Peppermint is a perennial aromatic herb that is a natural hybrid of Mentha aquatica L. (water mint) and M. spicata L. (spearmint). It is found growing wild throughout Europe and North America along stream banks and in moist wastelands where it has escaped from cultivation. A number of varieties, strains, or chemotypes are cultivated, including "Mitcham" (rubescens form of the officinalis variety), "white" (palescens form of the officinalis variety), "black" (var. vulgaris), and also the rubescens form of the sylvestris variety (Briggs, 1993; Bruneton, 1995;Grieve, 1979;Leung and Foster, 1996; Trease and Evans, 1989; Wichtl and Bisset, 1994).The material of commerceis obtained entirely from cultivation in Bulgaria, Greece, Spain, northern Europe, and the United States (BHP, 1996;Wichtl and Bisset, 1994).The United States is the leading producer of peppermint oil, especially in Washington, Oregon, Idaho, Wisconsin, and Indiana(Bruneton, 1995; Leung and Foster, 1996; Tyler et al., 1988).
The genus name Mentha is from the Greek Mintha, the name of a mythical nymph who metamorphosed into this plant; its species name piperita is from the Latin piper, meaning pepper, alluding to its aromatic and pungent taste (Tyler et al., 1988). Mint leaves have been used in medicine for several thousand years, according to records from the Greek, Roman, and ancient Egyptian eras (Briggs, 1993; Evans, 1991). The origin of peppermint cultivation is disputed, though there is some evidence that it was cultivated in ancient Egypt.Roman naturalist Pliny the Elder (ca. 2379 C.E.) wrote of its uses by the Greeks and Romans. Peppermint was first recognized as a distinct species by botanist John Ray in his Synopsis Stirpium Britannicorum (second edition, 1696), and his Historia Plantarum (1704). It became official in the London Pharmacopoeia in 1721 (Briggs, 1993; Grieve, 1979; Tyler et al., 1988). Today, peppermint leaf and/or its oil are official in the national pharmacopeias ofAustria,France, Germany,Great Britain,Hungary, Russia, and Switzerland, and the European Pharmacopoeia (BP, 1988; Bradley, 1992; DAB 10, 1991; AB, 1981; Ph.Eur.3, 1997; Ph.Fr.X, 1990; Ph.Helv.VII, 1987; Ph.Hg.VII, 1986; USSR X, 1973; Wichtl and Bisset, 1994).
In Germany, peppermint leaf is one of the most economically important individual herbs, demonstrated by the fact that in 1993 nearly four thousand tons were imported, and in 1994 almost five thousand tons. It is also one of Germany's own most important medicinal plant crops (Lange and Schippmann, 1997).It is licensed as a standard medicinal tea, is official in the German Pharmacopoeia, and approved in the Commission E monographs (leaf and oil).It is used as a monopreparation and also as a component of many cholagogue, bile-duct, gastrointestinal, and liver remedies, and some hypnotic/sedative drugs (BAnz, 1998; Bradley, 1992; Braun et al., 1997; DAB 10, 1991; Wichtl and Bisset, 1994). In German pediatric medicine, peppermint leaf (67%) is combined with chamomile flower (33%) as an herbal tea to treat gastric upset in children. It is also used as a component of various "kidney and bladder" teas for children. Peppermint oil is used as a component of Inhalatio composita (45% eucalyptus oil, 45% pumilio pine oil, 10% peppermint oil) specifically indicated for coryza and nasal catarrh in children (Schilcher, 1997). In the United States,peppermint leaf is used singly and as a main componentofa wide range of digestive, common cold, and decongestant dietary supplement and OTC drug products, in fluid and solid dosage forms. Peppermint leaf and peppermint oil are official in the U.S. National Formulary. Peppermint oil is used in the United States as a carminative in antacids, a counterirritant in topical analgesics, an antipruritic in sunburn creams, a decongestant in inhalants and lozenges, and as an antiseptic or flavoring agent in mouthwashes, gums, and toothpastes (Briggs, 1993; Leung and Foster, 1996; Tyler et al., 1988).
Most modern human studies have investigated peppermint oil rather than peppermint leaf as a treatment for stomachache (May et al., 1996), spastic colon syndrome (Somerville et al., 1984), postoperative nausea (Tate, 1997), relief of colonic muscle spasm during barium enema (Sparks et al., 1995), irritable bowel syndrome (Carling et al., 1989; Dew et al., 1984; Fern ndez, 1990; Koch, 1998; Lawson et al., 1988; Lech et al., 1988; Liu et al., 1997; Nash et al., 1986; Pittler and Ernst, 1998; Rees et al., 1979), prevention of abdominal distension in postoperative gynecological patients (Feng, 1997), and headaches (Gobel et al., 1994; Gobel et al., 1996). The use of peppermint oil for irritable bowel syndrome is based on preparations in enteric-coated capsules, causing a spasmolytic activity on smooth muscles of the gut. In animal tests, the probable mechanism of action has been shown to be the inhibition of smooth muscle contractions by blocking calcium influx into muscle cells (Forster et al., 1980; Giachetti et al., 1988).
In one double-blind, placebo-controlled multicenter trial, Enteroplant®, consisting of peppermint oil (90 mg) and caraway oil (50 mg) in an enteric-coated capsule, was studied in 45 patients with non-ulcerous dyspepsia. After four weeks of treatment both the intensity of pain and the global clinical impression were significantly improved for the group treated with the peppermint/caraway combination compared with the placebo group (p=0.015 and 0.008, respectively) (May et al., 1996).
