HERBAL MONOGRAPHS CAYENNE/ 167and should only be used again after 2 weeks. Longer usage
can cause festering dermatitis, blistering and ulceration (See
PRECAUTIONS).
Indian Medicine: Cayenne is used for gout, arthritis, sciatica,
coughs and hoarseness. It has been used for lowering the
"W temperature in malaria, yellow fever, scarlet fever and
typhus. It is used for cholera, edema and anorexia nervosa. It
is used in compound preparations for loss of appetite,
dyspepsia and diarrhea (tablets l:l:l; Cayenne pepper,
rhubarb and ginger root) and for alcoholism as an infusion
(Cayenne pepper with sugar and cinnamon) to reduce the
desire for alcohol.Homeopathic Uses: The herb is used for inflammation of the
efferent urinary tract, the alimentary canal, the mouth and
throat, and middle ear infection.
PRECAUTIONS AND ADVERSE REACTIONS
General: There has not yet been a final determination of
possible health hazards or side effects in conjunction with
the proper administration of designated therapeutic dosages.
Internal administration may increase gastrointestinal peristal-
sis resulting in diarrhea, intestinal and gallstone colics.
Besides the intended stimulating effect, external applications
mt can lead to blister and ulcer formation. Investigations into
mutagenicity, teratogenicity and carcinogenicity yielded
contradictory results. Warning: Use should be limited to 2
days and should only be used again after 2 weeks. Keep
away from the eyes!
Hematologic Effects: Capsicum has been found to induce
increased fibrinolytic activity and simultaneously cause
hypocoagulability of blood (Visudhiphan, 1982).
Hypersensitivity: Anaphylaxis and rhinoconjunctivitis symp-
toms have been associated with the herb due to its antigenic
components (Jensen-Jarolim, 1998; Vega de la Osada, 1998).
Contact dermatitis has been reported from the direct
handling of chili peppers containing capsaicin (Williams,
1995). A hypersensitivity reaction known as plasma cell
gingivitis may occur with the herb, and may cause severe
gingival inflammation, discomfort and bleeding (Serio,
1991). One study suggest the allergy is rarely an autonomous
sensitization, but rather a consequence of pollen allergy on
the basis of immunologic cross-reactivity (Ebner, 1998).•^ Respiratory Effects: Alveobronchiolitis and fibrotic changes
have occurred as a result oft a respirable paprika dust
preparation used after a single intratracheal dose (Tatrai,
1992). Chronic exposure to chili peppers has been associated
with an increase in cough (Blanc, 1991).
Drug Interactions: Aspirin and salicylic acid compounds-
The bioavailabilities of aspirin (acetylsalicyhc acid) and of
salicylic acid were reduced when given concomitantly withCapsicum annuum extract, containing 100 mg of capsaicin
per gram as a result of the gastrointestinal effects of
capsaicin (Cruz, 1999).
OVERDOSAGE
Toxic dosages lead to life-threatening hypothemias by
affecting the thermoreceptors. High doses of the drug (or the
herb) administered over extended periods can cause chronic
gastritis, kidney damage, liver damage and neurotoxic
effects. The treatment for poisonings proceeds
symptomatically.
DOSAGE
Mode of Administration: Preparations of Cayenne are
exclusively for external indications in antirheumatic oint-
ments and plasters.
How Supplied:
Capsules—400 mg, 445 mg, 450 mg, 455 mg, 500 mg
Cream—0.25% capsaicin, 0.75% capsaicin
Preparation: A liquid extract is prepared by percolating 100
gm drug with 60 gm ethanol. Other formulations include:
Capsicum-oleoresin with 90% ethanol and a tincture with
90% ethanol.
Daily Dosage: External daily dose: 10 gm drug; Tincture:
(1:10); Semi-solid preparations: maximum 50 mg capsaicin
in 100 gm neutral base. The cream is applied to the affected
area not more than 3 or 4 times daily (Zostrix Package Insert,
1998).Internal application: Decoction: '/: liter water with 5 gm
powdered drug, 3 gm powdered Cascarilla bark and 5 gm
powdered rhubarb root; 2 cups per day.
Homeopathic Dosage: 5 drops, 1 tablet or 10 globules every
30 to 60 minutes (acute) or 1 to 3 times a day (chronic);
ointment: once or twice daily (HAB1)
Storage: Should be well sealed and protected from light.
LITERATURE
Anonym, Behandlung chronischer Schmerzen: Capsaicin -
Lichtblick fur Schmerzpatienten. In: DAZ 137(13): 1027-1028.
1997.
Anonym, Phytotherapie:Pflanzliche Antirheumatika - was
bringen sie? In: DAZ 136(45):4012^015. 1996.
Bascom R, Kageysobotka A, Prous D, Effect of intranasal
capsaicin on symptoms and mediator release. In: J Pharmacol
Exp Ther 259(3): 1323. 1991.
Biro T, Acs G, Acs P et al., Receptor advances in
understanding of vanilloid receptors: a therapeutic target for
treatment of pain and inflammation in skin. J Invest Dermatol
1997; 2:56-60.
Blanc P, Liu D, Juarez C, Boushey HA, Cough in hot pepper
workers. Chest 1991 Jan;99(l):27-32.