Orally, German chamomile is used for flatulence, travel sickness, nasal mucous membrane inflammation, allergic rhinitis, nervous diarrhea, attention deficit hyperactivity disorder (ADHD), fibromyalgia, restlessness, and insomnia. It is also used for gastrointestinal (GI) spasms, colic, inflammatory diseases of the GI tract, GI ulcers associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and alcohol consumption, and as an antispasmodic for menstrual cramps.
Topically, German chamomile is used for hemorrhoids; mastitis; leg ulcers; skin, anogenital, and mucous membrane inflammation; and bacterial skin diseases, including those of the mouth and gums. It is also used topically for treating or preventing chemotherapy- or radiation-induced oral mucositis.
As an inhalant, German chamomile is used to treat inflammation and irritation of the respiratory tract.
In foods and beverages, German chamomile is used as flavor components.
In manufacturing, German chamomile is used in cosmetics, soaps, and mouthwashes.
Safety:
No concerns regarding safety, available studies validate this statement, when used orally in amounts commonly found in foods. German chamomile has Generally Recognized as Safe (GRAS) status in the US.1
No concerns regarding safetywhen used orally, short-term. There is some evidence that German chamomile can be used safely for up to 8 weeks.2,3,4 The long-term safety of German chamomile in medicinal doses is unknown, when used topically; avoid applying it near the eyes.5
Children: No concerns regarding safety when used orally and appropriately, short-term. Preliminary clinical research also suggests that a specific multi-ingredient product containing fennel 164 mg, lemon balm 97 mg, and German SourceURL:file://localhost/Users/ruthruane/Downloads/Herbal%20Medicine-Newest.doc
chamomile 178 mg (ColiMil, Milte Italia SPA) is safe in infants when used for up to a week.6
Pregnancy and Lactation: Insufficient reliable information available; avoid using.
Effectiveness:
POSSIBLY EFFECTIVE
Colic. A clinical trial shows that breast-fed infants with colic who are given a specific multi-ingredient product containing fennel 164 mg, lemon balm 97 mg, and German chamomile 178 mg (ColiMil, Milte Italia SPA) twice daily for a week have reduced crying times compared to placebo.6
Dyspepsia. A specific combination product containing German chamomile (Iberogast, Medical Futures, Inc) seems to improve symptoms of dyspepsia. The combination includes German chamomile plus peppermint leaf, clown's mustard plant, caraway, licorice, milk thistle, celandine, angelica, and lemon balm.7,3 A meta-analysis of studies using this combination product suggests that taking 1 mL orally three times daily over a period of 4 weeks significantly reduces severity of acid reflux, epigastric pain, cramping, nausea, and vomiting compared to placebo.8
Oral mucositis. Using a German chamomile oral rinse (Kamillosan Liquidum) might help prevent or treat mucositis induced by radiation therapy and some types of chemotherapy.2 German chamomile oral rinse seems to prevent or treat mucositis secondary to radiation therapy and some types of chemotherapy including asparaginase (Elspar), cisplatin (CDDP, Platinol-AQ), cyclophosphamide (Cytoxan, Neosar), daunorubicin (DaunoXome), doxorubicin (Adriamycin, Rubex), etoposide (VP-16, Etopophos, VePesid, Toposar), hydroxyurea (Hydrea), mercaptopurine (6-MP, Purinethol), methotrexate (MTX, Rheumatrex), procarbazine (MIH, Mutlane), and vincristine (VCR, Oncovin, Vincasar) (2). However, the rinse doesn't seem to be better than placebo for preventing fluorouracil (5-FU)-induced oral mucositis.9
POSSIBLY INEFFECTIVE
Dermatitis. Applying German chamomile cream topically does not seem to prevent dermatitis induced by cancer radiation therapy.10
Mechanism of Action:
The applicable part of German chamomile is the flowerhead. Active constituents of German chamomile include quercetin, apigenin, and coumarins, and the essential oils.5
German chamomile might have anti-inflammatory effects. Preliminary research suggests it can inhibit the pro inflammatory enzymes. Other constituents may inhibit histamine related to allergies,5,4
The constituent(s) responsible for the sedative activity of German chamomile are unclear. Preliminary research suggests that extracts of German chamomile might inhibit morphine dependence and withdrawal.11 Other preliminary research suggests that German chamomile flower extract taken orally might have an antipruritic effect.12 Preliminary research suggests that German chamomile blocks slow wave activity in the small intestine, which could slow peristaltic movement.13
Adverse Reactions:
Orally, German chamomile tea can cause allergic reactions including severe reactions in some patients.14
Interactions with Herbs & Supplements:
HERBS AND SUPPLEMENTS WITH SEDATIVE PROPERTIES: Theoretically, concomitant use with herbs that have sedative properties might have additive effects which needs to be taken into account.5,16
Interactions with Drugs:
Benzodiazepines: Consult a Medical Herbalist
CNS Depressants: Consult a Medical Herbalist
Warfarin (Coumadin): Consult a Medical Herbalist
Interactions with Foods:
None known.
