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Ayurveda · Traditional Chinese medicine · Western herbalism

Black pepperPiper nigrum

A pungent spice whose alkaloid piperine raised curcumin absorption 2,000 percent in one human study; no trial has tested pepper for digestive symptoms.

Botanical name
Piper nigrum
Part used
dried unripe fruit (peppercorn)
Also called
Sanskrit Maricha; Hindi Kali mirch; pinyin Hu jiao (胡椒); Piperine (the main pungent alkaloid), White pepper (the same fruit, hulled)
Used in
Ayurveda, Traditional Chinese medicine, Western herbalism
Taken for
Indigestion, Appetite, Nausea, Loose stools and diarrhea
Sold as
ground spice, whole peppercorns, capsules, piperine extract, essential oil

What black pepper is

Black pepper is the dried, nearly ripe fruit of Piper nigrum, a climbing vine of the pepper family (Piperaceae). The Chinese Pharmacopoeia describes black pepper as the fruit collected while dark green and dried, and white pepper as the red ripe fruit soaked in water, rubbed free of its outer layer and dried. A systematic review of black pepper calls it the “king of spices” and notes that the seeds and fruits are the parts most often used medicinally, mostly as powder, pills or paste.

In supplements, black pepper appears in three ways. One is ground pepper or a whole-fruit extract, sold on its own for digestion. The second is a standardized piperine extract, added to other products to improve absorption; the studies below used 20 mg. The third is black pepper essential oil, used for aroma. Piperine is the compound behind both the pungency and most of the research.

Black pepper is also a component of the Ayurvedic mixture Trikatu (“three pungents”), together with ginger and long pepper.

What the traditions use it for

Ayurveda (about Ayurveda)

In Ayurveda black pepper is maricha. Charaka Samhita database entries list its taste as pungent, its qualities as light, sharp and dry, its potency as hot, and its post-digestive effect as pungent, and say it pacifies kapha and vata, helps break down ama (the tradition’s term for undigested metabolic residue), and kindles digestive fire (agni). Charaka lists it as an appetizer (deepaniya), digestant (pachana), worm-expelling (krimighna) and antispasmodic (shoolaprashaman) herb, and as a remedy for loss of appetite, vomiting, abdominal pain and the malabsorption pattern called grahani. A critical review of Trikatu in Ayurvedic classics describes the three-pepper mixture as the drug of choice for agnimandya, weak digestion.

Traditional Chinese medicine (about TCM)

Chinese medicine uses black pepper as hu jiao. A university TCM database classes it as hot and pungent, entering the stomach and large intestine channels, and gives its actions as warming the middle, dispersing cold, directing qi downward and transforming phlegm. The pattern it is used for is cold in the stomach, with abdominal pain eased by warmth, vomiting of clear fluid and watery diarrhea.

Western herbalism

In the Western literature black pepper is mainly a culinary spice. A review of its physiology reports that dietary piperine stimulates pancreatic digestive enzymes and shortens gastrointestinal transit time, drawing on animal studies. We found no European Medicines Agency monograph for it, so there is no regulator’s traditional-use statement. Western research interest has shifted to piperine as an absorption enhancer, which is documented in human pharmacokinetic studies.

The constituents

The pungent compound is piperine, an alkaloid. Black pepper also carries an essential oil, which is the material used in the aroma studies. In animals, piperine stimulates pancreatic digestive enzymes and shortens gastrointestinal transit time according to one review, while a separate study found that piperine inhibited gastric emptying of solids and gastrointestinal transit in rats and mice at 1 mg/kg and 1.3 mg/kg. These two animal findings point in different directions and have not been resolved in people. Piperine also inhibits drug-metabolizing enzymes and transporters, including glucuronidation, CYP3A4 and P-glycoprotein; this is the mechanism behind the interaction findings below.

The human evidence

We could find no randomized trial of black pepper or piperine for dyspepsia, bloating, nausea, constipation or diarrhea. The human data are about swallowing, feeding, and absorption of other compounds.

In a one-month randomized trial of 105 older nursing-home residents who had had a stroke, inhaling black pepper oil for a minute shortened the latency of the swallowing reflex compared with lavender oil and distilled water (P < .03), and a month of the inhalation improved it further. In ten children on long-term tube feeding, scenting with the oil for a minute before meals was continued for 3 months in eight, and five of those eight took more food by mouth. Both are aromatherapy studies of the oil, not a test of pepper as a digestive aid.

The most reproducible human finding is on absorption: 20 mg of piperine given with 2 g of curcumin raised the serum concentration and bioavailability of curcumin by 2,000 percent in healthy volunteers. In 12 volunteers, 20 mg of piperine a day for 10 days increased the maximum concentration of carbamazepine by 68.7 percent and AUC by 47.9 percent, and in another 12 it increased fexofenadine AUC from 3,403.7 to 5,724.7 ng·h/mL. These show piperine changes drug exposure, which is a risk as well as an effect.

Animal data on gastric emptying and enzymes are summarized under compounds. No study we found shows that ordinary dietary pepper changes digestive symptoms in people.

StudyDoseWhat it found
Randomized trial, 105 post-stroke older adults with swallowing dysfunction (not a gut-symptom outcome) PMID 16970649Black pepper oil inhaled, 1 minute; 1-month interventionShorter swallowing-reflex latency than lavender oil or water (P < .03)
Crossover study in healthy volunteers PMID 961912020 mg piperine with 2 g curcuminCurcumin bioavailability up 2,000%
Sequential study, 12 healthy volunteers PMID 2777636620 mg piperine daily for 10 days, then carbamazepine 200 mgCarbamazepine Cmax +68.7%, AUC +47.9%
Sequential study, 12 healthy volunteers PMID 2798134920 mg piperine daily for 10 days, then fexofenadine 120 mgFexofenadine AUC 3,403.7 to 5,724.7 ng*h/mL

Doses, in trials and in practice

No dose of black pepper has been tested for a gut outcome. The human studies used 20 mg of piperine, taken as a single dose with curcumin or once daily for 10 days. The swallowing trial used black pepper oil inhaled for one minute. Ayurvedic and Chinese practice use the powdered fruit inside a formula or alongside other warming spices, with amounts set by the practitioner. Standardized piperine extracts are the only form with a stated milligram dose.

