Pharmaceutical Drugs that Interact with BLACK PEPPER


Some pharmaceutical drugs react with black pepper.  Please use caution when using black pepper if you are prescribed the following medications:

  • Lithium

    Black and white pepper might have an effect like a water pill or "diuretic."  Taking black or white pepper might decrease how well the body gets rid of lithium.  This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.

  • Cytochrome P450 3A4 (CYP3A4) substrates are medications that are changed by the liver.  Black pepper might decrease how quickly the liver breaks down some medications. Taking black pepper along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking black pepper, talk to your healthcare provider.

    Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

  • Medications moved by pumps in the cells  (P-Glycoprotein Substrates) interacts with black and white pepper making the pumps less active and increase how much of some medications get absorbed by the body. This might cause more side effects from some medications.

  • Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, digoxin, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.

  • Take note of the following medications when using black and/or white pepper:

  • Phenytoin (Dilantin), Propranolol (Inderal), Rifampin and Theophylline interact with black and white pepper and might increase how much of these medications the body absorbs.  Taking black and white pepper along with the following medications might increase the effects and side effects of these medications.

    Carbamazepine (Tegretol) interacts with black and white pepper and might increase the amount of carbamazepine (Tegretol) absorbed by the body. It might also decrease how quickly the body breaks down and gets rid of carbamazepine. This could increase how much carbamazepine is in the body and potentially increase the chance of side effects. However, there is not enough known about this potential interaction to know if it is a big concern.  Talk with your healthcare provider if you are taking Carbamazepine.


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