Interactions with Lab Tests:
Creatinine: Chronic ingestion of German chamomile for two 2 weeks can reduce urinary creatinine output. This effect may be prolonged for up to two weeks after discontinuing German chamomile. The mechanism for this effect is unclear.4
Interactions with Diseases or Conditions:
Surgery: Avoid from 2 weeks prior to elective surgery.
Dosage/Administration:
Oral: For dyspepsia, a specific combination product containing German chamomile (Iberogast, Medical Futures, Inc) and several other herbs has been used in a dose of 1 mL three times daily.7,3,8
For colic in infants, a specific multi-ingredient product containing fennel 164 mg, lemon balm 97 mg, and German chamomile 178 mg (ColiMil, Milte Italia SPA) twice daily for a week has been used.6
Topical: For chemotherapy- or radiation-induced oral mucositis, an oral rinse made with 10-15 drops of German chamomile liquid extract in 100 mL warm water has been used three times daily.2
Comments:
German chamomile is an annual herb found throughout Europe and in portions of Asia. German chamomile has a mild apple-like scent. The name "chamomile" is Greek for "Earth apple."
Specific References: CHAMOMILE
1. FDA. Center for Food Safety and Applied Nutrition, Office of Premarket Approval, EAFUS: A food additive database. Available at: vm.cfsan.fda.gov/~dms/eafus.html.
2. Carl W, Emrich LS. Management of oral mucositis during local radiation and systemic chemotherapy: a study of 98 patients. J Prosthet Dent 1991;66:361-9.
3. Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion 2004;69:45-52.
4. Wang Y, Tang H, Nicholson JK, et al. A metabonomic strategy for the detection of the metabolic effects of chamomile (Matricaria recutita L.) ingestion. J Agric Food Chem 2005;53:191-6.
5. Hormann HP, Korting HC. Evidence for the efficacy and safety of topical herbal drugs in dermatology: part I: anti-inflammatory agents. Phytomedicine 1994;1:161-71.
6. Savino F, Cresi F, Castagno E, et al. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants. Phytother Res 2005;19:335-40.
7. Holtmann G, Madisch A, Juergen H, et al. A double-blind, randomized, placebo-controlled trial on the effects of an herbal preparation in patients with functional dyspepsia [Abstract]. Ann Mtg Digestive Disease Week 1999 May.
8. Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279-87.
9. Fidler P, Loprinzi CL, O'Fallon JR, et al. Prospective evaluation of a chamomile mouthwash for prevention of 5-FU-induced oral mucositis. Cancer 1996;77:522-5.
10. Maiche AG, Grohn P, Maki-Hokkonen H. Effect of chamomile cream and almond ointment on acute radiation skin reaction. Acta Oncol 1991;30:395-6.
11. Gomaa A, Hashem T, Mohamed M, Ashry E. Matricaria chamomilla extract inhibits both development of morphine dependence and expression of abstinence syndrome in rats. J Pharmacol Sci 2003;92:50-5.
12. Kobayashi Y, Nakano Y, Inayama K, et al. Dietary intake of the flower extracts of German chamomile (Matricaria recutita L.) inhibited compound 48/80-induced itch-scratch responses in mice. Phytomedicine 2003;10:657-64.
13. Storr M, Sibaev A, Weiser D, et al. Herbal extracts modulate the amplitude and frequency of slow waves in circular smooth muscle of mouse small intestine. Digestion 2004;70:257-64.
14. Subiza J, Subiza JL, Hinojosa M, et al. Anaphylactic reaction after the ingestion of chamomile tea; a study of cross-reactivity with other composite pollens. J Allergy Clin Immunol 1989;84:353-8.
15. Viola H, Wasowski C, Levi de Stein M, et al. Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Med 1995;61:213-6.
16. Avallone R, Zanoli P, Puia G, et al. Pharmacological profile of apigenin, a flavonoid isolated from Matricaria chamomilla. Biochem Pharmacol 2000;59:1387-94.
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