Chamomile Medicinal Uses, Interactions, Side Effects, Dosage


A number of plants have "chamomile" as part of their common name. For medicinal use, German chamomile (Matricaria recutita) is by far the most popular, but Roman chamomile (Chamaemelum nobile) is also used. These plants belong to the Asteraceae family. The flower heads are the primary plant parts used in herbal medicine.
Uses and Benefits:
German and Roman chamomile have been employed rnedicinally for centuries, dating back to Egyptian and Roman Gras. Chamomile is most often adopted as an anti-inflammatory, antispasmodic, and calming agent. It is used topically to treat inflammatory skin and mucous membrane disorders, or orally for minor colicky digestive problems and anxiety or nervousness. It is also extensively used as a beverage, food additive, and flavoring agent, and in cosmetic, bath, and hair products.
Constituents of chamomile considered to be most pharmacologically active include the terpenoids (e.g., alpha­bisabolol and bisabolol oxide derivatives, farnesene, matricine, and chamazulene). These constituents are derived from the es­sential oil obtained from the flower head of the plant. Other impor­tant constituents that are more hydrophilic include the flavonoids (e.g., apigenin and luteolin), coumarins, and a mucilage.
In vitro, chamomile constituents can inhibit the inflammatory mediators of the arachidonic acid cascade such as 5-lipoxyge­nase and cyclo-oxygenase. 3 Flavonoid compounds reportedly have in vitro anti-inflammatory effects similar to low-dose in­domethacin. 1 Numerous animal studies have also evaluated the anti-inflammatory effects of chamomile. In one study, mice ex­posed to an inflammatory skin agent had a reduction in edema and inflammation when treated with an extract of chamomile com­pared to placebo.
Sedative and antispasmodic activities also have been demon­strated. The flavonoid apigenin appears to bind to central benzo­diazepine receptors. The essential oil of chamomile reduced experimentally induced spasm of pig small intestine, resulting in decreased tonus and peristalsis compared to placebo. The terpenoid alpha-bisabolol was noted to inhibit the development of stomach ulceration following treatment of rats with indomethacin, stressful stimuli, or alcohol.

Clinical Trials:
. Topical Uses-Most clinical trials have reported benefits with topical applications of chamomile for the treatment of mucositis and dermatitis. Many are uncontrolled or open studies, and re­sults are not well substantiated in randomized controlled trials (RCTs). For example, a chamomile oral rinse was used during head and neck radiation and/or chemotherapy in an uncontrolled series of 98 patients. With a prophylactic chamomile rinse, only 1 of 20 patients receiving radiation therapy developed mucositis, and 10 of 46 patients receiving chemotherapy developed mucosi­tis. 8 However, in a relatively large, double-blind RCT, patients receiving chemotherapy were given chamomile or placebo mouthwash t. i.d. for 14 days. No differences were noted between the treatment and placebo groups.9 In another double-blind RCT, 48 women who had surgery for local breast cancer applied chamomile cream or almond ointment to the affected breast during radiation therapy.1o Neither agent prevented radiation-in­duced skin changes, and there was no significant difference be­tween the two treatments.
For inflammatory skin disorders, topically administered chamo­mile appears to have very mild effects. In an open comparative trial of 161 patients with an inflammatory dermatosis, a German cham­omile cream was found to have similar efficacy to low-potency (0.25%) hydrocortisone. In a partially double-blind RCT of patients with eczema, a chamomile cream was more effective than a 0.5% hydrocortisone cream, but the effects were also no different from a placebo (vehicle) cream. In a double-blind placebo-con­trolled trial, a chamomile extract was reported to decrease weep­ing in surgical wounds after dermabrasion of tattoos(pAdverse Effects:
Chamomile is generally regarded as a mild and safe herb, and it is widely available in foods, beverages, and cosmetics. Excessive use has reportedly led to mild gastroparesis and emesis. The only significant toxicity is an occasional allergic reaction, which may (rarely) lead to angioedema and anaphylaxis. These cases primarily involved patients who had an allergy to ragweed or other plants in the Asteracea family.
Side Effects and Interactions:
Theoretically, chamomile may enhance the effects of other sedatives. However, the popularity and common use of chamomile tea suggests that no relevant sedation occurs that necessitates a warning for users. Chamomile was reported to inhibit the in vitro activity of the 3A4 isozyme of cytochrome P450, a common drug-metabolizing enzyme. This has not been validated in vivo, and there are no clinical drug interactions reported for chamomile.
Safety during pregnancy or breast feeding has not been evaluated. Several animal studies have noted reduction in body weight at birth and increased abortions with high dosage administration. Patients with a history of allergies to ragweed or other Asteracea plants (e.g., daisies, sunflowers, chrysanthe­mums) should avoid chamomile products.
Preparations & Doses:
There is no universally accepted standardization of chamomile products. Traditional doses include 2-4 g of dried flower heads or an equivalent infusion (tea), tincture, or extract, usually taken t.i.d. The majority of studies of German chamomile administered topically to both humans and animals involved the product Kamillosan, which is manufactured in Germany and available in the U.S. as Camillosan in Camocare skin care products (Abkit, Inc.).

Summary Evaluation:
Chamomile has a long history of use as an anti-inflammatory, an­tispasmodic, and anxiolytic. Other than the treatment of infant colic in one study (with a combination product), there are few well­designed, controlled clinical trials to support these potential bene­fits. Based on empiric use and the relative safety of the herb, it is acceptable for patients to consider chamomile for the treatment of colic, mild skin or mucous membrane conditions, and anxiety. However, clinical benefits are likely to be small, and have not been proven beyond a reasonable doubt.
Steve Mathew is a writer, who writes many great articles on herbal medicines and ayurvedic medicines for common ailments and diseases. Visit us for more information on herbal remedies and ayurvedic medicines
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