Herb & supplement monograph

Capsicum Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Capsicum interacts with medications. The heart of this page is the interaction list — every drug Capsicum is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Capsicum is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Capsicum Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Capsicum drug interaction appears low for most people. None of the listed interactions are rated major, and none have been confirmed in well-controlled human studies.

Interactions deserving the most attention

The best-supported concern involves blood thinners, since population research links capsicum with more self-reported bleeding in people taking warfarin, though a clinical study of a single dose did not show a problem. Capsicum may also modestly lower blood sugar after meals, so people on diabetes medications should watch for signs of low blood sugar. There are also animal findings suggesting capsicum could change how the body handles theophylline, aspirin, and ciprofloxacin, but these effects have not been shown in people.

What the rest of the list means

Although capsicum is listed alongside a long list of medications, most of these interactions are theoretical, based on lab or animal research rather than effects seen in patients. In some cases, such as theophylline given intravenously, the predicted effect did not appear at all. For most people, eating chili peppers or taking capsicum with everyday medicines is unlikely to cause a meaningful problem.

Check your medications against Capsicum

Based on HelloPharmacist’s Capsicum interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Capsicum

239 medications have a known interaction with Capsicum, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
AbciximabReoPro
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Abciximab interaction
AbrocitinibCibinqo
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Abrocitinib interaction Abrocitinib drug page: uses, dosage & side effects
AcarboseGlucobay, Prandase, Precose
Moderate Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full Capsicum + Acarbose interaction Acarbose drug page: uses, dosage & side effects
AcenocoumarolSintrom
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Acenocoumarol interaction
Acetaminophen, AspirinGemnisyn
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Aspirin

Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.

Read the full Capsicum + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, IbuprofenCombogesic
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Acetaminophen, Ibuprofen interaction
AcetohexamideDymelor
Moderate Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full Capsicum + Acetohexamide interaction
Acetylsalicylic AcidEntrophen
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Acetylsalicylic Acid interaction Acetylsalicylic Acid drug page: uses, dosage & side effects
AlbiglutideTanzeum
Moderate Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full Capsicum + Albiglutide interaction
AlogliptinNesina
Moderate Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full Capsicum + Alogliptin interaction Alogliptin drug page: uses, dosage & side effects
Alogliptin, MetforminKazano
Moderate Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full Capsicum + Alogliptin, Metformin interaction
Alogliptin, PioglitazoneOseni
Moderate Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full Capsicum + Alogliptin, Pioglitazone interaction
Alteplase, TpaActilyse, Activase
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Alteplase, Tpa interaction
Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interaction
Aluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
Moderate Aspirin

Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.

Read the full Capsicum + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interaction Aluminum Hydroxide, Aspirin, Magnesium Hydroxide drug page: uses, dosage & side effects
Anacaulase-bcdbNexoBrid
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Anacaulase-bcdb interaction
AnagrelideAgrylin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Anagrelide interaction Anagrelide drug page: uses, dosage & side effects
AnisindioneMiradon
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Anisindione interaction
Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi
Moderate Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full Capsicum + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interaction
Antithrombin IiiThrombate III
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Antithrombin Iii interaction
ApixabanEliquis
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Apixaban interaction Apixaban drug page: uses, dosage & side effects
ArgatrobanArgatroban
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Argatroban interaction
AspirinAngettes 75, ASA, Asaphen, Aspirin, Caprin, Cartia +8 more
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Aspirin interaction Aspirin drug page: uses, dosage & side effects
Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
Moderate Aspirin

Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.

Read the full Capsicum + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interaction
Aspirin, ButalbitalAxotal
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Aspirin, Butalbital interaction
Aspirin, Butalbital, CaffeineFiorinal
Moderate Aspirin

Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.

Read the full Capsicum + Aspirin, Butalbital, Caffeine interaction Aspirin, Butalbital, Caffeine drug page: uses, dosage & side effects
Aspirin, Butalbital, Caffeine, Codeine PhosphateFiorinal w/ Codeine
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Aspirin, Butalbital, Caffeine, Codeine Phosphate interaction
Aspirin, Butalbital, Caffeine, PhenacetinMarnal
Moderate Aspirin

Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.

Read the full Capsicum + Aspirin, Butalbital, Caffeine, Phenacetin interaction
Aspirin, CaffeineAnacin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Capsicum + Aspirin, Caffeine interaction
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Capsicum combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Capsicum affects

Every type of medication (drug category) Capsicum is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 6 drug categories Capsicum interacts with
Anticoagulant/antiplatelet DrugsAntidiabetes DrugsAspirinTheophyllineAce Inhibitors (aceis)Ciprofloxacin (cipro)
Anticoagulant/Antiplatelet Drugs

Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro research shows that capsicum might increase the effects of antiplatelet drugs. Also, population research shows that capsicum is associated with an increased risk of self-reported bleeding in patients taking warfarin. However, clinical research shows that taking a single dose of capsaicin (Asian Herbex Ltd.), the active ingredient in capsicum, 400-800 mcg orally in combination with aspirin 500 mg does not decrease platelet aggregation when compared with taking aspirin 500 mg alone. Also, there was no notable effect on measures of platelet aggregation with capsaicin. It is unclear whether capsaicin must be used in more than a single dose to affect platelet aggregation.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.
Preliminary clinical research shows that consuming capsicum 5 grams along with a glucose drink attenuates the rise in plasma glucose after 30 minutes by 21%, decreases the 2-hour postprandial area under the curve of plasma glucose by 11%, and increases the 2-hour postprandial area under the curve of plasma insulin by 58% in healthy individuals when compared with placebo. Other clinical research shows that taking capsicum 5 mg daily for 28 days significantly reduces postprandial blood glucose and insulin levels, but not fasting blood glucose and insulin levels, in patients with gestational diabetes.

Likelihood Possible Evidence B
Aspirin

Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.
Animal research shows that acute or chronic intake of capsicum pepper reduces oral aspirin bioavailability. This has not been shown in humans.

Likelihood Possible Evidence D
Theophylline

Theoretically, taking capsicum with theophylline might increase the levels and adverse effects of theophylline.
In animal research, oral administration of capsicum reduced excretion of theophylline. However, capsicum does not seem to affect the pharmacokinetics of theophylline when administered intravenously.

Likelihood Possible Evidence D
Ace Inhibitors (Aceis)

Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.
There is one case report of a topically applied capsaicin cream contributing to the cough reflex in a patient using an ACEI. However, it is unclear if this interaction is clinically significant.

