• acyclic diterpene glycosides, African Capsicum, African chillies, African pepper, anastasia black, anastasia red, anastasia red of sweet pepper, ancho chilli, anteraxanthin, anthocyanins, arnoia peppers, ascorbic acid, bell pepper, belrubi, beta-apo-8'-carotenal, beta-carotene, beta-cryptoxanthin, bg 2816, big jim, bird eye chilli, bird pepper, bounty banana pepper plants, C. chinense cultigens PA-426 and PA-350, C. praetermissum, CAAN4, capsaicin, capsaicin oleoresins, capsaicin-beta-D-glucopyranoside, capsaicinoids, capsanthin, capsiate, capsibiol, capsibiol-t, capsiconiate, capsiconinoids, capsicosides, Capsicum annuum L., Capsicum annuum L. accession Criollo de Morelos-334, Capsicum annuum L. 'avelar', Capsicum annuum L. 'bellboy', Capsicum annuum L. 'buchon', Capsicum annuum L. 'Bugang', Capsicum annuum L. Bukang, Capsicum annuum L. 'California', Capsicum annuum L. 'California wonder', Capsicum annuum L. Chilsungcho, Capsicum annuum L. CM334, Capsicum annuum L. coraciforme, Capsicum annuum L. 'dabotop', Capsicum annuum L. 'early calwonder', Capsicum annuum L. 'excalibur', Capsicum annuum L. fruit extract, Capsicum annuum L. grossum, Capsicum annuum L. 'hyang chon', Capsicum annuum L. 'jejujaerae', Capsicum annuum L. 'kyonami', Capsicum annuum L. 'lamuyo', Capsicum annuum L. 'mazurka', Capsicum annuum L. 'NuMex RNaky', Capsicum annuum L. 'P1482', Capsicum annuum L. 'padron', Capsicum annuum L. parent 'maor', Capsicum annuum L. 'pukang', Capsicum annuum L. 'Saeng-Ryeog #211', Capsicum annuum L. 'Saeng-Ryeog #213', Capsicum annuum L. 'TF68', Capsicum annuum L. type lamuyo, Capsicum annuum L. var. Anaheim, Capsicum annuum L. var. angulosum Mill., Capsicum annuum L. var. angulosum Mill. (Solanaceae), Capsicum annuum L. var. annuum (chili jalapeño chigol), Capsicum annuum var. annuum L., Capsicum annuum L. var. bronowicka ostra, Capsicum annuum L. var. California, Capsicum annuum L. var. conoides, Capsicum annuum var. conoides takanotume (RP), Capsicum annuum var. glabriusculum, Capsicum annuum L. var. Km-622, Capsicum annuum var. longum sendtner, Capsicum annuum var. lycopersiciforme rubrum, Capsicuum annuum var. variata, Capsicum annuum L. var. yolo wonder b, Capsicum annuum L. 'yaglik', Capsicum baccatum, Capsicum baccatum 'PBC80', Capsicum callus, Capsicum chinense, Capsicum chinense 'Habanero', Capsicum chinense Jacq., Capsicum chacoense, Capsicum eximium, Capsicum fruit, Capsicum frutescens, Capsicum frutescens accession BG2814-6, Capsicum frutescens fruit, Capsici fructus acer, Capsicum minimum, Capsicum oleoresin, Capsicum pendulum, Capsicum pubescens, capsidiol, capsin, capsinoids, capsiplast, capsorubin, capzasin, Carolina cayenne, carotenoids, cas 404-86-4, cas 84603-55-4, cascabel chilli, casorubin, cay-1, cayenne pepper, Charleston belle, chilaca, chile, chile ancho (Capsicum annuum L. 'San Luis'), chili, chili guajillo puya (Capsicum annuum L.), chili guajillo puya flour, chili pepper, chilli, chillies, chung yang variety, civamide, cremor capsici compositus fna (ccc), criollo de morelos 334, datler, delfin, dihydrocapsaicin, dihydrocapsaicin-beta-D-glucopyranoside, dihydrocapsiconiate, dn3, dn5, dohevanil, dolorac, dolorub capsico, dr6, early jalapeño, feruloylserotonin, fiery jack, flavonoids, fructus capsici, gang ja variety, garden pepper, glucosides, goat's pepper, goat's pod, grains of paradise, green bell pepper, green Capsicum, green chili pepper, green pepper, guajillo peppers, high heat, homocapsaicin, homodihydrocapsaicin, honka, hot chili pepper, hot pepper, Hungarian pepper, hydroxycapsaicin, ici fructus, jalapeño, Japanese Capsicum, jaranda, jariza, keystone resistant giant, lignan glycosides, Louisiana long pepper, Louisiana sport pepper, lr2, lr7, lutein, ma1, ma3, mana, Mexican chillies, minerals, mulato, ne-21610, negral, neoxanthin, New Mexico no. 6 chile, nonivamide, nordihydrocapsaicin, nordihydrocapsiate, numex, oleoresin Capsicum (oc) spray, p-coumaroylserotonin, padrón-type, pageant banana pepper plants, pain-free HPT, paprika, pepper, pepper ('Padrón'), pimento, pimiento, poblano, pod pepper, ponv-Capsicum plaster (pas), proteins, provitamins E, P, B1, B2, and B3, pungent pepper, quercetin, red chiles, red chili, red chili spur pepper, red pepper, resiniferitoxin, resiniferatoxin (rtx), Rheumaplast®, rn1, rn2, Russian sweet pepper, saponin, serrano, sesquiterpenoids, Solanaceae (family), steroidal saponins, sweet pepper, tabasco pepper, thiols, trans-8-methyl-N-vanillyl-6-nonenamide, ubatuba cambuchi, uchu, vanilloid, vanillyl fatty acid amides, violaxanthin, vitamin A, vitamin C, volatile oils, Wärme-PflasterT, yolo wonder, xilli, Zanzibar pepper, zeaxanthin, Zostrix®.
• Note: This monograph focuses on cayenne and pungent Capsicum spp. and does not specifically include clinical trials investigating the effects of isolated capsaicin or information on nonpungent varieties of Capsicum. However, due to the nature of Capsicum (pungent and nonpungent varieties within the same species and occasionally the same variety), some information on nonpungent Capsicum is included.

