- How It Works
- Purported Uses
- Research Evidence
- Patient Warnings
- Do Not Take If
- Side Effects
- Dosage (Inside MSKCC Only)
Scientific Name
Matricaria recutita L.
Common Name
Hungarian chamomile, wild chamomile, Chamomilla recutita
Clinical Summary
Chamomile, a traditional herbal remedy, is widely used in teas for its relaxing and calming effects. Topical and oral administrations are safe except in patients with allergies to ragweed or chrysanthemums (2). Chamomile extract was shown to possess anti-inflammatory (11), antihyperglycemic (12), antigenotoxic (13), and anticancer (14) properties in vitro and in animal studies. Apigenin, a flavone present in chamomile, has strong chemopreventive effects (15). Bisabololoxide A, another constituent of chamomile, was shown to reduce the dose of 5-fluorouracil when used together against leukemic cells (19).
Chamomile extract may have a mild to moderate effect in patients with generalized anxiety disorder (16). Studies of chamomile mouthwash produced conflicting results regarding its benefit in reducing 5-FU induced mucositis (8) (9) (17). More research is warranted.
Potential drug interactions include platelet inhibition leading to additive anticoagulant effect and potentially increased sedation from sedatives or hypnotics (4).
Purported Uses
- Colic
- GI disorders
- Hemorrhoids
- Infections
- Inflammation
- Mastitis
- Mucositis
- Sedation
- Skin ulcers
- Spasms
- Stomach and intestinal gas
Constituents
Flower head
- Coumarins
- Flavonoids (up to 8%): Quercetin, rutin, apigenin, luteolin, apigetrin and apiin
- Volatile oils: Alpha bisabolol (up to 50%), azulene and chamazulene
- Other constituents: Amino acids, choline polysaccharide, plant and fatty acids, tannin, triterpene hydrocarbons
(1)
Mechanism of Action
In animal studies, a wide range of pharmacological activities have been documented including antibacterial, anti-inflammatory, antispasmodic, anti-ulcer, antiviral, and hypouraemic activities. Apigenin, a flavone, interacts with GABA(A)-benzodiazepine receptors in vitro and inhibits locomotor behavior in rats (5). The azulene components of the volatile oil are thought to contribute by inhibiting histamine release, and they have been reported to prevent allergic seizures in animals. Matricin, the precursor to chamazulene, is reported to be a more effective anti-inflammatory agent than chamazulene. Anti-inflammatory and antiulcerogenic activity has also been documented for alpha bisabolol. The coumarin constituents were shown to have antibacterial activity. In addition, antispasmodic activity was demonstrated by the flavonoid and bisabolol constituents (2).
Contraindications
People allergic to ragweed or members of the Compositae family, such as chrysanthemums, should avoid this product.
Adverse Reactions
Hypersensitivity reactions in people allergic to ragweed or members of the Compositae family, ranging from contact dermatitis to anaphylaxis (2) (3).
Case report: A 38-year-old Caucasian man developed an episode of severe anaphylaxis with generalized urticaria, angioedema and severe dyspnoea one hour after consuming camomile tea. The symptoms improved followed an emergency treatment with an intravenous antihistamine (18).
Herb-Drug Interactions
Herb Lab Interactions
May increase PT, APTT, and INR
Literature Summary and Critique
Fidler P, et al. Prospective evaluation of a chamomile mouthwash for prevention of 5-FU-induced oral mucositis. Cancer 1996;77: 522-5.
A phase III, double-blind, placebo-controlled clinical trial with 164 patients equally randomized to both treatment groups. Patients received 30 minutes of oral cryotherapy prior to bolus of 5-FU-based chemotherapy. Chamomile or placebo mouthwash was used three times a day for fourteen days beginning on the first day of chemotherapy. Graded stomatitis scores were not significantly different between the two treatment groups. Chamomile mouthwash did not appear to be beneficial in the prevention of 5-FU induced stomatitis.
References
- Blumenthal, et al. Herbal Medicine, Expanded Commission E Monographs, 1st ed. Austin: American Botanical Council; 2000.
- Newall C, et al. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press; 1996.
- Tyler, V. Herbs of Choice, the Therapeutical Use of Phytomedicinals. Binghamton: Pharmaceutical Press; 1994.
- Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Sandy (OR): Eclectic Medical; 2001.
- Avallone R, et al. Pharmacological profile of apigenin, a flavonoid isolated from Matricaria chamomilla. Biochem Pharmacol 2000;59:1387-94.
- Kyokong O, et al. Efficacy of chamomile-extract spray for prevention of post-operative sore throat. J Med Assoc Thai 2002;85(suppl):S180-5.
- Budzinski JW, et al. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82.
- Fidler P, et al. Prospective evaluation of a chamomile mouthwash for prevention of 5-FU-induced oral mucositis. Cancer 1996;77: 522-5.
- Carl W, et al. Management of oral mucositis during local radiation and systemic chemotherapy: a study of 98 patients. J Prosthet Dent 1991;30:395-6.
- Segal R, et al. Warfarin interaction with Matricaria chamomilla. CMAJ. 2006 Apr 25;174(9):1281-2.
- Srivastava JK, Pandey M, Gupta S. Chamomile, a novel and selective COX-2 inhibitor with anti-inflammatory activity. Life Sci. 2009 Nov 4;85(19-20):663-9.