Likelihood Unlikely Evidence D
Ciprofloxacin (Cipro)

Theoretically, taking capsicum with ciprofloxacin might increase levels and adverse effects of ciprofloxacin.
Animal research shows that concomitant use of capsaicin, the active constituent of capsicum, and ciprofloxacin increases the bioavailability of ciprofloxacin by up to 70%.

Likelihood Possible Evidence D
Monograph

Capsicum: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Capsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin products are supported by reasonable evidence for some nerve and joint pain, but oral supplements are far less proven. Use it carefully, follow product directions, and talk to your pharmacist or doctor before starting.

Scientific name
Capsicum annuum
Family
Solanaceae
Part used
Fruit (pepper), often as a topical extract
Common forms
Topical creams, gels, and patches; oral capsules; dried powder (cayenne); tinctures
People commonly use it for
  • Nerve pain (neuropathy)
  • Muscle and joint pain (arthritis)
  • Back pain
  • Digestive support
  • Cluster headache (intranasal)

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Generally considered safe as food and in approved topical products, but it commonly causes burning and irritation.

PregnancyLikely Safe

When used topically and appropriately.

Read the full pregnancy detail
BreastfeedingLikely Safe

When used topically and appropriately.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Capsicum is the group of plants that give us chili peppers, including cayenne and many other hot peppers. These plants are grown around the world and have long been used both as food and as a folk remedy. The active ingredient that gives peppers their heat is called capsaicin.

People use capsicum in two main ways. The most studied use is on the skin as a cream, gel, or patch to help with certain kinds of pain. It is also taken by mouth in capsules or as dried powder, often for digestion or general wellness, though these oral uses have much weaker evidence.

How it works

Capsaicin acts on a nerve receptor called TRPV1, which is involved in sensing heat and pain. When you first apply it, it triggers a burning or warming feeling. With repeated use, it is thought to reduce the amount of a pain-signaling chemical called substance P, which may make nerves less able to send pain messages.

Other proposed effects, such as boosting metabolism, aiding digestion, or acting as an antioxidant, come mostly from laboratory and animal studies. These effects are not well proven in people, so they should be viewed as preliminary.

Effectiveness

Does Capsicum work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 36 uses evaluated
2 Likely effective 6 Possibly effective 28 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.
Likely Effective Diabetic neuropathy
Rating & evidence shown verbatim from Natural Medicines

Applying a specific prescription patch containing capsaicin 8% or a specific cream containing capsaicin 0.075% can reduce pain in diabetic neuropathy.

Likely Effective Postherpetic neuralgia
Rating & evidence shown verbatim from Natural Medicines

Applying a specific prescription patch containing capsaicin can reduce postherpetic neuralgia pain, especially in patients with the lowest pain scores.

Possibly Effective Back pain
Rating & evidence shown verbatim from Natural Medicines

Topical capsicum or capsaicin seems to be beneficial for reducing back pain.

Possibly Effective Cluster headache
Rating & evidence shown verbatim from Natural Medicines

Intranasal capsaicin seems to be beneficial for preventing cluster headaches. Its effect in the treatment of cluster headache is unclear.

Possibly Effective Nonallergic rhinitis
Rating & evidence shown verbatim from Natural Medicines

Intranasal capsaicin in a dose of at least 0.1 mM seems to improve symptoms of nonallergic rhinitis. It is unclear if lower doses of capsaicin are beneficial.

Possibly Effective Osteoarthritis
Rating & evidence shown verbatim from Natural Medicines

The American College of Rheumatology (ACR) conditionally recommends topical capsaicin for knee osteoarthritis, but not for hip or hand osteoarthritis.

Possibly Effective Postoperative nausea and vomiting (PONV)
Rating & evidence shown verbatim from Natural Medicines

Applying topical capsicum to acupoints seems to be beneficial for preventing PONV.

Possibly Effective Postoperative pain
Rating & evidence shown verbatim from Natural Medicines

Applying topical capsicum-containing plaster to acupoints seems to be beneficial for reducing postoperative pain. It is unclear if a capsicum patch or capsaicin instillation prior to wound closure is beneficial for reducing postoperative pain.

Also studied for 28 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Allergic rhinitis (hay fever)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if intranasal capsaicin is beneficial for preventing allergic rhinitis symptoms.

Insufficient Reliable Evidence To Rate Amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease)
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral capsicum for ALS, there is insufficient reliable information about the clinical effects of capsicum for this condition.

Insufficient Reliable Evidence To Rate Athletic performance
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsaicin is beneficial for improving athletic performance; the available research is limited to small, conflicting studies.

Insufficient Reliable Evidence To Rate Burning mouth syndrome
Rating & evidence shown verbatim from Natural Medicines

It is unclear if applying topical capsaicin in the mouth is beneficial for burning mouth syndrome.

Insufficient Reliable Evidence To Rate Cancer
Rating & evidence shown verbatim from Natural Medicines

It is unclear if eating more chili is beneficial for preventing mortality due to cancer.

Insufficient Reliable Evidence To Rate Cannabinoid hyperemesis syndrome (CHS)
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research suggests that topical capsaicin might be beneficial for reducing symptoms of CHS.

Insufficient Reliable Evidence To Rate Cardiovascular disease (CVD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if eating more chili is beneficial for preventing mortality due to CVD.

Insufficient Reliable Evidence To Rate Diabetes
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsaicin is beneficial for gestational diabetes. <b>Details</b>: Preliminary clinical research shows that taking chili powder containing capsaicin 5 mg daily for 4 weeks modestly reduces total cholesterol levels and reduces postprandial blood glucose levels by an average of 36 mg/dL and postprandial insulin levels by an average of 14 IU/L in patients with gestational diabetes. Compared to a placebo group, these changes are significant. However, capsaicin intake does not alter fasting plasma glucose or insulin levels.

Sources Ref 96457
Insufficient Reliable Evidence To Rate Dry skin
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsicum is beneficial for dry skin.

Insufficient Reliable Evidence To Rate Dyslipidemia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsicum is beneficial for reducing lipid levels.

Insufficient Reliable Evidence To Rate Dyspepsia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsicum is beneficial for dyspepsia.

Insufficient Reliable Evidence To Rate Fibromyalgia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsicum is beneficial for fibromyalgia.