In a randomized, placebo-controlled, double-blind crossover study, the effectiveness of peppermint oil against Paracetamol® (acetaminophen) and placebo was studied for use of headaches. The liquid test preparation contained 10 g of peppermint oil and ethanol (90%) (LI 170, Lichtwer Pharma, Germany); the placebo was a 90% ethanol solution to which traces of peppermint oil were added for blinding purposes. The reference preparation contained 500 mg acetaminophen. The study included analyses of 164 headache attacks of 41 male and female patients between 16 and 45 years of age suffering from tension-type headaches in accordance with the International Headache Society classification. The authors concluded that a 10% peppermint oil in ethanol solution efficiently alleviated tension-type headaches and that it was a well-tolerated and cost-effective alternative to conventional therapies (Gobel et al., 1996).
The approved modern therapeutic applications for peppermint are supportable based on its history of use in well established systems of traditionaland conventional medicines,extensive phytochemical investigations, in vitro studies, in vivo pharmacological studies in animals, and human clinical studies.
Pharmacopeial grade peppermint leaf must be composed of thedried whole or cut leaf with not more than 5% stem fragments greater than 1 mm in diameter and not more than 10% leaves with brown spots caused by Puccinia menthae. The whole leaf must contain not less than 1.2% (ml/g) and the cut leaf must contain not less than 0.9% volatile oil.Botanical identity must be confirmed by macroscopic and microscopic examinations and organoleptic evaluation(Ph.Eur.3, 1997; Wichtl and Bisset, 1994).The ESCOP peppermint leaf monograph requires that the material comply with the European Pharmacopoeia (ESCOP, 1997).
European pharmacopeial grade peppermint oil is the volatile oil distilled with steam from the fresh aerial parts of the flowering plant. Its relative density must be between 0.900 and 0.916, refractive index between 1.457 and 1.467, optical rotation between 10 and 30?, among other quantitative standards. Identity must be confirmed by thin-layer chromatography (TLC), organoleptic evaluation, and quantitative analysis of internal composition by gas chromatography. It must contain 1.05.0% limonene, 3.514.0% cineole, 14.032.0% menthone, 1.09.0% menthofuran, 1.510.0% isomenthone, 2.810.0% menthylacetate, 30.055.0% menthol, maximum 4.0% pulegone, and maximum 1.0% carvone (Ph.Eur.3, 1997).French pharmacopeial grade peppermint oil must contain not less than 44% menthol, from 4.510% esters calculated as menthyl acetate, and from 1532% carbonyl compounds calculated as menthone. TLC is used for identification, quantification of compounds, and verification of the absence of visible bands corresponding to carvone, pulegone, and isomenthone (Bruneton, 1995; Ph.Fr.X, 1990).
Peppermint leaf consists of the fresh or dried leaf of Mentha x piperita L. [Fam. Lamiaceae] and its preparations in effective dosage. The herb contains at least 1.2% (v/w) essential oil. Other ingredients are tannins characteristic of Lamiaceae.
Peppermint leaf contains luteolin, hesperidin, and rutin; caffeic, chlorogenic, and rosmarinic acids, and related tannins; choline; a- and b-carotenes; gum; minerals; resin; a and g tocopherols; a-amyrin and squalene triterpenes; volatile oil (1.23%) composed mostly of monoterpenes2955% menthol, 1040% menthone, 213% cineole, 111% pulegone, 110% menthyl acetate, 010% menthofuran, and 0.26% limonene (Bradley, 1992; Bruneton, 1995; Budavari, 1996; ESCOP, 1997; Leung and Foster, 1996; Wichtl and Bisset, 1994).
The Commission E reported direct antispasmodic action on the smooth muscle of the digestive tract as well as choleretic and carminative activity.
Note:There is a separate monograph for peppermint oil.
The British Herbal Compendium reported carminative, spasmolytic, and choleretic activity (Bradley, 1992). In human pharmacological studies, peppermint leaf extracts had carminative action by causing a reduction in tonus of the esophageal sphincter, thus enabling release of entrapped air (Demling and Steger, 1969).
The Commission E approved the internal use of peppermint leaf for spastic complaints of the gastrointestinal tract, the gallbladder, and bile ducts.
The British Herbal Compendium indicates peppermint leaf for dyspepsia, flatulence, intestinal colic, and biliary disorders (Bradley, 1992). ESCOP indicates its use for symptomatic treatment of digestive disorders such as dyspepsia, flatulence, gastritis, and enteritis (ESCOP, 1997). The German Standard License for peppermint leaf tea indicates its use for gastrointestinal and gallbladder ailments (Braun et al., 1997).
In case of gallstones, first consult a physician.
No restrictions known (McGuffin et al., 1997).
Internal: Unless otherwise prescribed: 36 g per day of cut leaf for infusions and extracts.
Infusion: 2 g in 150 ml water, two to three times daily.
Fluidextract 1:1 (g/ml): 2 ml, two to three times daily.
Tincture 1:5 (g/ml): 10 ml, two to three times daily.
Tincture: 515 g (Erg.B.6).
Dry normalized extract 3.54.5:1 (w/w): 0.440.57 g, two to three times daily.
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- This material was adapted from The Complete German Commission E MonographsTherapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.
- 1) The Overview section is new information.
- 2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.
- 3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:
- Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
- Infusion: 2 g in 150 ml of water
- Fluidextract 1:1 (g/ml): 2 ml
- Tincture 1:5 (g/ml): 10 ml
- 4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.
- This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.