- Cemek M, Kaða S, Simþek N, Büyükokuroðlu ME, Konuk M. Antihyperglycemic and antioxidative potential of Matricaria chamomilla L. in streptozotocin-induced diabetic rats. J Nat Med. 2008 Jul;62(3):284-93.
- Hernández-Ceruelos A, Madrigal-Bujaidar E, de la Cruz C. Inhibitory effect of chamomile essential oil on the sister chromatid exchanges induced by daunorubicin and methyl methanesulfonate in mouse bone marrow. Toxicol Lett. 2002 Sep 5;135(1-2):103-110.
- Srivastava JK, Gupta S. Antiproliferative and apoptotic effects of chamomile extract in various human cancer cells. J Agric Food Chem. 2007 Nov 14;55(23):9470-8.
- Patel D, Shukla S, Gupta S. Apigenin and cancer chemoprevention: progress, potential and promise (review). Int J Oncol. 2007 Jan;30(1):233-45.
- Amsterdam JD, Li Y, Soeller I, et al. A randomized, double-blind, placebo-controlled trial of oral Matricaria recutita (chamomile) extract therapy for generalized anxiety disorder. J Clin Psychopharmacol. 2009 Aug;29(4):378-82.
- Pavesi VC, Lopez TC, Martins MA, et al. Healing action of topical chamomile on 5-fluouracil induced oral mucositis in hamster. Support Care Cancer. 2011 May;19(5):639-46.
- Andres C, Chen WC, Ollert M, et al. Anaphylactic reaction to camomile tea. Allergol Int. 2009 Mar;58(1):135-6.
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Ogata-Ikeda I, Seo H, Kawanai T, Hashimoto E, Oyama Y. Cytotoxic action of bisabololoxide A of German chamomile on human leukemia K562 cells in combination with 5-fluorouracil. Phytomedicine. 2011 Mar 15;18(5):362-5.
How It Works
Bottom Line: It is not clear from clinical trials whether chamomile mouth wash helps prevent chemotherapy-induced mucositis. More studies are needed.
Several studies have used chamomile extracts in animals to test their effects. They show that substances in chamomile can kill bacteria, reduce inflammation, calm muscle spasms, inhibit the growth of polio and herpes viruses and cancer cells, and prevent the growth of ulcers. Several chemicals found in chamomile leaves are known to inhibit substances in the body that cause an inflammatory response. Apigenin, a compound isolated from chamomile, binds to brain cells in the same areas as well-known depressant drugs, which could explain chamomile’s sedative effects. A clinical trial showed that chamomile may have a modest effect on generalized anxiety disorder. Further research is needed.
Purported Uses
- Topically, as an antiseptic and to treat skin ulcers
Studies in animals show that substances in chamomile can kill bacteria and viruses, reduce inflammation, and prevent the growth of ulcers, but there is no proof from clinical trials to support this use in humans. - To treat disorders of the gastrointestinal tract
Studies in animals show that substances in chamomile can kill bacteria and viruses, reduce inflammation, and prevent the growth of ulcers, but there is no proof from clinical trials to support this use in humans. - Topically, to reduce the inflammation of hemorrhoids
Animal studies show that substances in chamomile can reduce inflammation, but there is no proof from clinical trials that chamomile can treat hemorrhoids. - For a feeling of sedation or relaxation
It has long been thought that chamomile tea can induce relaxation, but there is no proof from clinical trials that chamomile is effective for this use. - As a mouthwash, to treat mucositis associated with radiation therapy and chemotherapy
Clinical trials show conflicting results for this use. More research is needed. - To treat mastitis (inflammation of the breasts)
Animal studies show that substances in chamomile can reduce inflammation in general, but there is no proof from clinical trials that chamomile is effective for this use. - To relieve flatulence
No scientific evidence supports this use - To alleviate muscle spasms
Animal studies show that substances in chamomile can calm muscle spasms, but there is no proof from clinical trials that chamomile is effective for this use.
Research Evidence
Chemotherapy-induced mucositis:
A clinical trial evaluated the use of a chamomile mouthwash for the treatment of mucositis (inflammation of the mucous membranes of the mouth) resulting from chemotherapy with 5-fluorouracil. Starting on the first day of chemotherapy, half of the patients used a chamomile mouthwash and the other half used a placebo mouthwash three times a day for two weeks. Mouth inflammation ratings were not very different between the groups, indicating that chamomile mouthwash is not helpful in treating chemotherapy-induced mucositis.
Patient Warnings
- This product is regulated by the F.D.A. as a dietary supplement. Unlike approved drugs, supplements are not required to be manufactured under specific standardized conditions. This product may not contain the labeled amount or may be contaminated. In addition, it may not have been tested for safety or effectiveness.
Do Not Take If
- You are allergic to ragweed or flowers in the Compositae family.
- You take warfarin or other blood thinners (in large amounts, chamomile may increase the risk of bruising or bleeding).
- You use sedatives (Chamomile may cause added drowsiness).
Side Effects
- Hypersensitivity allergic reactions, ranging from dermatitis (redness and swelling of the skin) to anaphylactic shock.
- Case report: A 38-year-old Caucasian man developed an episode of severe anaphylaxis with generalized urticaria, angioedema and severe dyspnoea one hour after consuming camomile tea. The symptoms improved followed an emergency treatment with an intravenous antihistamine.
Dosage (Inside MSKCC Only)
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Aliases
Matricaria Recutita
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