Insufficient Reliable Evidence To Rate HIV/AIDS-related peripheral neuropathy
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical capsaicin is beneficial for this condition.

Insufficient Reliable Evidence To Rate Hypertension
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsicum is beneficial for lowering blood pressure.

Insufficient Reliable Evidence To Rate Intermetatarsal neuroma
Rating & evidence shown verbatim from Natural Medicines

It is unclear if injecting capsaicin into the third intermetatarsal space is beneficial for intermetatarsal neuroma.

Insufficient Reliable Evidence To Rate Irritable bowel syndrome (IBS)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsicum is beneficial for IBS.

Insufficient Reliable Evidence To Rate Laryngitis
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in gargling with capsicum for laryngitis, there is insufficient reliable information about the clinical effects of capsicum for this condition.

Insufficient Reliable Evidence To Rate Motion sickness
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in oral capsicum for motion sickness, there is insufficient reliable information about the clinical effects of capsicum for this condition.

Insufficient Reliable Evidence To Rate Myofascial pain syndrome
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical capsaicin is beneficial for myofascial pain syndrome.

Insufficient Reliable Evidence To Rate Neck pain
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical capsaicin is beneficial for neck pain.

Insufficient Reliable Evidence To Rate Neuropathic pain
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical capsicum is beneficial for neuropathic pain.

Insufficient Reliable Evidence To Rate Obesity
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsicum is beneficial for obesity.

Insufficient Reliable Evidence To Rate Overall mortality
Rating & evidence shown verbatim from Natural Medicines

Eating chili may be beneficial for preventing mortality. It is unclear if taking capsicum supplements is beneficial for preventing overall mortality.

Insufficient Reliable Evidence To Rate Peptic ulcers
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral capsicum is beneficial for peptic ulcers.

Insufficient Reliable Evidence To Rate Peripheral neuropathy
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research suggests that topical capsaicin might be beneficial for reducing peripheral neuropathy pain.

Insufficient Reliable Evidence To Rate Prurigo nodularis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical capsaicin is beneficial for prurigo nodularis.

Insufficient Reliable Evidence To Rate Sinonasal polyposis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if intranasal capsaicin is beneficial for sinonasal polyposis.

Insufficient Reliable Evidence To Rate Swallowing dysfunction
Rating & evidence shown verbatim from Natural Medicines

Preliminary research shows that oral capsaicin might be beneficial for improving swallowing ability.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Capsicum is widely eaten as food and is generally safe in those amounts. Topical products are also considered safe for most people when used as directed, but they very commonly cause burning, stinging, and redness where applied. Avoid getting it in your eyes, nose, mouth, or on broken or irritated skin, and wash your hands well after use.

People with sensitive stomachs, acid reflux, ulcers, or irritable bowel symptoms may find that oral capsicum worsens their symptoms. Use caution if you have these conditions.

Pregnancy and breastfeeding: Eating peppers as food is likely fine. However, concentrated supplements or medicinal doses have not been well studied during pregnancy or breastfeeding, so it is safest to avoid them unless your doctor approves. Always check with a pharmacist or doctor before using capsicum supplements.

Side effects

The most common side effects of topical capsicum are burning, stinging, itching, and redness at the application site. This often lessens with continued use but can be uncomfortable, especially at first or with high-strength products.

Taken by mouth, capsicum can cause stomach upset, heartburn, nausea, or a burning feeling in the stomach or when passing stool. Rarely, severe irritation, allergic reactions, or breathing problems from inhaling the powder can occur. Stop use and seek medical care if you have severe pain, blistering, or trouble breathing.

Capsicum: Reported Adverse Effects

Documented safety reports on Capsicum from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, capsicum is generally well tolerated in amounts typically found in food or when the extract is used in doses of up to 200 mg daily. Topically and intranasally, capsaicin, a constituent of capsicum, is generally well tolerated.

Most Common Adverse Effects:

Orally: Belching, bloating, burning, diarrhea, dyspepsia, gas, headache, mild constipation, nausea, rhinorrhea, skin flushing, and sweating.

Serious Adverse Effects (Rare):

Orally: Cases of myocardial infarction and hypertensive crisis have been reported.

Reports by condition
Cancer Oncologic

Population research suggests that moderate to high intake of capsaicin, the active constituent of capsicum, is associated with an increased risk of gastric cancer, while low intake is associated with a decreased risk. It is not clear from the study what amount of capsaicin is considered high versus low intake. Additionally, some research suggests that any link may be due to contamination of capsaicin products with carcinogens.

  1. Pabalan N, Jarjanazi H, Ozcelik H. The impact of capsaicin intake on risk of developing gastric cancers: a meta-analysis. J Gastrointest Cancer. 2014;45(3):334-41.
  2. Bley, K., Boorman, G., Mohammad, B., McKenzie, D., and Babbar, S. A comprehensive review of the carcinogenic and anticarcinogenic potential of capsaicin. Toxicol.Pathol. 2012;40(6):847-873.
Cancer Gastrointestinal

Orally, capsicum can cause upper abdominal discomfort, including irritation, fullness, dyspepsia, gas, bloating, nausea, epigastric pain and burning, anal burning, diarrhea, mild constipation, and belching. There is a case report of a 3-year-old female who experienced a burning and swollen mouth and lips after touching the arm of a parent that had been treated with a capsaicin patch and then placing the fingers in the mouth. Excessive amounts of capsaicin can lead to gastroenteritis and hepatic necrosis. In a case report, a 40-year-old male with diabetes consumed white wine daily and chewed cayenne which was thought to result in black teeth stains and loss of enamel. Some preliminary research links ingestion of capsaicin with stomach and gallbladder cancer; however the link may be due to contamination of capsaicin products with carcinogens.

Topically, capsaicin can cause diarrhea and vomiting.