• Cayenne is a spice derived mainly from two cultivated species of the Capsicum genus, Capsicum annuum L. and Capsicum frutescens L. Capsicum adds color, pungency, and aroma to dishes around the world. Although originally cultivated in the tropical Americas, it is now grown worldwide. Capsicum annuum is cultivated almost exclusively in Europe and the United States, and Capsicum frutescens is cultivated in the tropics and warmer regions of the United States.
• The level of pungency (heat) of the Capsicum species depends mainly on the concentration of capsaicinoids, primarily capsaicin. Chili peppers and red peppers come from plants with capsaicinoid levels 30-600 parts per million and 600-13,000 parts per million, respectively. Paprika is derived from plants with lower levels of capsaicinoids and is used to flavor less spicy foods, such as ketchup, cheese, and salads. Spanish paprika (pimento) is mainly used for coloring. The more spicy chilies and chili pepper from Capsicum annuum L. and Capsicum frutescens L. are used in curry powder, Tabasco® sauce, and chili powder. Cayenne pepper is made by grinding the pungent fruit of Capsicum into a powder.
• Overall, clinical evidence is good for the use of topical Capsicum in a plaster for low back pain and at various acupoints for postoperative pain, nausea, and vomiting. Cayenne pepper is approved by the Commission E as a topical ointment for the relief of painful muscle spasms. The mechanism of action for topical pain relief by Capsicum is well studied. It is likely that the pain-relieving effect of pungent Capsicum spp. is due to capsaicin.
• Capsicum is traditionally used for other purposes, including (but not limited to) weight loss, sore throat, tonsillitis, gastrointestinal disorders, diabetes, cardiovascular disorders, muscle pain, and skin conditions. However, clinical support for Capsicum for these uses is lacking. The main constituent of Capsicum, capsaicin, has also been investigated in clinical study.
• Cayenne was proposed as a chemical weapon during the American Civil War. Today, oleoresin of Capsicum has mostly replaced use of earlier riot control agents, such as chloroacetophenone and chlorodihydrophenarsazine.
• Capsicum essential oil and cayenne pepper are listed in the U.S. Food and Drug Administration (FDA) Generally Recognized as Safe (GRAS) list for use as a spice in foods. When used orally, Capsicum may cause gastrointestinal irritation, mouth and throat irritation, damaged taste buds with reduced ability to taste foods, fullness, flatulence, dyspepsia, diarrhea, ulcer aggravation, and stomach pain. Based on secondary sources, large amounts may cause kidney and liver damage. Topically, Capsicum may cause burning, redness, and irritation. Inhalation of Capsicum may cause dyspnea and cough. It may also irritate mucous membranes.

