Chamomile

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Chamomile

Common Names

  • German chamomile
  • Hungarian chamomile
  • Wild chamomile
  • Scented mayweed

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.


What is it?

Chamomile is an herb used in traditional medicine for its relaxing and calming effects. It’s mostly taken as herbal tea. You can also take chamomile capsules or tablets.

What is it used for?

Chamomile is used to:

  • Lower  stress
  • Treat insomnia (trouble falling asleep, staying asleep, or waking up too early)
  • Lower anxiety (strong feelings of worry or fear)
  • Treat mouth sores from cancer treatment

Chamomile also has other uses that haven’t been studied by doctors to see if they work.

It’s generally safe to take chamomile in the form of tea, but talk with your healthcare providers before taking chamomile supplements. Herbal supplements are stronger than the herbs you would use in cooking. They can also interact with some medications and affect how they work. For more information, read the “What else do I need to know?” section below.

What are the side effects?

You are more likely to have allergic reactions to chamomile if you’re allergic to plants related to chamomile such as ragweed, chrysanthemums, marigolds, or daisies. Allergic reactions can include:

  • Asthma (respiratory condition which makes it difficult to breathe)
  • Contact dermatitis (red, itchy rash)
  • Anaphylaxis (a serious allergic reaction)
What else do I need to know?
  • Don’t take chamomile if you’re allergic to ragweed or flowers in the sunflower family.
  • Talk to your healthcare provider if you’re taking blood thinners such as warfarin (Coumadin®, Jantoven®). Chamomile may increase your risk of bruising or bleeding.
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For Healthcare Professionals

Scientific Name
Matricaria recutita, Chamomilla recutita, Matricaria chamomilla
Clinical Summary

Chamomile, an aromatic annual herb, has a long history of use in traditional medicine to treat muscle spasms, menstrual disorders, insomnia, ulcers, wounds, stomach disorders, rheumatic pain, hay fever, and hemorrhoids. It is widely used in teas for its relaxing and calming effects. In vitro and animal studies indicate that chamomile extracts have anti-inflammatory (11), anti-hyperglycemic (12), antigenotoxic (13), and anticancer (14) properties. Apigenin, a flavone present in chamomile, has chemopreventive effects (15). Bisabololoxide A, another constituent, had additive inhibitory effects in some instances when used with 5-fluorouracil against leukemic cells (19).

Clinical data suggest modest benefits with oral chamomile in chronic insomnia (20) (41) and for moderate cyclic mastalgia (42). Chamomile tea had positive effects on glycemic control in patients with diabetes (33). Several studies have reported that chamomile extracts are effective against mild-to-moderate (16) and moderate-to-severe generalized anxiety disorder (GAD) (37) (38). Chamomile may also affect a substantial reduction in depressive symptoms in subjects with comorbid GAD plus depression (45) and improve biological markers of stress in people with chronic anxiety (40). In other controlled trials, application of a chamomile compress was effective and superior to hydrocortisone ointment in facilitating healing of peristomal skin lesions following colostomy (21), and a chamomile oleogel affected pain relief in patients who had migraine without aura (43).

In an animal study, chamomile extract showed some protective effects against radiation‐induced intestinal mucositis (1). A chamomile mouthwash reduced 5-fluorouracil-induced mucositis in hamsters (17), but data from human studies are conflicting (8) (9). In patients with head and neck cancer, an aqueous solution of propolis, aloe vera, calendula and chamomile did not prevent mucositis during chemo-radiotherapy (2) although preliminary findings suggest some benefit of a chamomile gel in preventing acute radiation dermatitis (46).

Purported Uses
  • Anxiety
  • Depression
  • GI disorders
  • Hemorrhoids
  • Infections
  • Inflammation
  • Insomnia
  • Mucositis
Mechanism of Action

The anti-inflammatory activity of chamomile involves the release of LPS-induced prostaglandin E(2) in RAW 264.7 macrophages via inhibition of COX-2 enzyme activity (11). Methanol extracts of chamomile exert anti-allergic effects by inhibiting histamine release from mast cells (23). Neuroprotective activity has occurred via decreased lipid peroxidation and increased superoxide dismutase, catalase, glutathione, and total thiol levels (24).

Topical chamomile reduced the tissue levels of IL-1β and TNF-α in hamsters with oral mucositis (34). In another study, a chamomile extract provided gastroprotection against ethanol-induced ulceration by increasing glutathione levels (25). In an animal model of radiation‐induced intestinal mucositis, apoptotic effects from chamomile occurred via increases in cytosolic cytochrome c, caspase‐3, and depletion of mitochondrial B‐cell lymphoma‐2/ Bax ratio (1).

Apigenin, a flavone component of chamomile, interacts with GABA(A)-benzodiazepine receptors in vitro and inhibits locomotor behavior in rats (5). It also affected alternative splicing of key mRNAs by inhibiting dimerization of hnRNPA2, a factor associated with many cellular malignancies and in mRNA metabolism and splicing (32).

