Peppermint oil metabolites are excreted in the urine in part as glucuronic acid conjugates with ≥ 50% of a 100 mg oral dose of menthol appearing in urine as menthol glucuronide. Following biliary excretion, menthol glucuronide undergoes enterohepatic circulation. 9, 10 Therefore there is the potential for pharmacogenomics and other substances which impact either CYP2A6 or UGT2B7 activity to alter peppermint oil’s concentration-time curve. 3, 5 In particular, data show the importance of both CYP2A6 (the major P450 enzyme involved in menthol hydroxylation) and UGT2B7 expression in determining menthol clearance. 2, 3 Menthol is excreted into bile as menthol glucuronide. Menthol is primarily metabolized in the liver via hepatic microsomal P450 enzymes and subsequently undergoes biotransformation via UDP-glucuronosyltransferases. 8 In addition, development (reflected by age) may impact the pharmacokinetics of menthol as we showed in a pilot study in healthy children administered peppermint oil. 6 A L-menthol preparation sprayed directly onto the gastric mucosa was rapidly absorbed with peak concentrations reached within one hour after administration. 7 However, as noted, pharmacokinetics are greatly dependent on the formulation used. 6 In healthy adults, an oral dose of 100 mg of menthol results in an average peak blood concentration of 16.7 ± 5.5 μmol/L and an apparent elimination t 1/2 of 56 ± 8 min. The delayed release formulation did not alter the absorption half-life or total area under the curve. non-delayed release formulations) altered menthol urinary pharmacokinetics by increasing the apparent lag time and time to peak plasma concentrations. 5 Though done in a small study (n=13), delayed release formulations of peppermint oil (vs. 3, 5, 6 However, when taken in capsule form designed for delayed release, approximately 70% reaches the colon. 3, 4 Studies in rats and limited data in humans demonstrate that peppermint oil is rapidly absorbed. 3 The main constituent and active ingredient of peppermint oil appears to be menthol although it contains a large number (greater than 80) of other components. 5.Pharmacokinetic data relating to peppermint oil in humans are limited. Speak to your pharmacist, doctor or call 111 if you're worried, or have taken 2 extra doses or more. If you take 1 extra dose of peppermint oil, it's unlikely to harm you. Never take an extra dose to make up for a forgotten one. If that happens, just skip the missed dose and take the next one at the usual time. If you forget to take a dose, take it as soon as you remember, unless it's nearly time for the next dose. It’s best to take peppermint oil around 1 hour before meals. Take peppermint oil capsules as and when you have symptoms. You can increase this to 2 capsules, taken 3 times a day, if 1 capsule has not helped your symptoms.ĭo not take it for longer than 2 weeks unless prescribed by a doctor. The usual dose of peppermint oil for adults and children aged 12 and over is 1 capsule, taken 3 times a day until your symptoms get better. have digestive problems such as reflux disease, severe constipation or ulcerative colitisĪlways follow the instructions that come with the capsules, or as advised by your doctor.are pregnant, or think you may be pregnant.look paler than your usual skin tone, and feel tired.feel sick (nausea) or are being sick (vomiting).have suffered abnormal vaginal bleeding or discharge.have noticed that the symptoms you were taking peppermint oil for have changed.are 40 or over and have IBS, but have not had an attack for a while.are allergic to peanuts (some brands contain arachis oil, so it would be best to avoid those brands).weigh less than 40kg (around 6st 5lbs) or are losing weight.have ever had an allergic reaction to peppermint oil or any other medicine.To make sure peppermint oil is safe for you, tell your pharmacist or doctor before starting it if you: Peppermint oil is not suitable for some people. Check the leaflet that comes with your medicine. Some brands, however, are only suitable for those aged 15 years and above. Most adults and children aged 12 and over can take peppermint oil capsules for irritable bowel syndrome (IBS).
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