Black Pepper

Piper nigrum L. · herb

Evidence tier: limited

In plain terms

Black pepper is the dried fruit of the Piper nigrum vine. In studies that gave 20 mg of its pungent compound, piperine, blood levels of some medicines rose, so a piperine supplement needs care alongside medicines.

How it works

Piperine slows two of the body's main drug handling systems in the gut and liver: the CYP3A4 enzyme, which breaks many medicines down, and P-glycoprotein, a pump that pushes substances back out of gut cells (PMID 12130727, cell and liver microsome study). Slowing both raises how much of a substance reaches the blood. That is the whole basis of its use as an absorption aid, and also of its drug interactions.

What the evidence says

Limited, and only for one thing: piperine, the pungent compound in black pepper, makes the body absorb certain other substances more. With 20 mg of piperine, curcumin from 2 g of turmeric extract reached about 20 times higher blood levels in volunteers (PMID 9619120), and the same 20 mg dose raised levels of propranolol, theophylline, nevirapine and carbamazepine in human studies (PMIDs 1815977, 17963429, 27776366). These are blood level studies, not proof that anyone feels better, and no trial shows a health outcome from adding pepper to a supplement. In lab work piperine blocks P-glycoprotein and CYP3A4 (PMID 12130727), which is the same reason it raises drug levels. In PlantRx Ashwagandha the amount is 5 mg of black pepper fruit per capsule, much less than the 20 mg of pure piperine studied, and the claims register allows no bioavailability claim at that dose (ASHW-07).

Dose and timing

No health dose exists. Human absorption studies used 20 mg of pure piperine (PMIDs 9619120, 1815977, 27776366). Culinary pepper is a normal food.

Piperine is an absorption aid, not a health ingredient in its own right. It can raise blood levels of some medicines, including anti seizure drugs, theophylline, propranolol and nevirapine [PMIDs 11808866, 27776366, 1815977, 17963429]. Anyone on a prescription medicine should ask a pharmacist before taking concentrated piperine.

Dose by form

• standardised piperine extract (studied dose): 20 mg piperine once daily was the dose used in human absorption studies [PMIDs 9619120, 1815977, 27776366].
• absorption aid in a capsule (PlantRx Ashwagandha): 5 mg black pepper fruit per capsule, taken as directed on the product; no effect is claimed at this amount [PlantRx claims register ASHW-07].

Preparation forms

• culinary spice
• capsule ingredient
• standardised piperine extract

Safety

Pregnancy: caution

Breastfeeding: caution

Active compounds: piperine

Remedies using Black Pepper · Browse by body system · Check it against what you take

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.