• Age-related macular degeneration, aging, alcoholism, analgesic, antifungal, anti-inflammatory, antimicrobial, antiseptic, antioxidant, appetite stimulant, arthritis, asthma, bladder cancer, bladder disorders (overactive bladder), bleeding, blood clot prevention, cancer, cardiovascular disorders, chilblains, colds, colic, cosmetic uses, cramps, delirium, depression, diabetes, diarrhea, digestive stimulant, diuretic, dropsy, energy, erectile dysfunction, eye disorders, fever, fibromyalgia, food flavoring, food uses (coloring), food uses (taste repellant for accidental poisoning prevention), frostbite, gas, gastrointestinal disorders, gum disease, headaches, hemorrhoids, high blood pressure, high cholesterol, hoarseness, improved blood circulation, insecticidal, itch, joint and muscle pain, laryngitis, male infertility, memory, menstrual cramps, motion sickness, muscle spasms, myalgia, nail biting, nasal polyps, nerve regeneration, neuralgia, neuropathy, pain (following amputation), pleurisy, pneumonia, poor circulation, psoriasis, saliva stimulant, shingles, skin conditions, skin irritation, sleep aid, snake bites, sprains, thumbsucking, tonic, toothache, ulcer, urinary incontinence / detrusor instability, urinary tract cancer, varicose veins, yellow fever.

Adults (18 years and older)

• According to secondary sources, the dose of Capsicum is dependent on the reason for its use. It has been recommended that the patient talk to a caregiver or follow the directions on product packaging. Doses may range from 30 milligram to 400 milligrams, 1 to 4 capsules, or 10 to 15 drops (0.5 milliliters) in water four times throughout the day, daily. In the United States, oral supplemental Capsicum appears to be most commonly available in capsule form.
• According to secondary sources, an infusion of cayenne may be made by pouring one cup of boiling water onto one-half to one teaspoonful of cayenne and leaving it to infuse for 10 minutes. One tablespoonful in hot water as needed. 0.25-1 milliliters of tincture of cayenne three times daily or as needed.
• For duodenal ulcers, 3 grams of red chili powder has been taken in three divided doses daily for four weeks without evidence of benefit or adverse effects.
• For indigestion (dyspepsia) 2.5 grams of powdered Capsicum annuum has been taken daily (before meals) for five weeks.
• A dose of six sliced fresh jalapeños has been used for Helicobacter pylori infection without evidence of benefit.
• Capsicum spices have been used as a stimulant, but the dose and duration are unknown.
• According to secondary sources, for chilblains, a piece of flannel may be saturated with Capsicum and rubbed well over the seat of the chilblain until a strong "tingling and electrical" feeling occurs. This is repeated daily until the chilblain is gone (2-3 days). Do not apply to broken skin.
• According to secondary sources, powdered Capsicum may be sprinkled inside the socks on unbroken skin to treat cold feet. Dose and duration are not well described.
• For lower back pain, a topical plaster containing Capsicum has been applied to the skin for up to three weeks. A Capsicum-based gel with 0.1 grams of Capsicum oleoresin per 11 grams of gel has also been used three times daily for one week.
• For soft tissue pain, Capsicum cream has been applied to the skin. However, the dose and duration are unclear.
• For postoperative nausea and vomiting, 1 x 1 centimeters of Capsicum plaster has been applied at the P6 acupoint. Treatment was applied 30 minutes before anesthesia until six hours after the patients were transferred to the postoperative unit. Capsicum plaster has also been used at the K-D2 or P6 acupoints before anesthesia until eight hours after surgery.
• For postoperative pain, Capsicum plaster has been used at the Hegu LI4 or Zusanli acupoints from before anesthesia for eight hours daily for three consecutive days.
• For postoperative sore throat, Capsicum plaster has been applied to the K-A20 acupoint from prior to anesthesia until eight hours after surgery.
• For rhinitis, a Capsicum oleous nasal spray has been used once in each nostril (4 micrograms per "puff"), three times daily for three consecutive days. Each "puff" was separated by 30 minutes.

