

Cyclosporine (Neoral, Sandimmune)
The body breaks down cyclosporine (Neoral, Sandimmune) to get rid of it. Peppermint oil might decrease how quickly the body breaks down cyclosporine (Neoral, Sandimmune). Taking peppermint oil products along with cyclosporine (Neoral, Sandimmune) might increase the risk of side effects for cyclosporine (Neoral, Sandimmune).

Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)
Some medications are changed and broken down by the liver. Peppermint oil might decrease how quickly the liver breaks down some medications. Taking peppermint oil along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking peppermint oil, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), and others.

Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)
Some medications are changed and broken down by the liver. Peppermint oil might decrease how quickly the liver breaks down some medications. Taking peppermint oil along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking peppermint oil, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.

Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
Some medications are changed and broken down by the liver. Peppermint oil might decrease how quickly the liver breaks down some medications. Taking peppermint oil along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking peppermint oil, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Some medications are changed and broken down by the liver. Peppermint oil might decrease how quickly the liver breaks down some medications. Taking peppermint oil along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking peppermint oil, 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.

Minor

Be watchful with this combination.

Antacids
Some peppermint oil products are covered with a special (enteric) coating. Antacids are used to decrease stomach acid. Low stomach acid can cause the coating of these peppermint oil products to dissolve too quickly. When peppermint oil products dissolve too quickly they can sometimes cause heartburn and nausea. Take antacids at least two hours after coated peppermint oil products.

Some antacids include calcium carbonate (Tums, others), dihydroxyaluminum sodium carbonate (Rolaids, others), magaldrate (Riopan), magnesium sulfate (Bilagog), aluminum hydroxide (Amphojel), and others.

Medications that decrease stomach acid (H2-Blockers)
Some peppermint oil products are covered with a special (enteric) coating. Some medications that decrease stomach acid might cause the coating of these peppermint oil products to dissolve too quickly. When peppermint oil products dissolve too quickly, they can sometimes cause heartburn and nausea. Take medications that decrease stomach acid at least two hours after coated peppermint oil products.

Some medications that decrease stomach acid include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).

Medications that decrease stomach acid (Proton pump inhibitors)
Some peppermint oil products are covered with a special (enteric) coating. Some medications that decrease stomach acid might cause the coating of these peppermint oil products to dissolve too quickly. When peppermint oil products dissolve too quickly, they can sometimes cause heartburn and nausea. Take medications that decrease stomach acid at least two hours after coated peppermint oil products.

Some medications that decrease stomach acid include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium).

Are there interactions with herbs and supplements?

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Iron
Peppermint reduces the absorption of iron when taken at the same time.

Quercetin
Peppermint increases the absorption of quercetin when taken at the same time.

Are there interactions with foods?

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Food
Some peppermint oil products are covered with a special (enteric) coating. These products should be taken between meals.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For upset stomach: Peppermint oil 90 mg per day has been used in combination with caraway oil. A specific combination product containing peppermint leaf and several other herbs (Iberogast, Medical Futures, Inc) has been used in a dose of 1 mL three times daily.
APPLIED TO THE SKIN:
  • For tension headaches: 10% peppermint oil in ethanol solution applied across the forehead and temples, repeated after 15 and 30 minutes, has been used.
BY ENEMA:
  • For decreasing colonic spasms during barium enema: 8 mL of peppermint oil was added to 100 mL water along with a surface active agent, Tween 80. The insoluble fraction was removed, then 30 mL of the remaining peppermint solution was added to 300 mL of the barium solution.

Other names

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Black Peppermint, Bo He, Brandy Mint, Chinese Peppermint, Corn Mint, Extract of Mentha Piperita, Extract of Peppermint, Extract of Peppermint Leaves, Extract of Peppermint Leaves, Extrait de Feuilles de Menthe de Poivrée, Extrait de Mentha Piperita, Extrait de Menthe Poivrée, Feuille de Menthe Poivrée, Field Mint, Herba Menthae, Huile de Mentha Piperita, Huile de Menthe Poivrée, Huile Essentielle de Menthe Poivrée, Lamb Mint, Menta Piperita, Mentha arvensis, Mentha halpocalyx, Mentha lavanduliodora, Mentha Oil, Mentha Piperita, Mentha Piperita Extract, Mentha Piperita Oil, Mentha x piperita, Menthae Piperitae Aetheroleum, Menthae Piperitae Folium, Menthe, Menthe Anglaise, Menthe Poivrée, Menthe Pouliot, Menthe Sauvage, Menthe Verte, Menthol, Mint, Mint Balm, Oil of Peppermint, Paparaminta, Peppermint Essential Oil, Peppermint Extract, Peppermint Leaf, Peppermint Leaf Extract, Peppermint Oil, Sentebon, Western Peppermint, Yerba Buena.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Peppermint page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/705.html.

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Page last updated: 10 December 2014