White Pepper: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

White pepper grows in tropical Asian countries. Black pepper and white pepper both come from the same plant. But they are prepared differently. Black pepper is made by cooking the dried unripe fruit. White pepper is made by cooking and drying the ripe seeds.

People take white pepper by mouth to treat upset stomach, diarrhea, and many other conditions, but there is no good scientific evidence to support these uses.

White pepper contains a chemical called piperine. This chemical seems to have many effects in the body. It seems to reduce pain, improve breathing, and reduce inflammation. Piperine also seems to improve brain function, but it is not clear how.

White pepper is added to foods and drinks to add flavor.

White pepper essential oil is used in aromatherapy.

How does it work ?

White pepper contains a chemical called piperine. This chemical seems to have many effects in the body. It seems to reduce pain, improve breathing, and reduce inflammation. Piperine also seems to improve brain function, but it is not clear how.

Uses & Effectiveness

Insufficient Evidence for

Diarrhea.
Cancer.
A bacterial infection that causes diarrhea (cholera).
Malaria.
Pain.
Upset stomach.
Other conditions.

More evidence is needed to rate white pepper for these uses.

Side Effects

When taken by mouth: White pepper is LIKELY SAFE when taken in amounts commonly found in foods.

White pepper is POSSIBLY SAFE when taken appropriately as medicine. White pepper might cause an allergic reaction in some patients, although this is rare. White pepper might also cause a burning aftertaste. Piperine, a component of white pepper, has been reported to cause fast heart rate, nausea, headache, coughing, sneezing, and runny nose when used as a nasal spray.

Special Precautions and Warnings

Pregnancy: White pepper is LIKELY SAFE when taken by mouth in amounts commonly found in foods. There isn't enough reliable information to know if taking white pepper as medicine or applying white pepper oil to the skin is safe while pregnant. Stay on the safe side and stick to food amounts.

Breast-feeding: White pepper is LIKELY SAFE when taken by mouth in amounts commonly found in foods. There isn't enough reliable information to know if taking white pepper as medicine is safe while breast-feeding. Stay on the safe side and stick to food amounts.

Children: White pepper is LIKELY SAFE when taken by mouth in amounts commonly found in foods. It is POSSIBLY UNSAFE when taken by mouth in large amounts. Deaths have been reported in children.

Bleeding conditions: Piperine, a chemical in white pepper, might slow blood clotting. In theory, taking white pepper in amounts greater than those in food might increase the risk of bleeding in people with bleeding disorders.

Diabetes: White pepper might affect blood sugar levels. In theory, taking white pepper in amounts greater than those in food might affect blood sugar control in people with diabetes. Dosing adjustments for diabetes medications might be needed.

Surgery: Piperine, a chemical in white pepper, might slow blood clotting and affect blood sugar levels. In theory, white pepper might cause bleeding complications or affect blood sugar levels during surgery. You should stop taking white pepper in amounts greater than those in food at least 2 weeks before surgery.