  1. Schmulson MJ, Valdovinos MA, Milke P. Chili pepper and rectal hyperalgesia in irritable bowel syndrome. Am J Gastroenterol 2003;98:1214-5.
  2. Bortolotti M, Coccia G, Grossi G, Miglioli M. The treatment of functional dyspepsia with red pepper. Aliment Pharmacol Ther 2002;16:1075-82.
  3. Rodriguez-Stanley, S., Collings, K. L., Robinson, M., Owen, W., and Miner, P. B., Jr. The effects of capsaicin on reflux, gastric emptying and dyspepsia. Aliment.Pharmacol.Ther. 2000;14(1):129-134.
  4. Fett, D. D. Botanical briefs: Capsicum peppers. Cutis 2003;72(1):21-23.
  5. Petruzzi, M., Lauritano, D., De Benedittis, M., Baldoni, M., and Serpico, R. Systemic capsaicin for burning mouth syndrome: short-term results of a pilot study. J.Oral Pathol.Med. 2004;33(2):111-114.
  6. Milke, P., Diaz, A., Valdovinos, M. A., and Moran, S. Gastroesophageal reflux in healthy subjects induced by two different species of chilli (Capsicum annum). Dig.Dis. 2006;24(1-2):184-188.
  7. Gupta, P. J. Red hot chilli consumption is harmful in patients operated for anal fissure - a randomized, double-blind, controlled study. Dig.Surg. 2007;24(5):354-357.
  8. Gupta, P. J. Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial. Arq Gastroenterol. 2008;45(2):124-127.
  9. Gupta, P. J. Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. Ann.Ital.Chir 2008;79(5):347-351.
  10. van Boxel, O. S., ter Linde, J. J., Siersema, P. D., and Smout, A. J. Role of chemical stimulation of the duodenum in dyspeptic symptom generation. Am J Gastroenterol. 2010;105(4):803-811.
  11. Bortolotti, M. and Porta, S. Effect of red pepper on symptoms of irritable bowel syndrome: preliminary study. Dig.Dis.Sci 2011;56(11):3288-3295.
  12. Lim, L. G., Tay, H., and Ho, K. Y. Curry induces acid reflux and symptoms in gastroesophageal reflux disease. Dig.Dis.Sci 2011;56(12):3546-3550.
  13. Ludy, M. J., Moore, G. E., and Mattes, R. D. The effects of capsaicin and capsiate on energy balance: critical review and meta-analyses of studies in humans. Chem Senses 2012;37(2):103-121.
  14. Tominack, R. L. and Spyker, D. A. Capsicum and capsaicin--a review: case report of the use of hot peppers in child abuse. J.Toxicol.Clin.Toxicol. 1987;25(7):591-601.
  15. Kumar, N., Vij, J. C., Sarin, S. K., and Anand, B. S. Do chillies influence healing of duodenal ulcer? Br.Med.J.(Clin.Res.Ed) 6-16-1984;288(6433):1803-1804.
  16. Jorgensen MR, Pedersen AM. Analgesic effect of topical oral capsaicin gel in burning mouth syndrome. Acta Odontol Scand. 2017 Mar;75(2):130-6.
  17. Yuan LJ, Qin Y, Wang L, et al. Capsaicin-containing chili improved postprandial hyperglycemia, hyperinsulinemia, and fasting lipid disorders in women with gestational diabetes mellitus and lowered the incidence of large-for-gestational-age newborns. Clin
  18. Jang HH, Lee J, Lee SH, Lee YM. Effects of Capsicum annuum supplementation on the components of metabolic syndrome: a systematic review and meta-analysis. Sci Rep. 2020;10(1):20912.
  19. Joseph MSc A, John PhD F, Thomas MSc JV, Sivadasan SDP, Maliakel PhD B, Mohan PhD R, I M K. Influence of a novel food-grade formulation of red chili extract (Capsicum annum) on overweight subjects: Randomized, double-blinded, placebo-controlled study. J D
  20. Lassen CL, Meyer K, Bredthauer A, Klier TW. Facial and oral cross-contamination of a 3-year-old child with high concentration capsaicin: A case report. A A Pract. 2020;14(9):e01258.
  21. Surh YJ, Lee SS. Capsaicin in hot chili pepper: carcinogen, co-carcinogen or anticarcinogen? Food Chem Toxicol 1996;34:313-6.
  22. Schuurs, A. H., Abraham-Inpijn, L., van Straalen, J. P., and Sastrowijoto, S. H. An unusual case of black teeth. Oral Surg.Oral Med.Oral Pathol. 1987;64(4):427-431.
  23. Bley, K., Boorman, G., Mohammad, B., McKenzie, D., and Babbar, S. A comprehensive review of the carcinogenic and anticarcinogenic potential of capsaicin. Toxicol.Pathol. 2012;40(6):847-873.
  24. Predel HG, Ebel-Bitoun C, Peil B, Weiser TW, Lange R. Efficacy and safety of diclofenac?+?capsaicin gel in patients with acute back/neck pain: A multicenter randomized controlled study. Pain Ther. 2020;9(1):279-296.
Cluster headache Neurologic/CNS

Orally, capsicum can cause sweating and flushing of the head and neck, lacrimation, headache, faintness, and rhinorrhea. Topically, applying capsaicin can cause headache. Injection of capsaicin into the intermetatarsal space has also been associated with headache.

  1. Locock RA. Capsicum. Can Pharm J 1985;118:517-9.
  2. Bortolotti M, Coccia G, Grossi G, Miglioli M. The treatment of functional dyspepsia with red pepper. Aliment Pharmacol Ther 2002;16:1075-82.
  3. Joseph MSc A, John PhD F, Thomas MSc JV, Sivadasan SDP, Maliakel PhD B, Mohan PhD R, I M K. Influence of a novel food-grade formulation of red chili extract (Capsicum annum) on overweight subjects: Randomized, double-blinded, placebo-controlled study. J D
  4. Umigai N, Kozai Y, Saito T, Takara T. Effects of paprika carotenoid supplementation on bone turnover in postmenopausal women: a randomized, double-blind, placebo-controlled, parallel-group comparison study. Food Nutr Res. 2020;64.
  5. Van Nooten F, Treur M, Pantiri K, Stoker M, Charokopou M. Capsaicin 8% patch versus oral neuropathic pain medications for the treatment of painful diabetic peripheral neuropathy: a systematic literature review and network meta-analysis. Clin Ther. 2017 Ap
  6. Predel HG, Ebel-Bitoun C, Peil B, Weiser TW, Lange R. Efficacy and safety of diclofenac?+?capsaicin gel in patients with acute back/neck pain: A multicenter randomized controlled study. Pain Ther. 2020;9(1):279-296.
  7. Campbell CM, Diamond E, Schmidt WK, et al. A randomized, double-blind, placebo-controlled trial of injected capsaicin for pain in Morton's neuroma. Pain. 2016 Jun;157(6):1297-304.
Cough Pulmonary/Respiratory

Orally, difficulty breathing was reported in a clinical trial.

