Related Terms

• Alpha-humulene, alpha-pinene, beta-caryophyllene, beta-eudesmol, beta-pinene, black pepper, blanc poivre (French), caryophyllene oxide, chavicine, cis-beta-ocimene, coumaperine, delta-3-carene, dipiperamide D, dipiperamide E, (e)-beta-caryophyllene, eugenol, hedycaryol, isochavicine, isopiperine, kali mirchi, kosho, krishna, limonene, linalool, marich, maricha, pepe, pepper, pepper extract, pepper plant, peppercorn, Pfeffer (German), pimienta (Spanish), piper, Piper guineense, Piper nigrum, Piper umbellatum, Piperaceae, piperamide, piperanine, piperdardine, piperettine, piperine, piperlonguminine, poivre (French), poivre noir (French), sabinene, safrole, tenuazonic acid, terpinen-4-ol, vellaja.

• Combination product examples: Armorex™ (extracts of sesame oil, garlic oil, clove oil, rosemary oil, and white pepper); Trikatu (an herbal combination containing Piper longum fruit, Piper nigrum fruit, and Zingiber officinale rhizome powder).

• Note: Black pepper, white pepper, green pepper, pink pepper, and red pepper are all differently preserved berries or seeds of the Piper nigrum plant. Only white pepper is covered in this monograph.

Background

• White and black pepper both come from the pepper plant (Piper nigrum). The final color of the pepper relates to the level of ripeness. Black pepper is made from the unripe berries, whereas white pepper comes from the seed of a fully ripe fruit, called the peppercorn.

• Pepper has been known in Indian cooking since at least 2000 BC and is common in Chinese cooking. White pepper is most commonly used as a spice in food.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Antibacterial, antioxidant, antispasmodic, arthritis, birth control, bronchodilator, carpal tunnel syndrome, diarrhea, diuretic, insecticide, joint pain/stiffness.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

• Insufficient available evidence.

Children (under 18 years old)

• Insufficient available evidence.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Avoid in individuals with a known allergy or sensitivity to white pepper.

Side Effects and Warnings

• White pepper may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

• White pepper may cause low blood pressure. Caution is advised in patients with low blood pressure and in those taking drugs, herbs, or supplements that affect blood pressure.

• White pepper may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

• White pepper may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be changed in the blood and may cause different effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

• Drowsiness or sedation may occur. Use cautiously in patients using drugs that affect the central nervous system. Use caution if driving or operating heavy machinery.

• Use cautiously in patients with liver, thyroid, or autoimmune disorders, or in patients trying to become pregnant and in their partners.

• Avoid inhaling into the lungs.

• Avoid getting into eyes. White pepper may cause redness and burning.

Pregnancy and Breastfeeding

• White pepper is not recommended in pregnant or breastfeeding women, due to a lack of available scientific evidence.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• White pepper may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

• White pepper may cause low blood pressure. Caution is advised in patients with low blood pressure and in those taking drugs that affect blood pressure.

• White pepper may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

• White pepper may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be changed in the blood and may cause different effects or potentially serious adverse reactions. Patients using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

• White pepper may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

• White pepper may also interact with antibiotics, anticancer drugs, antifungal agents, antihistamines, anti-HIV drugs, anti-inflammatory agents, antiparasitic agents, antiseizure drugs, heart drugs, cholesterol-lowering drugs, drugs that affect breathing, drugs that affect hormone levels, drugs that affect the digestive system, drugs that affect the immune system, drugs that affect the nervous system, drugs that affect the thyroid, drugs that may damage the liver, fertility drugs, painkillers, p-glycoprotein-regulated agents, and UDP substrates.

Interactions with Herbs and Dietary Supplements

• White pepper may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

• White pepper may cause low blood pressure. Caution is advised in patients with low blood pressure and in those taking herbs and supplements that may affect blood pressure.

• White pepper may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

• White pepper may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may change in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

• White pepper may increase the amount of drowsiness caused by some herbs or supplements.

