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.

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

Contraindicated in:

• Allergy to chamomile, ragweed, asters, chrysanthemums, and other members of the family Asteraceae/Compositae
• OB: Pregnancy and lactation.

Use Cautiously in:

• Hormone sensitive cancers (may have estrogenic effects)
• Surgery (discontinue 2 wk prior to procedure).

Derm: contact dermatitis.
Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS.

Natural-Drug Products:

• Alcohol-containing preparations may interact with disulfiram and metronidazole.
• Theoretically, 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:

• Theoretically, 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, , wild carrot, wild lettuce, willow, and others.

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

• PO (Adults): Capsules/tablets: 400–1600 mg daily 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 three to four times per day; Liquid extract: 1–4 mL up to tid; Gargle: 10 drops of fluid extract per glass of water as needed.

German, Hungarian, or common chamomile (Matricaria chamomilla, Matricaria recutita), Roman, English, or common chamomile (Anthemis nobilis)

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

• Relief of abdominal discomfort.

Therapeutic Classification: gastrointestinal anti-inflammatories, sedative/hypnotics

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-life: Unknown.

• Inform patients 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.
• Instruct patients not to take other medications at the same time as the tea as it may inhibit absorption and decrease therapeutic effect of other agents.
• Advise patients on anticoagulant therapy to avoid concomitant use as it may enhance the effect of anticoagulants increasing the potential for bleeding.
• Warn pregnant women to avoid chamomile because of the potential abortifacient effect it may exert. Not recommended for use by breast-feeding women as safety has not been established.
• Topical: Teach patients using it topically to observe for allergic reactions and to immediately discontinue use if this develops.

kam-o-MEAL