Herbs & Supplements

What interactions should I watch for?

Prescription Drugs

Eating or taking capsicum by mouth causes an increase in the production of stomach acid that could interfere with drugs used to suppress stomach acid. Examples of acid-suppressing drugs are:

• H2 blockers such as cimetidine, famotidine, nizatidine, and ranitidine
• Proton pump inhibitors such as Nexium and omeprazole

In clinical studies and case reports, oral capsicum has been shown to increase the time blood needs to clot. When it is taken with antiplatelet or anticoagulant drugs, the effect of the drug may be increased, resulting in uncontrolled bleeding.

• Antiplatelet drugs include clopidogrel and Ticlid
• Anticoagulants include heparin and warfarin

When topical capsicum was used at the same time that some patients were also taking a type of high blood pressure medication known as an ACE Inhibitor, the tendency to have a cough was increased. ACE inhibitors include benazepril, captopril, enalapril, fosinopril, lisinopril and quinapril.

In theory, capsicum may interfere with some of the neurotransmitters that are also affected by a type of antidepressant drugs known as MAO inhibitors (MAOIs). Altered drug effects may result. MAOIs include:

• Marplan
• Nardil
• tranylcypromine (Parnate)

Selegiline (Eldepryl) and rasagiline (Azilect), drugs which are related to the MAOI antidepressants and which are used to treat Parkinson's disease, also should not be taken with capsicum.

When oral capsicum is used with prescription drugs that promote sleepiness, the effects of the drug may be exaggerated, resulting in sedation or mental impairment. Prescription drugs that can cause sleepiness include:

• Anticonvulsants such as carbamazepine (Tegretol), phenytoin (Dilantin), and valproic acid (Depakote)
• Barbiturates such as phenobarbital
• Benzodiazepines such as alprazolam, diazepam, and lorazepam
• Drugs for insomnia such as Lunesta, Rozerem, zaleplon, and zolpidem
• Tricyclic antidepressants such as amitriptyline, amoxapine, doxepin, and nortriptyline

While a single dose of capsicum had little effect on theophylline levels, some animal studies have shown that capsicum taken orally on a daily basis may increase blood levels of the drug theophylline. Used to treat asthma and chronic obstructive pulmonary disease (COPD), theophylline may cause problems if blood levels are too high. Symptoms of high theophylline levels may include nausea, shakiness, and a fast heartbeat. . Individuals who take theophylline should check with a doctor before starting to take capsicum.

Non-prescription Drugs

Eating or taking capsicum by mouth causes an increase in the production of stomach acid that could interfere with drugs used to suppress stomach acid. Examples of non-prescription acid-suppressing drugs are:

• Antacids such as Maalox, Rolaids, or Tums
• H2 blockers such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac-75)
• The proton pump inhibitor, omeprazole (Prilosec-OTC)

In studies, blood levels of aspirin were much less than expected in laboratory animals given capsicum chronically and then given aspirin. As a result, aspirin may not be effective in relieving pain. In addition, both capsicum and aspirin may decrease the blood's ability to clot. If they are taken together on a regular basis, uncontrolled bleeding may occur.

The sleep-producing effects of over-the-counter products containing diphenhydramine or doxylamine can be enhanced by taking oral capsicum at the same time. Diphenhydramine and doxylamine are contained in many over-the-counter sleep aids as well as in some cough and cold products, therefore caution should be used when taking these medications with oral capsicum because excessive drowsiness may result.

Herbal Products

Theoretically, if oral capsicum is used with other herbs that affect blood clotting, excessive bleeding may occur. Some of the most common herbal products that might inhibit blood clotting are:

• Danshen
• Devil's claw
• Garlic
• Ginger
• Gingko
• Ginseng
• Horse chestnut
• Papain
• Red clover
• Saw palmetto

Oral capsicum may cause excessive sleepiness if taken with other sedating herbs such as:

• Catnip
• Hops
• Kava
• St. John's wort
• Valerian

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how capsicum interacts with drugs, other herbals, and foods and the severity of those interactions, please use our Drug Interactions Checker to check for possible interactions.