Topically, nasopharyngitis related to the use of a cream containing capsaicin has been reported.

Inhalation of capsicum and exposure to capsicum oleoresin spray can cause cough, dyspnea, pain in the nasal passages, sneezing, rhinitis, and nasal congestion. In rare cases, inhalation of the capsicum oleoresin or pepper spray has caused cyanosis, apnea, respiratory arrest and death in people. Death was caused by asphyxiation probably due to acute laryngeal edema and bronchoconstriction from inhalation of the capsicum oleoresin spray.

In a case report, a 47-year-old female who was exposed to capsaicin gas for more than 20 minutes experienced acute cough, shortness of breath, short-term chest pain, wheezing, and difficulty breathing for months afterwards. In rare cases, exposure to capsicum oleoresin spray resulted in apnea, pulmonary injury, cyanosis, and even respiratory arrest.

  1. Joseph MSc A, John PhD F, Thomas MSc JV, Sivadasan SDP, Maliakel PhD B, Mohan PhD R, I M K. Influence of a novel food-grade formulation of red chili extract (Capsicum annum) on overweight subjects: Randomized, double-blinded, placebo-controlled study. J D
  2. Predel HG, Ebel-Bitoun C, Peil B, Weiser TW, Lange R. Efficacy and safety of diclofenac?+?capsaicin gel in patients with acute back/neck pain: A multicenter randomized controlled study. Pain Ther. 2020;9(1):279-296.
  3. Millqvist E. Cough provocation with capsaicin is an objective way to test sensory hyperreactivity in patients with asthma-like symptoms. Allergy 2000;55:546-50.
  4. Marabini S, Ciabatti PG, Polli G, et al. Beneficial effects of intranasal applications of capsaicin in patients with vasomotor rhinitis. Eur Arch Otorhinolaryngol 1991;248:191-4.
  5. de Jong, N. W., van der Steen, J. J., Smeekens, C. C., Blacquiere, T., Mulder, P. G., van Wijk, R. G., and de Groot, H. Honeybee interference as a novel aid to reduce pollen exposure and nasal symptoms among greenhouse workers allergic to sweet bell pepp
  6. Final report on the safety assessment of capsicum annuum extract, capsicum annuum fruit extract, capsicum annuum resin, capsicum annuum fruit powder, capsicum frutescens fruit, capsicum frutescens fruit extract, capsicum frutescens resin, and capsaicin.
  7. Blanc, P., Liu, D., Juarez, C., and Boushey, H. A. Cough in hot pepper workers. Chest 1991;99(1):27-32.
  8. Niemcunowicz-Janica, A., Ptaszynska-Sarosiek, I., and Wardaszka, Z. [Sudden death caused by an oleoresin capsicum spray]. Arch.Med.Sadowej.Kryminol. 2009;59(3):252-254.
  9. Steffee, C. H., Lantz, P. E., Flannagan, L. M., Thompson, R. L., and Jason, D. R. Oleoresin capsicum (pepper) spray and "in-custody deaths". Am.J.Forensic Med.Pathol. 1995;16(3):185-192.
  10. Busker, R. W. and van Helden, H. P. Toxicologic evaluation of pepper spray as a possible weapon for the Dutch police force: risk assessment and efficacy. Am.J.Forensic Med.Pathol. 1998;19(4):309-316.
  11. Copeland S, Nugent K. Persistent respiratory symptoms following prolonged capsaicin exposure. Int J Occup Environ Med. 2013;4(4):211-5.
  12. Olajos, E. J. and Salem, H. Riot control agents: pharmacology, toxicology, biochemistry and chemistry. J.Appl.Toxicol. 2001;21(5):355-391.
Dermatitis Dermatologic

Orally, capsicum or its constituent capsaicin may cause urticaria and skin wheals in rare cases.

Topically, capsicum can cause a prickling sensation, itching, pain, burning, edema, stinging, irritation, rash, and erythema. About 1 in 10 patients who use capsaicin topically discontinue treatment because of adverse effects. These effects seem to occur more often with topical formulations containing higher concentrations of capsaicin, the active constituent of capsicum. Side effects tend to diminish with continued use. In one case, application of a capsaicin 8% patch (Qutenza) for 60 minutes caused a second-degree burn, characterized by burning, erythema, severe pain, and blistering at the administration site. The burn was treated with topical corticosteroids, but 9 months later neuropathic pain persisted, resulting in limited mobility. It is unclear whether the mobility sequalae were caused by topical capsaicin or the patient's pre-existing neurological disorders. Skin contact with fresh capsicum fruit can also cause irritation or contact dermatitis.

Intranasally, capsaicin can cause nasal burning and pain in most patients. It also often causes lacrimation, sneezing, and excessive nasal secretion; however, these side effects appear to diminish with repeat applications. In some cases, the burning sensation disappears after 5-8 applications. In some cases, patients are pretreated with intranasal lidocaine to decrease the pain of intranasal capsaicin treatment. However, even with lidocaine pretreatment, patients seem to experience significant pain.