• White pepper may also interact with antibiotics, anticancer herbs and supplements, antifungal herbs and supplements, antihistamines, anti-HIV herbs and supplements, anti-inflammatory herbs and supplements, antioxidants, antiparasitic herbs and supplements, antiseizure herbs and supplements, capsaicin (the chemical in chili peppers that makes them hot), cholesterol-lowering herbs and supplements, curcumin (a component of turmeric), Eclipta alba (false daisy), epigallocatechin gallate (EGCG; also known as epigallocatechin 3-gallate; the main polyphenol in green tea), fertility herbs and supplements, ferulic acid (a phenol compound derived from plants), gallic acid (an astringent derived from plants), green tea (Camellia sinensis), herbs and supplements that affect breathing, herbs and supplements that affect the heart, herbs and supplements that affect hormone levels, herbs and supplements that affect the digestive system, herbs and supplements that affect the immune system, herbs and supplements that affect the nervous system, herbs and supplements that affect the thyroid, herbs and supplements that may damage the liver, painkillers, p-glycoprotein regulated herbs and supplements, Rhodiola, UDP substrates, and valerian.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Ee GC, Lim CM, Lim CK,et al. Alkaloids from Piper sarmentosum and Piper nigrum. Nat. Prod. Res. 2009;23:1416-1423.View Abstract

2. Kumar S, Warikoo R, Wahab N. Larvicidal potential of ethanolic extracts of dried fruits of three species of peppercorns against different instars of an indian strain of dengue fever mosquito, Aedes aegypti L. (Diptera: Culicidae). Parasitol Res. 2010;107(4):9017.View Abstract

3. Liu Y, Yadev VR, Aggarwal BB, et al. Inhibitory effects of black pepper (Piper nigrum) extracts and compounds on human tumor cell proliferation, cyclooxygenase enzymes, lipid peroxidation and nuclear transcription factor-kappa-B. Nat Prod Commun. 2010;5(8):1253-7.View Abstract

4. Misharina TA, Terenina MB, Krikunova NI. [Antioxidant properties of essential oils]. Prikl Biokhim Mikrobiol. 2009;45(6):710-6.View Abstract

5. Mishra RK, Singh SK. Antispermatogenic and antifertility effects of fruits of Piper nigrum L. in mice. Indian J. Exp. Biol. 2009;47:706-712.View Abstract

6. Moreno Martínez E, Christensen CM. Fungus flora of black and white pepper (Piper nigrum L.). Rev Latinoam Microbiol. 1973;15(1):19-22.View Abstract

7. Muraz B, Chaigneau M. [Decontamination of spices by ethylene oxide. The case of cloves (Eugenia caryophyllus Spreng.) and white pepper (Piper nigrum L.)]. Ann Pharm Fr. 1985;43(1):15-21.View Abstract

8. Orav A, Stulova I, Kailas T, Müürisepp M. Effect of storage on the essential oil composition of Piper nigrum L. fruits of different ripening states. J Agric Food Chem. 2004;52(9):2582-6.View Abstract

9. Reddy SV, Srinivas PV, Praveen B, et al. Antibacterial constituents from the berries of Piper nigrum. Phytomedicine. 2004;11(7-8):697-700.View Abstract

10. Sato T. Effect of nasal mucosa irritation on airway resistance. Auris Nasus Larynx. 1980;7(1):39-50.View Abstract

11. Srinivasan K. Black pepper and its pungent principle-piperine: a review of diverse physiological effects. Crit Rev Food Sci Nutr. 2007;47(8):735-48.View Abstract

12. Steinhaus M, Schieberle P. Characterization of odorants causing an atypical aroma in white pepper powder (Piper nigrum L.) based on quantitative measurements and orthonasal breakthrough thresholds. J Agric Food Chem. 2005;53(15):6049-55.View Abstract

13. Steinhaus M, Schieberle P. Role of the fermentation process in off-odorant formation in white pepper: on-site trial in Thailand. Agric Food Chem. 2005;53(15):6056-60.View Abstract

14. Tiwari KC, Majumder R, Bhattacharjee S. Folklore information from Assam for family planning and birth control. Int J Crude Drug Res. 1982;20(3):133-7.View Abstract

15. Tsukamoto S, Tomise K, Miyakawa K, et al. CYP3A4 inhibitory activity of new bisalkaloids, dipiperamides D and E, and cognates from white pepper. Bioorg Med Chem. 2002;10(9):2981-5.View Abstract