Contraindications

Individuals allergic to ragweed or members of the Compositae family, such as chrysanthemums, should avoid this product (26) (27). In addition, individuals with mugwort pollen allergies should also avoid chamomile, as there have been multiple cases of cross-reactions to chamomile (44).

Adverse Reactions

Hypersensitivity reactions including asthma, contact dermatitis, and anaphylaxis can occur following exposure to chamomile (26) (27).

Case reports
Premature constriction of fetal ductus arteriosus: Following consumption of chamomile tea by the mother during pregnancy (31).
Severe anaphylaxis with generalized urticaria, angioedema, and severe dyspnea: In a 38-year-old Caucasian man, 1 hour after consuming chamomile tea. Symptoms improved following treatment with an intravenous antihistamine (18).
Pollen-food allergy syndrome: In a 65-year-old Japanese woman with mugwort allergies, who experienced hives, vomiting, and shortness of breath 30 minutes after drinking chamomile tea. About a dozen other cases of allergic reactions to chamomile have also been associated with mugwort pollen allergies (44). The patient was advised to avoid all chamomile-containing products.
Multiple internal hemorrhages: In a 70-year-old woman following concurrent use of chamomile products and warfarin. Her symptoms resolved after treatment with intravenous heparin (28).
Occupational allergic rhinoconjunctivitis: From the inhalation of chamomile dried flowers (36).
Increased lactogenesis and breast tension: In a lactating woman, a few hours after consuming chamomile (39).

Herb-Drug Interactions

Anticoagulants / Antiplatelets: Chamomile may increase the anticoagulant effects and inhibit platelet activity due to its coumarin content (28).
Sedatives: Chamomile may increase the effects of sedatives  (4).
Cytochrome P450 substrates: In vitro, chamomile inhibits CYP1A2, CYP2C9, CYP2D6, and CYP3A4, and may affect the intracellular concentration of drugs metabolized by these enzymes (29). The clinical relevance has yet to be determined.
Cyclosporine: Concurrent use resulted in increased serum levels of cyclosporine (35).

