Use: Peppermint, peppermint oil, and its menthol extract have been evaluated for use in GI conditions, including nonserious constipation or diarrhea associated with irritable bowel syndrome (IBS) to reduce global symptoms of pain, and bloating; antispasmodic properties of the oil and menthol extract has led to use in endoscopic GI procedures. Quality clinical trials are lacking to recommend use for treatment of dyspepsia. Menthol, a component of peppermint oil, is often added to respiratory products to provide subjective decongestant action and is used as a vasodilatory agent to aid in penetration of topically applied anesthetic drugs. Limited or equivocal data are available for other uses.
Dosing: Up to 1,200 mg daily (180 to 400 mg 3 times daily) of peppermint oil in enteric-coated capsules has been used to treat nonserious constipation and diarrhea associated with IBS.
Contraindications: Peppermint oil should not be administered to patients with gastroesophageal reflux or active gastric ulcers because the oil decreases esophageal sphincter pressure. Peppermint oil should not be applied to the face, especially under the nose of a child or infant. Enteric-coated preparations are not recommended for use in children younger than 8 years.
Pregnancy/Lactation: Adverse reactions, particularly with higher doses, have been documented with use of peppermint. Avoid internal use because of emmenagogue effects.
Interactions: Peppermint oil may inhibit cytochrome P450 (CYP-450) 3A4; use caution when administering with drugs metabolized by this enzyme.
Adverse Reactions: Peppermint oil may cause allergic reactions characterized by contact dermatitis, cutaneous burning, flushing, lacrimation, and headache, and may worsen the symptoms of heartburn, hiatus hernias, and stomach ulcers. Cutaneous and mucosal burns and skin necrosis have been reported with topical formulations.
Toxicology: Peppermint has generally recognized as safe (GRAS) status in amounts used in seasoning or flavoring, but medicinal use of the plant can cause adverse reactions. (See Adverse Reactions.)
Scientific Family: Lamiaceae (mint)domestic remedy for the flatulence of infants, and is a useful vehicle for children’s medicine generally.