Interactions

Moderate Interaction

Be cautious with this combination

Medications changed by the liver (Cytochrome P450 1A1 (CYP1A1) substrates) interacts with White Pepper
Some medications are changed and broken down by the liver. White pepper might decrease how quickly the liver breaks down some medications. Taking white pepper along with some medications that are broken down by the liver might increase the chance of side effects from some medications. Before taking white pepper, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include chlorzoxazone, theophylline, and bufuralol.
Medications changed by the liver (Cytochrome P450 2B1 (CYP2B1) substrates) interacts with White Pepper
Some medications are changed and broken down by the liver. White pepper might decrease how quickly the liver breaks down some medications. Taking white pepper along with some medications that are broken down by the liver might increase the chance of side effects from some medications. Before taking white pepper, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include cyclophosphamide, ifosfamide, barbiturates, bromobenzene, and others.
Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates) interacts with White Pepper
Some medications are changed and broken down by the liver. White pepper might decrease how quickly the liver breaks down some medications. Taking white pepper along with some medications that are broken down by the liver might increase the chance of side effects from some medications. Before taking white pepper, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), haloperidol (Haldol), imipramine (Tofranil), metoprolol (Lopressor, Toprol XL), ondansetron (Zofran), paroxetine (Paxil), risperidone (Risperdal), tramadol (Ultram), venlafaxine (Effexor), and others.
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with White Pepper
Some medications are changed and broken down by the liver. White pepper might decrease how quickly the liver breaks down some medications. Taking white pepper along with some medications that are broken down by the liver might increase the chance of side effects from some medications. Before taking white pepper, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include some calcium channel blockers (diltiazem, nicardipine, verapamil), chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), glucocorticoids, cisapride (Propulsid), alfentanil (Alfenta), fentanyl (Sublimaze), losartan (Cozaar), fluoxetine (Prozac), midazolam (Versed), omeprazole (Prilosec), ondansetron (Zofran), propranolol (Inderal), fexofenadine (Allegra), and many others.
Lithium interacts with White Pepper
White pepper might have an effect like a water pill or "diuretic." Taking white pepper might decrease how well the body gets rid of lithium. This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.
Medications moved by pumps in cells (P-Glycoprotein Substrates) interacts with White Pepper
Some medications are moved by pumps in cells. White pepper might make these pumps less active and increase how much of some medications get absorbed by the body. In theory, this might cause more side effects from some medications.

Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, digoxin, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
Cyclosporine (Neoral, Sandimmune) interacts with White Pepper
White pepper contains a chemical called piperine. Piperine might increase levels of cyclosporine in the body. In theory, taking white pepper with cyclosporine might increase the effects and side effects of cyclosporine.
Pentobarbital (Nembutal) interacts with White Pepper
White pepper contains a chemical called piperine. Piperine might increase sleepiness caused by pentobarbital. In theory, taking white pepper with pentobarbital might increase the sedative side effects of pentobarbital.
Phenytoin (Dilantin) interacts with White Pepper
White pepper might increase how much phenytoin the body absorbs. Taking white pepper along with phenytoin might increase the effects and side effects of phenytoin.
Propranolol (Inderal) interacts with White Pepper
White pepper might increase how much propranolol the body absorbs. Taking white pepper along with propranolol might increase the effects and side effects of propranolol.
Rifampin (Rifadin) interacts with White Pepper
White pepper might increase how much rifampin the body absorbs. Taking white pepper along with rifampin might increase the effects and side effects of rifampin.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with White Pepper
White pepper contains a chemical called piperine. Piperine might slow blood clotting. In theory, taking white pepper along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Medications for diabetes (Antidiabetes drugs) interacts with White Pepper
White pepper contains a chemical called piperine. Some research shows that piperine might decrease blood sugar levels. In theory, white pepper might cause an interaction with diabetes medications resulting in blood sugar levels going too low. Until more is known, monitor your blood sugar closely if you take white pepper. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
Theophylline interacts with White Pepper
White pepper can increase how much theophylline the body can absorb. This might cause increased effects and side effects of theophylline.

Minor Interaction

Be watchful with this combination

Nevirapine (Viramune) interacts with White Pepper
White pepper contains a chemical called piperine. Piperine might increase levels of nevirapine in the body. In theory, taking white pepper with nevirapine might increase the effects and side effects of nevirapine. However, there is not enough known about this potential interaction to know if it is a big concern.
Amoxicillin (Amoxil, Trimox) interacts with White Pepper
White pepper contains a chemical called piperine. Piperine might increase levels of amoxicillin in the blood. In theory, taking white pepper with amoxicillin might increase the effects and side effects of amoxicillin. However, there is not enough known about this potential interaction to know if it is a big concern.
Carbamazepine (Tegretol) interacts with White Pepper
White pepper might increase the amount of carbamazepine (Tegretol) absorbed by the body. It might also decrease how quickly the body breaks down and gets rid of carbamazepine. This could increase how much carbamazepine is in the body and potentially increase the chance of side effects. However, there is not enough known about this potential interaction to know if it is a big concern.
Cefotaxime (Claforan) interacts with White Pepper
White pepper contains a chemical called piperine. Piperine might increase levels of cefotaxime in the blood. In theory, taking white pepper with cefotaxime might increase the effects and side effects of cefotaxime. However, there is not enough known about this potential interaction to know if it is a big concern.

