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Peppermint

Other Name(s):

Black Peppermint, Brandy 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 lavanduliodora, Mentha Oil, Mentha Piperita, Mentha Piperita Extract, Mentha Piperita Oil, Mentha x piperita, Menthae Piperitae Aetheroleum, Menthae Piperitae Folium, Menthe, Menthe Poivrée, Menthol, Mint, Mint Balm, Oil of Peppermint, Paparaminta, Peppermint Essential Oil, Peppermint Extract, Peppermint Leaf, Peppermint Leaf Extract, Peppermint Oil, Western Peppermint.

Overview

Peppermint is a plant in the mint family. 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 other 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, diarrhea, bacterial overgrowth of the small intestine, and gas.

Some people also use peppermint for menstrual problems, preventing spasms during endoscopy procedures, fevers, headaches, to reduce stomach bloating after surgery, and as a stimulant.

Peppermint oil is applied to the skin for headache, muscle pain, nerve pain, toothache, inflammation of the mouth, joint conditions, bad breath, menopausal symptoms, hot flashes during treatment for breast cancer, itchiness of the skin during pregnancy, hives, for repelling mosquitoes, for reducing plaque, and for reducing nipple discomfort during breastfeeding.

People use peppermint oil rectally to relax the colon during barium enemas.

Some people inhale peppermint oil for treating symptoms of cough and colds, as a painkiller, to improve mental function, and to reduce stress.

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 does it work?

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.

Uses & Effectiveness

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. Most trials have used specific peppermint oil products (Colpermin by Tillotts Pharma; Mintoil by Cadigroup).

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 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 a specific product containing peppermint oil and caraway oil (Enteroplant by Dr Willmar Schwabe Pharmaceuticals) by mouth seems to reduce feelings of fullness and stomach spasms. Another specific combination product containing peppermint (Iberogast by Steigerwald Arzneimittelwerk GmbH) 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. Another similar combination product containing peppermint leaf, clown's mustard, German chamomile, caraway, licorice, and lemon balm (STW 5-II by Steigerwald Arzneimittelwerk GmbH) also seems to help.
  • 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.
  • Tension headache. Applying peppermint oil to the skin seems to help relieve tension headaches.

Possibly Ineffective for...

  • Bloating of the stomach after surgery. One study shows that taking a specific peppermint product (Copermin by Tillotts Pharma) after surgery does not reduce stomach bloating or heartburn. Another study shows that taking this product does not relieve bloating or stomach pain following removal of the appendix.

Insufficient Evidence to Rate Effectiveness for...

  • Hot flashes. Early research suggests that a combination spray containing peppermint and other ingredients does not relieve hot flashes in most women receiving chemotherapy treatments for breast cancer.
  • Mental function. Early research suggests that peppermint slightly improves memory and performance on mental tasks, but does not improve attention and speed of completing tasks.
  • Dental plaque. Early research shows that rinsing with a solution containing peppermint powder and other ingredients (HiOra by Himalaya Herbal Heathcare) reduces plaque compared to a water solution. However, it doesn't work better than a solution containing chlorhexidine.
  • Spasm in the esophagus. Early research shows that drinking water containing five drops of peppermint oil stops spasms in the esophagus.
  • 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.
  • Itchy skin during pregnancy. Early research suggests that applying oil containing 0.5% peppermint oil can reduce the severity of itchy skin in women with pregnancy-related itching.
  • Relieving pain caused by shingles. Early research suggests that applying peppermint oil to the skin might provide some relief for lingering pain caused by shingles.
  • Nausea and vomiting following surgery. Some early research shows that inhaling peppermint oil might relieve nausea after surgery. However, other research shows that inhaling peppermint oil does is not more effective than inhaling alcohol or saline. It's possible that any nausea relief seen with peppermint aromatherapy is due to improved breathing patterns rather than peppermint oil itself.
  • Stress. Early research shows that peppermint aromatherapy can reduce stress.
  • Bacteria overgrowth in the intestines.
  • Cough and symptoms of cold.
  • Infections.
  • Inflammation of mouth and respiratory tract lining.
  • Lung infections.
  • Morning sickness.
  • Muscle or nerve pain.
  • Nausea and vomiting.
  • Painful menstrual periods.
  • Toothaches.
  • Other conditions.
More evidence is needed to rate peppermint 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).

Side Effects

Peppermint and peppermint oil are LIKELY SAFE when by mouth, applied to the skin, or used rectally. The peppermint leaf is POSSIBLY SAFE when taken by mouth short-term. The safety of using peppermint leaf longer than 8-weeks is unknown.

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

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.

Children and infants: Peppermint is LIKELY SAFE when taken by mouth in food amounts. 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.

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.

Interactions


Cyclosporine (Neoral, Sandimmune)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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

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

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

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

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.


AntacidsInteraction Rating: Minor Be cautious with this combination.Talk with your health provider.

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)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

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)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

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).

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • For irritable bowel syndrome (IBS): one to two enteric-coated capsules each providing 0.2 mL or 180-225 mg of peppermint oil three times daily has been used. Most trials have used specific peppermint oil products (Colpermin by Tillotts Pharma; Mintoil by Cadigroup).
  • For spasms during endoscopy: Enteric-coated capsules containing 187 mg of 0.2 mL of peppermint oil have been taken 4 hours before a colonoscopy.
  • For upset stomach: A specific product containing 90 mg of peppermint oil and 50 mg of caraway oil (Enteroplant by Dr Willmar Schwabe Pharmaceuticals), taken two or three times daily for up to 4 weeks. A specific combination product containing peppermint leaf and several other herbs (Iberogast by Steigerwald Arzneimittelwerk GmbH) has been used in a dose of 1 mL three times daily. A similar herbal preparation containing extracts from clown's mustard, German chamomile flower, peppermint leaves, caraway, licorice root, and lemon balm (STW 5-II by Steigerwald Arzneimittelwerk GmbH), 1 mL taken three times daily for up to 8 weeks, has been used.
APPLIED TO THE SKIN:
  • For nipple discomfort due to breastfeeding: Peppermint oil gel (0.2% v/w concentration of peppermint oil) applied daily for 2 weeks. Also, solution containing peppermint oil has been applied after every breastfeeding for 2 weeks.
  • For spasms during endoscopy: 20 mL of spray containing 0.4-1.6% peppermint oil applied to the antrum during endoscopy. Also 16-40 mL of solution containing peppermint oil has been applied into the lumen during endoscopy.
  • 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. Also, 16 mL of peppermint oil and 0.4 mL of polysorbate was diluted in 2 liters of purified water, then 30 mL of the peppermint solution was added to barium paste suspended in 370 mL of water in an enema bag, and 10 mL of the peppermint solution was added to the enema tubing (6739).
CHILDREN

BY MOUTH:

  • For irritable bowel syndrome (IBS): One or two enteric-coated capsules containing 0.2 mL of peppermint oil per capsule (Colpermin by Tillotts Pharma) has been taken three times daily for 2 weeks by children aged 8 years and older.