Piper nigrum (Black Pepper)
Piper nigrum (Black Pepper)      Black pepper (Piper nigrum) is native to India and other southeastern Asian countries. Black pepper, white pepper, green pepper, pink pepper, and red pepper are all differently preserved berries or seeds of the Piper nigrum plant. Although black pepper has been used as a spice for millennia, it has also been traditionally used in India to treat diarrhea. Recent laboratory studies indicate that black pepper may also be beneficial in pain and Alzheimer's disease. In clinical trials, inhalation of black pepper oil improved withdrawal symptoms of cigarette smoking and the ability to swallow in post-stroke patients.      Ingestion of black pepper may cause dyspepsia and other gastrointestinal adverse effects. Inhalation of black pepper has caused respiratory irritation and edema, and even respiratory arrest, severe anoxia, and death. There may also be a link between ingestion of black pepper and nasopharyngeal or esophageal cancer.      Black pepper has been found to contain piperine, alkamides, piptigrine, wisanine, dipiperamide D, and dipiperamide E.      Its well-known medicinal and pharmacological activities include:      Cytochrome P (CYP) 450 effects: In in vitro studies, constituents isolated from Piper nigrum, including piperine and dipiperamides D and E, potently inhibited some CYP450 metabolic pathways, including CYP2D6 and CYP3A4.      Antioxidant effects: Based on animal study, a polyherbal formulation (Aller-7/NR-A2) containing extracts from seven medicinal plants including Phyllanthus emblica, Terminalia chebula, Terminalia bellerica, Albizia lebbeck, Piper nigrum, Zingiber officinale, and Piper longum exhibited concentration-dependent scavenging activities toward biochemically generated hydroxyl radicals (IC50 741.73mcg/mL); superoxide anion (IC50 24.65mcg/mL by phenazine methosulfate-nicotinamide adenine dinucleotide [PMS-NADH] assay and IC50 4.27mcg/mL by riboflavin/nitroblue tetrazolium [NBT] light assay), nitric oxide (IC50 16.34mcg/mL); 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical (IC50 5.62mcg/mL); and 2,2-azinobis-ethyl-benzothiozoline-sulphonic acid diammonium salt (ABTS) radical (IC50 7.35mcg/mL). Aller-7 inhibited free radical-induced hemolysis in the concentration range of 20-80mcg/mL. Aller-7 also significantly inhibited nitric oxide release from lipopolysaccharide-stimulated murine macrophages. Safety Profile      Since Black pepper has been used as part of food, it is considered safe. However it should be used cautiously in patients taking antiasthmatic drugs, as inhalation of black pepper has caused respiratory irritation and edema, and even respiratory arrest and severe anoxia. Herb Drug interactions      Antioxidants: Based on animal study, a polyherbal formulation (Aller-7/NR-A2) containing extracts from seven medicinal plants including Piper nigrum exhibited concentration-dependent scavenging activities. Aller-7 also significantly inhibited nitric oxide release from lipopolysaccharide-stimulated murine macrophages.      Rifamipicin (rifampin): Based on a study in patients with pulmonary tuberculosis, piperine may increase plasma concentrations of rifamipicin (rifampin)      Antibiotics: Based on an in vivo study piperine increases bioavailability of antibiotics. Selected relevant published references • Br J Pharmacol 2005;144(6):781-790. • J Ethnopharmacol 2003;89(2-3):261-264. • Drugs Exp Clin Res 2004;30(3):99-109. • Int J Cancer 9-15-1990;46(3):421-425.