Dosing

The appropriate dose of white pepper depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for white pepper (in children/in adults). Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

View References

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Selvendiran, K., Thirunavukkarasu, C., Singh, J. P., Padmavathi, R., and Sakthisekaran, D. Chemopreventive effect of piperine on mitochondrial TCA cycle and phase-I and glutathione-metabolizing enzymes in benzo(a)pyrene induced lung carcinogenesis in Swiss albino mice. Mol.Cell Biochem. 2005;271(1-2):101-106.

Selvendiran, K., Banu, S. M., and Sakthisekaran, D. Oral supplementation of piperine leads to altered phase II enzymes and reduced DNA damage and DNA-protein cross links in Benzo(a)pyrene induced experimental lung carcinogenesis. Mol.Cell Biochem. 2005;268(1-2):141-147.

Krishnakumar, N., Manoharan, S., Palaniappan, P. R., Venkatachalam, P., and Manohar, M. G. Chemopreventive efficacy of piperine in 7,12-dimethyl benz [a] anthracene (DMBA)-induced hamster buccal pouch carcinogenesis: an FT-IR study. Food Chem.Toxicol. 2009;47(11):2813-2820.

Selvendiran, K., Senthilnathan, P., Magesh, V., and Sakthisekaran, D. Modulatory effect of Piperine on mitochondrial antioxidant system in Benzo(a)pyrene-induced experimental lung carcinogenesis. Phytomedicine. 2004;11(1):85-89.

Selvendiran, K., Singh, J. P., Krishnan, K. B., and Sakthisekaran, D. Cytoprotective effect of piperine against benzo[a]pyrene induced lung cancer with reference to lipid peroxidation and antioxidant system in Swiss albino mice. Fitoterapia 2003;74(1-2):109-115.

Khajuria, A., Thusu, N., Zutshi, U., and Bedi, K. L. Piperine modulation of carcinogen induced oxidative stress in intestinal mucosa. Mol.Cell Biochem. 1998;189(1-2):113-118.

Selvendiran, K., Padmavathi, R., Magesh, V., and Sakthisekaran, D. Preliminary study on inhibition of genotoxicity by piperine in mice. Fitoterapia 2005;76(3-4):296-300.

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Rauscher, F. M., Sanders, R. A., and Watkins, J. B., III. Effects of piperine on antioxidant pathways in tissues from normal and streptozotocin-induced diabetic rats. J Biochem.Mol.Toxicol. 2000;14(6):329-334.

D'Hooge, R., Pei, Y. Q., Raes, A., Lebrun, P., van Bogaert, P. P., and de Deyn, P. P. Anticonvulsant activity of piperine on seizures induced by excitatory amino acid receptor agonists. Arzneimittelforschung. 1996;46(6):557-560.

Mori, A., Kabuto, H., and Pei, Y. Q. Effects of piperine on convulsions and on brain serotonin and catecholamine levels in E1 mice. Neurochem.Res. 1985;10(9):1269-1275.

Gevaert, T., Vandepitte, J., Hutchings, G., Vriens, J., Nilius, B., and De Ridder, D. TRPV1 is involved in stretch-evoked contractile changes in the rat autonomous bladder model: a study with piperine, a new TRPV1 agonist. Neurourol.Urodyn. 2007;26(3):440-450.

Hu, Y., Guo, D. H., Liu, P., Rahman, K., Wang, D. X., and Wang, B. Antioxidant effects of a Rhodobryum roseum extract and its active components in isoproterenol-induced myocardial injury in rats and cardiac myocytes against oxidative stress-triggered damage. Pharmazie 2009;64(1):53-57.