  1. Yuan LJ, Qin Y, Wang L, et al. Capsaicin-containing chili improved postprandial hyperglycemia, hyperinsulinemia, and fasting lipid disorders in women with gestational diabetes mellitus and lowered the incidence of large-for-gestational-age newborns. Clin
  2. Umigai N, Kozai Y, Saito T, Takara T. Effects of paprika carotenoid supplementation on bone turnover in postmenopausal women: a randomized, double-blind, placebo-controlled, parallel-group comparison study. Food Nutr Res. 2020;64.
  3. Mason L, Moore RA, Derry S, et al. Systematic review of topical capsaicin for the treatment of chronic pain. BMJ 2004;328:991.
  4. Frerick H, Keitel W, Kuhn U, et al. Topical treatment of chronic low back pain with a capsicum plaster. Pain 2003;106:59-64.
  5. Keitel W, Frerick H, Kuhn U, et al. Capsicum pain plaster in chronic non-specific low back pain. Arzneimittelforschung 2001;51:896-903.
  6. Stam, C., Bonnet, M. S., and van Haselen, R. A. The efficacy and safety of a homeopathic gel in the treatment of acute low back pain: a multi-centre, randomised, double-blind comparative clinical trial. Br Homeopath J 2001;90(1):21-28.
  7. McCarthy, G. M. and McCarty, D. J. Effect of topical capsaicin in the therapy of painful osteoarthritis of the hands. J.Rheumatol. 1992;19(4):604-607.
  8. Misra, M. N., Pullani, A. J., and Mohamed, Z. U. Prevention of PONV by acustimulation with capsicum plaster is comparable to ondansetron after middle ear surgery: [La prevention des NVPO par acustimulation avec un emplatre de Capsicum est comparable a ce
  9. Tandan, R., Lewis, G. A., Krusinski, P. B., Badger, G. B., and Fries, T. J. Topical capsaicin in painful diabetic neuropathy. Controlled study with long-term follow-up. Diabetes Care 1992;15(1):8-14.
  10. Reuter, J., Merfort, I., and Schempp, C. M. Botanicals in dermatology: an evidence-based review. Am J Clin Dermatol 2010;11(4):247-267.
  11. McCormack, P. L. Capsaicin dermal patch: in non-diabetic peripheral neuropathic pain. Drugs 10-1-2010;70(14):1831-1842.
  12. Webster, L. R., Peppin, J. F., Murphy, F. T., Lu, B., Tobias, J. K., and Vanhove, G. F. Efficacy, safety, and tolerability of NGX-4010, capsaicin 8% patch, in an open-label study of patients with peripheral neuropathic pain. Diabetes Res Clin Pract. 2011
  13. Derry, S. and Moore, R. A. Topical capsaicin (low concentration) for chronic neuropathic pain in adults. Cochrane.Database.Syst.Rev. 2012;9:CD010111.
  14. Knight, T. E. and Hayashi, T. Solar (brachioradial) pruritus--response to capsaicin cream. Int.J.Dermatol. 1994;33(3):206-209.
  15. Casanueva B, Rodero B, Quintial C, Llorca J, González-Gay MA. Short-term efficacy of topical capsaicin therapy in severely affected fibromyalgia patients. Rheumatol Int 2013;33(10):2665-70.
  16. Kim DH, Yoon KB, Park S, et al. Comparison of NSAID patch given as monotherapy and NSAID patch in combination with transcutaneous electric nerve stimulation, a heating pad, or topical capsaicin in the treatment of patients with myofascial pain syndrome o
  17. Kulkantrakorn K, Lorsuwansiri C, Meesawatsom P. 0.025% capsaicin gel for the treatment of painful diabetic neuropathy: a randomized, double-blind, crossover, placebo-controlled trial. Pain Pract. 2013;13(6):497-503.
  18. Simpson DM, Robinson-Papp J, Van J, et al. Capsaicin 8% patch in painful diabetic peripheral neuropathy: a randomized, double-blind, placebo-controlled study. J Pain. 2017 Jan;18(1):42-53.
  19. Dean DJ, Sabagha N, Rose K, et al. A pilot trial of topical capsaicin cream for treatment of cannabinoid hyperemesis syndrome. Acad Emerg Med. 2020;27(11):1166-1172.
  20. Kocak AO, Dogruyol S, Akbas I, et al. Comparison of topical capsaicin and topical piroxicam in the treatment of acute trauma-induced pain: A randomized double-blind trial. Am J Emerg Med. 2020;38(9):1767-1771.
  21. Predel HG, Ebel-Bitoun C, Peil B, Weiser TW, Lange R. Efficacy and safety of diclofenac?+?capsaicin gel in patients with acute back/neck pain: A multicenter randomized controlled study. Pain Ther. 2020;9(1):279-296.
  22. Trin K, Perino J, Allouchery M, Géniaux H, Miremont G, Salvo F. Second-degree burn induced by high-concentration topical capsaicin with mobility sequelae: A case report. Pain Pract 2023;23(2):216-219.
  23. Williams SR, Clark RF, Dunford JV. Contact dermatitis associated with capsaicin: Hunan hand syndrome. Ann Emerg Med 1995;25:713-5.
  24. Rapoport AM, Bigal ME, Tepper SJ, Sheftell FD. Intranasal medications for the treatment of migraine and cluster headache. CNS Drugs 2004;18:671-85.
  25. Levy RL. Intranasal capsaicin for acute abortive treatment of migraine without aura. Headache 1995;35:277.
  26. Sicuteri F, Fusco BM, Marabini S, et al. Beneficial effect of capsaicin application to the nasal mucosa in cluster headache. Clin J Pain 1989;5:49-53.
  27. Fusco BM, Marabini S, Maggi CA, et al. Preventative effect of repeated nasal applications of capsaicin in cluster headache. Pain 1994;59:321-5.
  28. Stjarne P, Rinder J, Heden-Blomquist E, et al. Capsaicin desensitization of the nasal mucosa reduces symptoms upon allergen challenge in patients with allergic rhinitis. Acta Otolaryngol 1998;118:235-9.
Erythema Ocular/Otic

Topically, capsicum can be extremely irritating to the eyes and mucous membranes. Capsicum oleoresin, an oily extract in pepper self-defense sprays, causes intense eye pain. It can also cause erythema, blepharospasm, tearing, shortness of breath, and blurred vision. In rare cases, corneal abrasions have occurred.

Inhalation of capsicum can cause eye irritation, and allergic alveolitis. In a case report, a 38-year-old female had acute anterior uveitis that developed about 12 hours after using a specific patch (Isola Capsicum N Plus) that contained capsaicin 1.5 mg per patch and methyl salicylate 132 mg per patch for neck pain. The uveitis was controlled with topical steroids and did not recur.