Children (under 18 years old)

• For postoperative pain, Capsicum plaster has been applied at the Zusanli acupoints.

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

1. Bortolotti, M, Coccia, G, Grossi, G, et al. The treatment of functional dyspepsia with red pepper. Aliment Pharmacol Ther 2002;16(6):1075-1082.
2. Ciabatti, PG and D'Ascanio, L. Intranasal Capsicum spray in idiopathic rhinitis: a randomized prospective application regimen trial. Acta Otolaryngol 2009;129(4):367-371.
3. Frerick, H, Keitel, W, Kuhn, U, et al. Topical treatment of chronic low back pain with a capsicum plaster. Pain 2003;106(1-2):59-64.
4. Friese, KH, Kruse, S, Ludtke, R, et al. The homoeopathic treatment of otitis media in children--comparisons with conventional therapy. Int J Clin Pharmacol Ther 1997;35(7):296-301.
5. Gagnier, JJ, van Tulder, MW, Berman, B, et al. Herbal medicine for low back pain: a Cochrane review. Spine (Phila Pa 1976.) 1-1-2007;32(1):82-92.
6. Gagnier, JJ, van Tulder, M, Berman, B, et al. Herbal medicine for low back pain. Cochrane Database Syst Rev 2006;(2):CD004504.
7. Ginsberg, F and Famaey, JP. A double-blind study of topical massage with Rado-Salil ointment in mechanical low-back pain. J Int Med Res 1987;15(3):148-153.
8. Graham, DY, Anderson, SY, and Lang, T. Garlic or jalapeno peppers for treatment of Helicobacter pylori infection. Am J Gastroenterol 1999;94(5):1200-1202.
9. Hoeger, WW, Harris, C, Long, EM, et al. Four-week supplementation with a natural dietary compound produces favorable changes in body composition. Adv Ther 1998;15(5):305-314.
10. Keitel, W, Frerick, H, Kuhn, U, et al. Capsicum pain plaster in chronic non-specific low back pain. Arzneimittelforschung 2001;51(11):896-903.
11. Kim, KS, Koo, MS, Jeon, JW, et al. Capsicum plaster at the korean hand acupuncture point reduces postoperative nausea and vomiting after abdominal hysterectomy. Anesth Analg 2002;95(4):1103-7, table.
12. Kumar, N, Vij, JC, Sarin, SK, et al. Do chillies influence healing of duodenal ulcer? Br Med J (Clin Res Ed) 6-16-1984;288(6433):1803-1804.
13. Meyer-Bahlburg, HF. Pilot studies on stimulant effects of capsicum spices. Nutr Metab 1972;14(4):245-254.
14. Misra, MN, Pullani, AJ, and Mohamed, ZU. Prevention of PONV by acustimulation with capsicum plaster is comparable to ondansetron after middle ear surgery: [La prevention des NVPO par acustimulation avec un emplatre de Capsicum est comparable a celle de l'ondansetron apres une operation a l'oreille moyenne]. Can J Anaesth 2005;52(5):485-489.
15. Park, HS, Kim, KS, Min, HK, et al. Prevention of postoperative sore throat using capsicum plaster applied at the Korean hand acupuncture point. Anaesthesia 2004;59(7):647-651.