chamomile (matricaria chamomilla, anthemis nobilis)

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: Gastrointestinal antispasmodic, digestive aid, and sedative
Pedi: Infantile colic
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.

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:

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).

Adv. Reactions/Side Effects ⬆ ⬇

Derm: contact dermatitis

Misc: ANAPHYLAXISALLERGIC REACTIONS, INCLUDING

Interactions ⬆ ⬇

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, turmeric, wild carrot, wild lettuce, willow, and others.

Route/Dosage ⬆ ⬇

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.

Availability ⬆ ⬇

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

Assessment ⬆ ⬇

Assess patient for abdominal distention and auscultate for bowel sounds.
Evaluate sleep pattern and anxiety level prior to initiation of this herbal supplement.
Note size, location and character of affected skin prior to and after topical application.

Implementation ⬆ ⬇

PO: May be taken orally without regard to food intake.
As a sleep aide take just prior to retiring.
As a topical application for skin irritation, apply to skin that has been cleansed with a mild nonalcohol-containing cleanser.

Patient/Family Teaching ⬆ ⬇

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.
Teach patients using it topically to observe for allergic reactions and to immediately discontinue use if this develops.

Evaluation/Desired Outcomes ⬆ ⬇

Relief of abdominal spasm and pain associated with gas.
Improved digestion and decreased sense of fullness after eating.
Decrease in anxiety.
Improved ability to fall asleep.
Resolution of skin irritation or inflammation.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