  1. Williams SR, Clark RF, Dunford JV. Contact dermatitis associated with capsaicin: Hunan hand syndrome. Ann Emerg Med 1995;25:713-5.
  2. Zollman TM, Bragg RM, Harrison DA. Clinical effects of oleoresin capsicum (pepper spray) on the human cornea and conjunctiva. Ophthalmology 2000;107:2186-9.
  3. Brown, L., Takeuchi, D., and Challoner, K. Corneal abrasions associated with pepper spray exposure. Am.J.Emerg.Med. 2000;18(3):271-272.
  4. Vesaluoma, M., Muller, L., Gallar, J., Lambiase, A., Moilanen, J., Hack, T., Belmonte, C., and Tervo, T. Effects of oleoresin capsicum pepper spray on human corneal morphology and sensitivity. Invest Ophthalmol.Vis.Sci. 2000;41(8):2138-2147.
  5. Olajos, E. J. and Salem, H. Riot control agents: pharmacology, toxicology, biochemistry and chemistry. J.Appl.Toxicol. 2001;21(5):355-391.
  6. Gerber, S., Frueh, B. E., and Tappeiner, C. Conjunctival proliferation after a mild pepper spray injury in a young child. Cornea 2011;30(9):1042-1044.
  7. Watson, W. A., Stremel, K. R., and Westdorp, E. J. Oleoresin capsicum (Cap-Stun) toxicity from aerosol exposure. Ann.Pharmacother. 1996;30(7-8):733-735.
  8. Millqvist E. Cough provocation with capsaicin is an objective way to test sensory hyperreactivity in patients with asthma-like symptoms. Allergy 2000;55:546-50.
  9. Bleuel I, Zinkernagel M, Tschopp M, Tappeiner C. Association of bilateral acute anterior uveitis with a capsaicin patch. Ocul Immunol Inflamm 2013;21(5):394-5.
Myocardial infarction (MI) Cardiovascular

Orally, palpitation was reported in one clinical trial.

One case of myocardial infarction has been reported in a 41-year-old male without cardiovascular risk factors; the event was attributed to the use of an oral capsicum pepper pill that the patient had been taking for weight loss. Another case of coronary vasospasm and acute myocardial infarction has been reported for a healthy 29-year-old male; the event was attributed to the use of a topical capsicum-containing patch that the patient had been applying to the middle of the back for 6 days. Two cases of arterial hypertensive crisis have been reported for individuals who ingested a large amount of peppers and chili peppers the day before. One of the patients also had an acute myocardial infarction, and the other had high levels of thyroid stimulating hormone.

  1. Joseph MSc A, John PhD F, Thomas MSc JV, Sivadasan SDP, Maliakel PhD B, Mohan PhD R, I M K. Influence of a novel food-grade formulation of red chili extract (Capsicum annum) on overweight subjects: Randomized, double-blinded, placebo-controlled study. J D
  2. Sayin, M. R., Karabag, T., Dogan, S. M., Akpinar, I., and Aydin, M. A case of acute myocardial infarction due to the use of cayenne pepper pills. Wien.Klin.Wochenschr. 2012;124(7-8):285-287.
  3. Akcay, A. B., Ozcan, T., Seyis, S., and Acele, A. Coronary vasospasm and acute myocardial infarction induced by a topical capsaicin patch. Turk.Kardiyol.Dern.Ars 2009;37(7):497-500.
  4. Patane, S., Marte, F., Di Bella, G., Cerrito, M., and Coglitore, S. Capsaicin, arterial hypertensive crisis and acute myocardial infarction associated with high levels of thyroid stimulating hormone. Int.J Cardiol. 5-1-2009;134(1):130-132.
  5. Patane, S., Marte, F., La Rosa, F. C., and La, Rocca R. Capsaicin and arterial hypertensive crisis. Int J Cardiol. 10-8-2010;144(2):e26-e27.
Urticaria Immunologic

In a case report, a 34-year-old female had anaphylaxis involving difficulty breathing and stupor and also urticaria after consuming a red bell pepper, which is in the capsicum genus. The causal chemical was theorized to be 1,3-beta-glucanase. In another case report, a 33-year-old female experienced angioedema, difficulty breathing and swallowing, and urticaria after ingesting raw green and red peppers.

  1. García-Menaya JM, Cordobés -Durán C, Bobadilla-González P, et al. Anaphylactic reaction to bell pepper (Capsicum annuum) in a patient with a latex-fruit syndrome. Allergol Immunopathol (Madr). 2014;42(3):263-5.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no single standard dose of capsicum that fits everyone. Topical products come in different strengths, and high-concentration patches are usually applied by a healthcare professional. For any product, the best approach is to follow the directions on the label or your provider's instructions.

Because oral supplements vary widely in strength and quality, and because too much can irritate the stomach, it is wise to start low and check with your pharmacist or doctor before using capsicum regularly, especially if you have a health condition or take medicines.

Pregnancy & Breastfeeding

Capsicum & Pregnancy

Likely Safe

When used topically and appropriately.

  1. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
Possibly Safe

When used orally and appropriately, short-term. Capsicum 5 mg daily has been used for up to 28 days during the latter half of the second trimester and the third trimester.

  1. Yuan LJ, Qin Y, Wang L, et al. Capsaicin-containing chili improved postprandial hyperglycemia, hyperinsulinemia, and fasting lipid disorders in women with gestational diabetes mellitus and lowered the incidence of large-for-gestational-age newborns. Clin

Capsicum & Breastfeeding

Likely Safe

When used topically and appropriately.

  1. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
Possibly Unsafe

When used orally. Dermatitis can sometimes occur in infants when foods heavily spiced with capsicum peppers are ingested during lactation. Also, observational research suggests that intake of raw capsicum peppers during pregnancy is associated with an increased risk of sensitization to inhalant allergens in children by the age of 2 years.