The amounts above are what trials and pharmacopoeias record, not a dose for you; your medicines and conditions change the answer, and a clinician or pharmacist who knows them is the person to ask.

What is known about safety

Black pepper is a common food spice, and the volunteer study of piperine with curcumin reported no adverse effects. The relevant safety concern is the one it creates for medicines, below. Concentrated piperine supplements are a different exposure from sprinkled pepper.

We found no heavy-metal or adulteration surveys for black pepper in the sources we reviewed, and no regulator sets a safe upper intake. Safety of concentrated piperine in pregnancy and breastfeeding has not been established by trials. One of the fexofenadine authors notes that supplements containing piperine may enhance the absorption of other drugs.

Where it meets prescription medicines

Piperine inhibits P-glycoprotein and CYP3A4 in humans. In volunteers, 20 mg a day for 10 days raised carbamazepine exposure (AUC +47.9 percent, clearance down 38.9 percent) and fexofenadine exposure (AUC from 3,403.7 to 5,724.7 ng·h/mL); the carbamazepine authors advise caution with any medicine metabolized by CYP3A4, and the fexofenadine authors say piperine-containing supplements may enhance drug absorption. Piperine also inhibits glucuronidation, which is why it multiplied curcumin absorption. Medicines flagged in these studies include antiepileptics such as carbamazepine and antihistamines such as fexofenadine; other drugs cleared by the same pathways could be affected in the same direction.

Medicines the site’s own interaction rules flag with black pepper

The quiz applies these rules when someone names a medicine. They come from published interaction references and are a reason to ask a pharmacist, not a diagnosis:

Catalog entries that list black pepper

If you want black pepper in a product rather than as a loose herb, these are the entries that carry it, with the label amounts and the reviews read.

Yogi Lemon Ginger Tea 4.7 out of 5 from 3,114 ratings from Amazon · $0.23 per cup on Amazon ($3.68 for 16 bags); $0.31 on iHerb and $0.44 for a single box on the brand’s site Jupi Debloat & Hydration Powder 4.1 out of 5 from 1,568 ratings from Amazon · $1.40 a day Urban Moonshine Original Digestive Bitters 4.4 out of 5 from 1,409 ratings from Amazon · $0.68 a day Yogi Stomach Ease Tea 4.7 out of 5 from 1,375 ratings from Amazon · $0.28 per cup on the Amazon 6-pack; $0.44 for a single box on the brand site Ancient Nutrition SBO Probiotics Ultimate 4.6 out of 5 from 1,300 ratings from Amazon · $1.70 a day GLP-1 SOS Daily Gut Relief 3.9 out of 5 from 623 ratings from Amazon · $1.63 a day Himalaya Organic Trikatu 4.4 out of 5 from 381 ratings from Amazon · $0.30 per day at one caplet ($17.99 for 60 at Amazon and Vitacost); $0.35 on the brand site Banyan Botanicals Hingvastak Powder 4.7 out of 5 from 173 ratings from Amazon · $0.24 per half-teaspoon serving ($22.99 for 8 oz on the brand site and Amazon, about 96 servings); $0.12 to $0.48 a day across the label’s quarter to half teaspoon once or twice daily Banyan Botanicals Vata Digest 4.6 out of 5 from 125 ratings from Amazon · $0.64 per day at two tablets ($28.99 for 90); the label allows one to two tablets once or twice a day, $0.32 to $1.29 Nuora Gut Ritual 2.2 out of 5 from 39 ratings from Amazon · $1.30 a day

Is a black pepper product right for you?

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Herbs that sit beside it

Ayurvedic Long pepper Piper longum Ayurvedic Trikatu Zingiber officinale + Piper nigrum + Piper longum Ayurvedic / TCM / Western Ginger Zingiber officinale Ayurvedic / TCM / Western Cardamom Elettaria cardamomum (small or green cardamom); Amomum species in Chinese medicine Ayurvedic / TCM / Western Turmeric Curcuma longa

What people want to know

Has black pepper been tested for digestion?

We could find no human trial for digestive symptoms. The human studies are of swallowing with the aroma of the oil, and of how piperine changes drug absorption. Digestive claims rest on tradition and animal work.

Why is piperine added to supplements?

In a human study, 20 mg of piperine with 2 g of curcumin raised curcumin bioavailability by 2,000 percent. It works by blocking enzymes and transporters that clear compounds quickly. The same action can raise levels of medicines.

What does Ayurveda say about black pepper?

Ayurvedic texts class maricha as pungent and hot, an appetizer and digestant, and part of the Trikatu mixture used for weak digestion. These are statements from the tradition, not trial results.

Does TCM use black pepper?

Yes, as hu jiao. It is listed as hot and pungent, for cold in the stomach with abdominal pain, vomiting and watery diarrhea. These are statements from the tradition, not trial results.

Which medicines does piperine affect?

In volunteers it raised blood levels of carbamazepine (an anti-seizure drug) and fexofenadine (an antihistamine). It inhibits CYP3A4 and P-glycoprotein, so other medicines cleared the same way could be affected. The studies advise caution with narrow-range drugs.

Sources