Dosage (OneMSK Only)
References
  1. Khayyal MT, Kreuter MH, Kemmler M, et al. Effect of a chamomile extract in protecting against radiation-induced intestinal mucositis. Phytother Res. Jan 10 2019.
  2. Marucci L, Farneti A, Di Ridolfi P, et al. Double-blind randomized phase III study comparing a mixture of natural agents versus placebo in the prevention of acute mucositis during chemoradiotherapy for head and neck cancer. Head Neck. Sep 2017;39(9):1761-1769.
  3. Tyler, V. Herbs of Choice, the Therapeutical Use of Phytomedicinals. Binghamton: Pharmaceutical Press; 1994.
  4. Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Sandy (OR): Eclectic Medical; 2001.
  5. Avallone R, et al. Pharmacological profile of apigenin, a flavonoid isolated from Matricaria chamomilla. Biochem Pharmacol 2000;59:1387-94.
  6. 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.
  7. 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.
  8. Fidler P, et al. Prospective evaluation of a chamomile mouthwash for prevention of 5-FU-induced oral mucositis. Cancer 1996;77: 522-5.
  9. 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.
  10. Segal R, et al. Warfarin interaction with Matricaria chamomilla. CMAJ. 2006 Apr 25;174(9):1281-2.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. Patel D, Shukla S, Gupta S. Apigenin and cancer chemoprevention: progress, potential and promise (review). Int J Oncol. 2007 Jan;30(1):233-45.
  16. 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.
  17. 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.
  18. Andres C, Chen WC, Ollert M, et al. Anaphylactic reaction to camomile tea. Allergol Int. 2009 Mar;58(1):135-6.
  19. 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.
  20. Zick SM, Wright BD, Sen A, Arnedt JT. Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: a randomized placebo-controlled pilot study. BMC Complement Altern Med. 2011 Sep 22;11:78.
  21. Charousaei F, Dabirian A, Mojab F. Using chamomile solution or a 1% topical hydrocortisone ointment in the management of peristomal skin lesions in colostomy patients: results of a controlled clinical study. Ostomy Wound Manage. 2011 May;57(5):28-36.
  22. Srivastava JK, Shankar E, Gupta S. Chamomile: A herbal medicine of the past with bright future. Mol Med Report. 2010 Nov 1;3(6):895-901.
  23. Chandrashekhar VM, Halagali KS, Nidavani RB, et al. Anti-allergic activity of German chamomile (Matricaria recutita L.) in mast cell mediated allergy model. J Ethnopharmacol. 2011 Sep 1;137(1):336-40.
  24. Ranpariya VL, Parmar SK, Sheth NR, Chandrashekhar VM. Neuroprotective activity of Matricaria recutita against fluoride-induced stress in rats. Pharm Biol. 2011 Jul;49(7):696-701.
  25. Al-Hashem FH. Gastroprotective effects of aqueous extract of Chamomilla recutita against ethanol-induced gastric ulcers. Saudi Med J. 2010 Nov;31(11):1211-6.
  26. Vandenplas O, Pirson F, D’Alpaos V, et al. Occupational asthma caused by chamomile. Allergy. 2008 Aug;63(8):1090-2.
  27. Jacob SE, Hsu JW. Reactions to Aquaphor: is bisabolol the culprit? Pediatr Dermatol. 2010 Jan-Feb;27(1):103-4.
  28. Segal R, et al. Warfarin interaction with Matricaria chamomilla. CMAJ. 2006 Apr 25;174(9):1281-2.
  29. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci. 2006 Jan 18;78(8):856-61.
  30. Amsterdam JD, Shults J, Soeller I, et al. Chamomile (Matricaria recutita) may provide antidepressant activity in anxious, depressed humans: an exploratory study. Altern Ther Health Med. 2012 Sep-Oct;18(5):44-9.
  31. Sridharan S, Archer N, Manning N. Premature constriction of the fetal ductus arteriosus following the maternal consumption of camomile herbal tea.Ultrasound Obstet Gynecol. 2009 Sep;34(3):358-9.
  32. Arango D, Morohashi K, Yilmaz A, et al. Molecular basis for the action of a dietary flavonoid revealed by the comprehensive identification of apigenin human targets. Proc Natl Acad Sci U S A. 2013 Jun 11;110(24):E2153-62.
  33. Rafraf M, Zemestani M, Asghari-Jafarabadi M. Effectiveness of chamomile tea on glycemic control and serum lipid profile in patients with type 2 diabetes.J Endocrinol Invest. 2015 Feb;38(2):163-70.
  34. Curra M, Martins MA, Lauxen IS, et al. Effect of topical chamomile on immunohistochemical levels of IL-1β and TNF-α in 5-fluorouracil-induced oral mucositis in hamsters Cancer Chemother Pharmacol. 2013 Feb;71(2):293-9.
  35. Colombo D, Lunardon L, Bellia G. Cyclosporine and herbal supplement interactions. J Toxicol. 2014;2014:145325.
  36. Benito P, Rodríguez-Perez R, García F, Juste S, Moneo I, Caballero ML. Occupational allergic rhinoconjunctivitis induced by Matricaria chamomilla with tolerance of chamomile tea. J Investig Allergol Clin Immunol. 2014;24(5):369-70.
  37. Keefe JR, Mao JJ, Soeller I, Li QS, Amsterdam JD. Short-term open-label chamomile (Matricaria chamomilla L.) therapy of moderate to severe generalized anxiety disorder.  Phytomedicine. 2016 Dec 15;23(14):1699-1705.
  38. Mao JJ, Xie SX, Keefe JR, Soeller I, Li QS, Amsterdam JD. Long-term chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial. Phytomedicine. 2016 Dec 15;23(14):1735-1742.
  39. Silva FV, Dias F, Costa G, Campos MDG. Chamomile reveals to be a potent galactogogue: the unexpected effect.J Matern Fetal Neonatal Med. 2018 Jan;31(1):116-118.
  40. Keefe JR, Guo W, Li QS, Amsterdam JD, Mao JJ. An exploratory study of salivary cortisol changes during chamomile extract therapy of moderate to severe generalized anxiety disorder. J Psychiatr Res. 2018 Jan;96:189-195.
  41. Adib-Hajbaghery M, Mousavi SN. The effects of chamomile extract on sleep quality among elderly people: A clinical trial.Complement Ther Med. 2017 Dec;35:109-114.
  42. Saghafi N, Rhkhshandeh H, Pourmoghadam N, et al. Effectiveness of Matricaria chamomilla (chamomile) extract on pain control of cyclic mastalgia: a double-blind randomised controlled trial. J Obstet Gynaecol. 2018 Jan;38(1):81-84.
  43. Zargaran A, Borhani-Haghighi A, Salehi-Marzijarani M, et al. Evaluation of the effect of topical chamomile (Matricaria chamomilla L.) oleogel as pain relief in migraine without aura: a randomized, double-blind, placebo-controlled, crossover study. Neurol Sci. 2018 Aug;39(8):1345-1353.
  44. Nakagawa M, Hanada M, Amano H. A case of anaphylactic reaction to chamomile tea in a patient with mugwort pollinosis. Allergol Int. Jul 2019;68(3):396-398.
  45. Amsterdam JD, Li QS, Xie SX, Mao JJ. Putative Antidepressant Effect of Chamomile (Matricaria chamomilla L.) Oral Extract in Subjects with Comorbid Generalized Anxiety Disorder and Depression. J Altern Complement Med. 2020 Sep;26(9):813-819.
  46. Ferreira EB, Ciol MA, de Meneses AG, et al. Chamomile Gel versus Urea Cream to Prevent Acute Radiation Dermatitis in Head and Neck Cancer Patients: Results from a Preliminary Clinical Trial. Integr Cancer Ther. 2020 Jan-Dec;19:1534735420962174.
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