  1. Cooper RL, Cooper MM. Red pepper-induced dermatitis in breast-fed infants. Dermatol 1996;93:61-2.
  2. Sausenthaler, S., Koletzko, S., Schaaf, B., Lehmann, I., Borte, M., Herbarth, O., von Berg, A., Wichmann, H. E., and Heinrich, J. Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age. Am J Clin Nu
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 89 references that drive our Capsicum monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  2. Cooper RL, Cooper MM. Red pepper-induced dermatitis in breast-fed infants. Dermatol 1996;93:61-2. PubMed
  3. Millqvist E. Cough provocation with capsaicin is an objective way to test sensory hyperreactivity in patients with asthma-like symptoms. Allergy 2000;55:546-50. DOI
  4. Locock RA. Capsicum. Can Pharm J 1985;118:517-9.
  5. Mason L, Moore RA, Derry S, et al. Systematic review of topical capsaicin for the treatment of chronic pain. BMJ 2004;328:991. PubMed
  6. Schmulson MJ, Valdovinos MA, Milke P. Chili pepper and rectal hyperalgesia in irritable bowel syndrome. Am J Gastroenterol 2003;98:1214-5. PubMed
  7. Surh YJ, Lee SS. Capsaicin in hot chili pepper: carcinogen, co-carcinogen or anticarcinogen? Food Chem Toxicol 1996;34:313-6. PubMed
  8. Bouraoui A, Brazier JL, Zouaghi H, Rousseau M. Theophylline pharmacokinetics and metabolism in rabbits following single and repeated administration of Capsicum fruit. Eur J Drug Metab Pharmacokinet 1995;20:173-8.
  9. Hogaboam CM, Wallace JL. Inhibition of platelet aggregation by capsaicin. An effect unrelated to actions on sensory afferent neurons. Eur J Pharmacol 1991;202:129-31. PubMed
  10. Wang JP, Hsu MF, Teng CM. Antiplatelet effect of capsaicin. Thromb Res 1984;36:497-507. PubMed
  11. Williams SR, Clark RF, Dunford JV. Contact dermatitis associated with capsaicin: Hunan hand syndrome. Ann Emerg Med 1995;25:713-5. PubMed
  12. Zollman TM, Bragg RM, Harrison DA. Clinical effects of oleoresin capsicum (pepper spray) on the human cornea and conjunctiva. Ophthalmology 2000;107:2186-9. PubMed
  13. Bortolotti M, Coccia G, Grossi G, Miglioli M. The treatment of functional dyspepsia with red pepper. Aliment Pharmacol Ther 2002;16:1075-82. PubMed
  14. Hakas JF Jr. Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy 1990;65:322-3.
  15. Rapoport AM, Bigal ME, Tepper SJ, Sheftell FD. Intranasal medications for the treatment of migraine and cluster headache. CNS Drugs 2004;18:671-85. PubMed
Keep reading

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Brand directory

Brands that make products with Capsicum

899 brands in our database make a supplement containing Capsicum.

Product directory

Supplement products with Capsicum

4,522 products in our database contain Capsicum. Open any to see its full ingredient list and every drug interaction we check.

(C)Lean Boost 495 mg by Jane Health Capsule 120 Capsule(s) View ingredients & interactions #10-FEM by Nutri-West Herbals Tablet Or Pill 100 Tablet(s) View ingredients & interactions #2 - CF by Nutri-West Liquid 1 oz. · 29.57 mL View ingredients & interactions #4 - B -P by Nutri-West Herbals Tablet Or Pill 100 Tablet(s) View ingredients & interactions 1 Activator by Systemic Formulas Bio Command Capsule 30 Capsule(s) View ingredients & interactions 10 Day Happy Colon Cleanse by Angry Supplements Capsule 30 Capsule(s) View ingredients & interactions 10 Day Happy Colon Cleanse by Angry Supplements Capsule 30 Capsule(s) View ingredients & interactions 100% Fermented Organic Greens Organic Chocolate by Natural Factors Whole Earth & Sea Powder 7.7 Ounce(s) · 219 Gram(s) View ingredients & interactions 100% Fermented Organic Greens Unflavored by Natural Factors Whole Earth & Sea Powder 6.9 Ounce(s) · 195 Gram(s) View ingredients & interactions 100% Natural Apple Cider Vinegar by Zeal Naturals Capsule 120 Capsule(s) View ingredients & interactions 100% Pure Garcinia Cambogia Drops by Infiniti Creations Liquid 2 Fluid Ounce(s) · 60 mL View ingredients & interactions 100% Pure Green Coffee Bean Drops by Infiniti Creations Liquid 2 Fluid Ounce(s) · 60 mL View ingredients & interactions 100% Pure Raspberry Keytones Drops by Infiniti Creations Liquid 2 Fluid Ounce(s) · 60 mL View ingredients & interactions 100% Whole Food Prenatal by Whole Body Research Capsule 120 Vegetarian Capsule(s) View ingredients & interactions 15-Day Weight Loss Support Cleanse & Flush by Nature's Secret Tablet Or Pill 60 Tablet(s) View ingredients & interactions 2-Day Diet Detox Natural Berry Flavor by SuperJuice Liquid 473 mL View ingredients & interactions 20 Veggies & Mushrooms by PureMax Labs YummyVite Capsule 60 Capsule(s) View ingredients & interactions 212 Degrees Thermo Sweet Heat Spicy Mango by Axe & Sledge Supplements Powder 189 Gram(s) · 6.67 Ounce(s) View ingredients & interactions 213 by Carbon Fire Capsule 80 Capsule(s) View ingredients & interactions 213 for Her by Carbon Fire Capsule 80 Capsule(s) View ingredients & interactions 3 Day Cleanse & Detox by Vitinity Tablet Or Pill 9 Tablet(s) View ingredients & interactions 3 in 1 Formula by Mountain Meadow Herbs Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions 360 Extreme Energy Memory & Focus 18 in 1 Advanced Complex by KAPPA NUTRITION Capsule 4 Capsule(s) View ingredients & interactions 50 & Wiser Men by Garden of Life Vitamin Code Capsule 120 Vegetarian Capsule(s) View ingredients & interactions
Pharmacist Counseling Corner

Capsicum: Common Questions

What is Capsicum used for, and does it work?
People use Capsicum for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting Capsicum for Diabetic neuropathy, Postherpetic neuralgia, Back pain and Cluster headache. For most other uses it has been studied for, the evidence is currently insufficient to rate. See the graded list on this page, and always confirm with your pharmacist or doctor.
Does Capsicum interact with prescription medications?
Yes. We list 239 medications with a known interaction with Capsicum. Use the checker above to see how Capsicum interacts with a specific drug.
How are Capsicum interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Capsicum with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Capsicum interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Capsicum used for?
It is most often used on the skin as a capsaicin cream or patch to help with nerve pain and joint or muscle pain. People also take it by mouth for digestion and other reasons, though those uses are far less proven.
Why does Capsicum cream burn when I put it on?
The capsaicin in Capsicum activates heat- and pain-sensing nerves, which causes a burning or warming feeling. This usually fades with repeated use, but you should avoid using it on broken skin or near your eyes.
Is Capsicum safe to take during pregnancy?
Eating peppers as food is generally considered fine, but concentrated supplements have not been well studied in pregnancy. It is safest to avoid medicinal doses unless your doctor says otherwise.
Can Capsicum help with weight loss?
Some lab and small human studies suggest capsaicin may slightly affect metabolism, but the evidence is weak and inconsistent. It should not be relied on as a weight-loss treatment.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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