Natural Products

German chamomile

Matricaria chamomilla, Chamomilla recutita

Efficacy

• Indications with proven efficacy:
  None
• Indications with possible, but poorly documented efficacy - the use of this product cannot be recommended:
  Treating or preventing mucositis induced by radiation therapy or chemotherapy
• Also used for these other indications, but with no proof of efficacy:
  Anogenital inflammation (topically)
  Bacterial skin diseases, including those of the mouth and gums (topically)
  Gastrointestinal spasms
  Hemorrhoids (topically)
  Inflammation and irritation of the respiratory tract (inhaled)
  Inflammatory diseases of the gastrointestinal tract
  Leg ulcers
  Mastitis
  Menstrual cramps
  Mild sedative effect
  Motion sickness
  Nervous diarrhea
  Skin and mucous membrane inflammation (topically)
  

Security

• Risk of Drug Interactions: Moderate
• Adverse Effects: Not Frequent

What is it?

Chamomile is an annual plant whose medicinal value has been known since the Roman Empire. In addition to its medicinal value, it was used as a hair colorant or conditioner. Harvested while in bloom, the very odorous flowerheads are dried and then steeped (tea) or used to produce an extract.

Several medicinal properties are associated to chamomile: anti-inflammatory, muscle relaxant, antispasmodic, deodorant, antibacterial, increased wound healing. Many of these properties appear to be related to the activity of the components of the essential oil found in the plant's flowerheads (chamazulene and bisabolol). The azulene derivatives can inhibit histamine release and thus diminish allergic and inflammatory reactions. Bisabolol has anti-inflammatory and antiulcer properties.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) or homeopathic medicine number (DIN-HM) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plants content varies naturally from plant to plant – just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

Does it work?

Chamomile may be effective when taken oral rinse to treat and prevent mucositis induced by radiation therapy or chemotherapy. It may be useful in the treatment of other medical problems, however available data are limited and insufficient to clearly establish its efficacy.

• Treating or preventing mucositis induced by radiation therapy or chemotherapy:
  Use an oral rinse made with 10 to 15 drops of liquid extract in 100 ml warm water 3 times a day.
• Anogenital inflammation (topically):
  Fifty grams chamomile in 10 litres of water, as a bath or in irrigation. Gel and ointments preparations containing 3 to 10% chamomile are also used.
• Skin and mucous membrane inflammation (topically):
  Gel and ointments preparations containing 3 to 10% chamomile are used.
• Bacterial skin diseases, including those of the mouth and gums (topically):
  Gel and ointments preparations containing 3 to 10% chamomile are used on skin lesions. In the mouth, a gargle made of fresh, cold tea, is used.
• Inflammatory diseases of the GI tract and GI spasms:
  Fresh tea is drank 3 to 4 times a day, between meals.
  How to prepare chamomile tea:

  Add 3 g chamomile to 150 ml boiling water
  Cover and steep 5 to 10 minutes
  Strain before drinking.

There is insufficient reliable information to conclude that chamomile is effective in any other indications.

Is it safe?

• Chamomile is not associated with any particular toxicity. Too strong a tea can cause nausea. Some people may be allergic to chamomile; severe anaphylactic reactions may occur. People who are allergic to chrysanthemums, ragweed and daisies should not use chamomile. Do not apply this product near the eyes, since it may be irritating.
• Chamomile can affect the menstrual cycle and cause fetal malformations when administered to animals during pregnancy. Because of these effects, chamomile is contraindicated during pregnancy. In breast-feeding there is insufficient reliable information concerning its safety. Women who breast-feed should avoid its use.
• Chamomile contains anticoagulant components. It can interfere with the activity of oral anticoagulant agents (Coumadintm). Concomitant use with drugs with sedative properties can cause additive effects. Before taking chamomile, check with your pharmacist to make sure that there are not interactions with your regular medications.

Clinical notes

• Chamomile is a widely used plant with significant antispasmodic properties. When used according to recommendations, it appears to have limited toxicity.

References

1. Blumethal M et al. The Complete German Commission E monographs, 1998
2. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2007
3. Lininger S. et Al. The Natural Pharmacy, Prima Health, 1998
4. Barnes J. et Al. Herbal Medicines, 2nd edition, Pharmaceutical Press, 2002
5. Pierce Andrea, Practical Guide to Natural Medicines, 1999
6. Facts & Comparisons, The Lawrence review of Natural Products, 1999
7. Passeportsanté.net. Camomille allemande. http://www.passeportsante.net
8. Herbal Companion to AHFS DI, American Society of Health-System Pharmacists, 2001
9. Taylor J. CE: Phytomedicinals: Uses, precautions, and drug interactions. Drug Topics 2003;1:79
10. Barnes J. et Al. Herbal Interactions, The Pharmaceutical Journal 2003; volume 270