Malini, T., Arunakaran, J., Aruldhas, M. M., and Govindarajulu, P. Effects of piperine on the lipid composition and enzymes of the pyruvate-malate cycle in the testis of the rat in vivo. Biochem.Mol.Biol.Int. 1999;47(3):537-545.

Piyachaturawat, P., Glinsukon, T., and Peugvicha, P. Postcoital antifertility effect of piperine. Contraception 1982;26(6):625-633.

Piyachaturawat, P., Sriwattana, W., Damrongphol, P., and Pholpramool, C. Effects of piperine on hamster sperm capacitation and fertilization in vitro. Int.J Androl 1991;14(4):283-290.

Taqvi, SI, Shah, AJ, and Gilani, AH. Insight into the possible mechanism of antidiarrheal and antispasmodic activities of piperine. Pharmaceutical Biology (Netherlands) 2009;47(660):664.

Capasso, R., Izzo, A. A., Borrelli, F., Russo, A., Sautebin, L., Pinto, A., Capasso, F., and Mascolo, N. Effect of piperine, the active ingredient of black pepper, on intestinal secretion in mice. Life Sci 9-27-2002;71(19):2311-2317.

Bajad, S., Bedi, K. L., Singla, A. K., and Johri, R. K. Antidiarrhoeal activity of piperine in mice. Planta Med 2001;67(3):284-287.

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Bai, Y. F. and Xu, H. Protective action of piperine against experimental gastric ulcer. Acta Pharmacol.Sin. 2000;21(4):357-359.

Matsuda, H., Ochi, M., Nagatomo, A., and Yoshikawa, M. Effects of allyl isothiocyanate from horseradish on several experimental gastric lesions in rats. Eur.J Pharmacol. 4-30-2007;561(1-3):172-181.

Ononiwu, I. M., Ibeneme, C. E., and Ebong, O. O. Effects of piperine on gastric acid secretion in albino rats. Afr.J Med Med Sci 2002;31(4):293-295.

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Johri, R. K., Thusu, N., Khajuria, A., and Zutshi, U. Piperine-mediated changes in the permeability of rat intestinal epithelial cells. The status of gamma-glutamyl transpeptidase activity, uptake of amino acids and lipid peroxidation. Biochem.Pharmacol. 4-1-1992;43(7):1401-1407.

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Unchern, S., Nagata, K., Saito, H., and Fukuda, J. Reduction of neurite extension by piperine, examined on hippocampal and septal neurons in serum-free cultures. Biol.Pharm.Bull 1994;17(7):898-901.

Eldershaw, T. P., Colquhoun, E. Q., Bennett, K. L., Dora, K. A., and Clark, M. G. Resiniferatoxin and piperine: capsaicin-like stimulators of oxygen uptake in the perfused rat hindlimb. Life Sci 1994;55(5):389-397.

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White Pepper - Uses, Side Effects, and More

Overview

How does it work ?

Uses & Effectiveness

Insufficient Evidence for

Side Effects

Special Precautions and Warnings

Interactions

Moderate Interaction

Medications changed by the liver (Cytochrome P450 1A1 (CYP1A1) substrates) interacts with White Pepper

Medications changed by the liver (Cytochrome P450 2B1 (CYP2B1) substrates) interacts with White Pepper

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates) interacts with White Pepper

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with White Pepper

Lithium interacts with White Pepper

Medications moved by pumps in cells (P-Glycoprotein Substrates) interacts with White Pepper

Cyclosporine (Neoral, Sandimmune) interacts with White Pepper

Pentobarbital (Nembutal) interacts with White Pepper

Phenytoin (Dilantin) interacts with White Pepper

Propranolol (Inderal) interacts with White Pepper

Rifampin (Rifadin) interacts with White Pepper

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with White Pepper

Medications for diabetes (Antidiabetes drugs) interacts with White Pepper

Theophylline interacts with White Pepper

Minor Interaction

Nevirapine (Viramune) interacts with White Pepper

Amoxicillin (Amoxil, Trimox) interacts with White Pepper

Carbamazepine (Tegretol) interacts with White Pepper

Cefotaxime (Claforan) interacts with White Pepper

Dosing