chamomile (Matricaria chamomilla, Anthemis nobilis)

General

Pronunciation
kam-o-MEAL [Pronunciation]

Trade Name(s)

• German, Hungarian, or common chamomile (Matricaria chamomilla, Matricaria recutita)

• Roman, English, or common chamomile (Anthemis nobilis)

Ther. class.
gastroinestinal anti inflammatories
sedative/hypnotics

Action

The volatile oil of chamomile contains several compounds with anti-inflammatory and antispasmodic activity.

Therapeutic Effect(s):
Relief of abdominal discomfort.

Pharmacokinetics

Absorption: Unknown.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

TIME/ACTION PROFILE

ROUTE	ONSET	PEAK	DURATION
PO, Topical	unknown	unknown	unknown

Contraindication/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 weeks prior to procedure).

Adverse Reactions/Side Effects

Derm: contact dermatitis.

Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS .

*CAPITALS indicates life-threatening.
*italic indicates most frequent.

Interactions

Natural Products-Drug

• 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 Products-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.

Potential Nursing Diagnoses

• Acute pain

• Insomnia

• Anxiety

Implementation

• PO: May be taken orally without regard to food intake.

• As a sleep aide take just prior to retiring.

• Topical: 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.

• Topical: 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.