chamomile

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

PO: GI antispasmodic, digestive aid, and sedative.
Pedi: Infantile colic.
Topical Anti-inflammatory for minor skin and mucous membrane (including anogenital) conditions.

Action ⬆ ⬇

The volatile oil of chamomile contains several compounds with anti-inflammatory and antispasmodic activity.

Therapeutic effects:

Relief of abdominal discomfort.
Improved ability to fall asleep.

Pharmacokinetics ⬆ ⬇

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO, Topical	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to chamomile, ragweed, asters, chrysanthemums, and other members of the Asteraceae/Compositae family.

Use Cautiously in:

Hormone sensitive cancers (may have estrogenic effects);
Surgery (discontinue ≥2 wk before procedure);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: contact dermatitis

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Natural-Drug Products:

Alcohol-containing preparations may interact with disulfiram and metronidazole.
Large chamomile ingestions with anticoagulant and antiplatelet drugs may ↑ risk of bleeding.
May have additive effects with CNS depressants.
May interfere with oral contraceptives, estrogens, and tamoxifen.

Natural-Natural Products:

Herbs with anticoagulant or antiplatelet properties may ↑ bleeding risk when combined with chamomile, including: anise, asafoetida, bogbean, boldo, capsicum, celery, clove, danshen, dong quai, fenugreek, feverfew, garlic, ginger, ginkgo, Panax ginseng, horse chestnut, horseradish, licorice, meadowsweet, prickly ash, onion, papain, passionflower, poplar, quassia, red clover, turmeric, wild carrot, wild lettuce, and willow.

Route/Dosage ⬆ ⬇

PO (Adults ): Capsules/tablets: 400–1600 mg/day in divided doses; Tea: 2–3 heaping teaspoons dried flowers per cup of water as a compress or beverage as needed; Tincture (1:5 in alcohol): 15 mL 3–4 times daily; Liquid extract: 1–4 mL up to 3 times daily; Gargle: 10 drops of fluid extract per glass of water as needed.

Availability ⬆ ⬇

Capsules/Tablets: ^OTC
Tea: ^OTC
Crude : ^OTC
Tincture: ^OTC
Liquid extract: ^OTC

Assessment ⬆ ⬇

Assess for abdominal distention and auscultate for bowel sounds.
Evaluate sleep pattern and anxiety level before starting herb.
Assess size, location, and character of affected skin before and after topical application.

Lab Test Considerations:

Monitor coagulation studies periodically during therapy.

Implementation ⬆ ⬇

PO: Administer with or without food.
Take 30–60 min before bedtime when using as a sleep aid.
Topical For skin irritation, apply to skin that has been cleansed with a mild nonalcohol-containing cleanser.

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of herb to patient.
Advise patient to consult with health care provider before using any herbal supplement, especially when taken concurrently with Rx or OTC medications or vitamins.
Advise patient that only a small amount of the volatile oil, the active ingredient in chamomile, is released when brewed to make a tea. However, long-term consumption of low concentrations of the volatile oil may have a cumulative therapeutic effect.
Advise patient not to take other medications at the same time as the tea, as it may inhibit absorption and ↓ therapeutic effect of other agents.
Advise patient on anticoagulant therapy to avoid concurrent use, as it may enhance the effect of anticoagulants and ↑ the potential for bleeding.
Topical Educate patient using it topically to observe for allergic reactions and to immediately discontinue use if this develops.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding before using this herb.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