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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Inflamex
Generic Name
Multivitamin
Active Ingredient
Black PepperCategory
Non-Standardized Plant Allergenic Extract [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 5 mg/1 | CAPSULE | ORAL | 59088-191 |
Detailed information about Inflamex
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Inflamex, you must consult a qualified healthcare professional.
Black Pepper (Piper nigrum) is utilized clinically as a Non-Standardized Plant Allergenic Extract for diagnostic testing and immunotherapy, while its active constituent, piperine, is studied for its significant effects on drug metabolism and bioavailability.
Dosage for Black Pepper varies significantly based on whether it is being used for diagnostic allergy testing or as a dietary supplement.
There are no specific dose adjustment guidelines for Black Pepper extracts in patients with renal impairment. However, because metabolites are excreted renally, caution is advised in patients with Stage 4 or 5 Chronic Kidney Disease (CKD).
Since piperine is metabolized by the liver and inhibits hepatic enzymes, patients with severe hepatic impairment (Child-Pugh Class C) should avoid high-dose oral black pepper supplements. For diagnostic skin testing, no adjustment is necessary.
Elderly patients may have thinner skin, which can lead to false-positive results in allergy testing (increased mechanical irritability). In oral form, the risk of drug-drug interactions is significantly higher in the elderly due to polypharmacy (taking multiple medications).
If you are taking Black Pepper as part of a daily supplement regimen and miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not double the dose to catch up.
In the event of an accidental large ingestion, contact a Poison Control Center immediately. Treatment is primarily supportive, focusing on hydration and soothing the gastrointestinal mucosa. If an allergic reaction occurs during testing, epinephrine is the first-line treatment.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance.
When used in clinical or dietary settings, the most frequent side effects associated with Black Pepper include:
> Warning: Stop taking Black Pepper and call your doctor immediately if you experience any of these symptoms of a severe allergic reaction (anaphylaxis):
There is limited data on the chronic use of concentrated Black Pepper extracts. However, potential long-term concerns include:
No FDA black box warnings for Black Pepper. However, as a non-standardized allergenic extract, it carries the inherent risk of systemic allergic reactions, and its use is strictly regulated to clinical environments where emergency resuscitation is available.
Report any unusual symptoms to your healthcare provider. Monitoring for gastrointestinal health and potential drug interactions is recommended for those using piperine supplements long-term.
Black Pepper, while a common food item, carries significant risks when used in concentrated clinical forms or high-dose supplements. The most critical safety concern is the potential for anaphylaxis during diagnostic testing. Patients with a history of severe food allergies or poorly controlled asthma are at the highest risk. Additionally, the 'bioenhancing' property of piperine is a double-edged sword; while it can improve the efficacy of some supplements, it can also lead to dangerous toxic levels of prescription medications.
No FDA black box warnings for Black Pepper. Unlike standardized potent allergens (like peanut or bee venom extracts), Black Pepper extracts are typically categorized as lower-risk, but they must still be used with caution under professional supervision.
For patients using high-dose Black Pepper or piperine supplements, the following monitoring may be necessary:
Black Pepper does not typically cause sedation or cognitive impairment. However, if a systemic allergic reaction occurs during testing, patients may experience dizziness or fainting, making driving unsafe. It is recommended to wait at least 30 minutes in the clinic after testing before driving.
Alcohol can increase the permeability of the gut lining and may exacerbate the gastric irritation caused by black pepper. Furthermore, alcohol can potentiate the vasodilation seen in allergic reactions, potentially making an anaphylactic event more severe. It is advised to avoid alcohol for 24 hours before and after allergy testing.
There is no known 'withdrawal syndrome' associated with Black Pepper. However, if you are using it to enhance the absorption of a critical medication, stopping it suddenly could lead to a significant drop in the blood levels of that medication, potentially causing a loss of therapeutic effect. Always consult your doctor before stopping a supplement regimen.
> Important: Discuss all your medical conditions with your healthcare provider before starting Black Pepper.
Black Pepper (specifically piperine) should not be used with drugs that have an extremely narrow therapeutic window where a 2-fold increase in concentration could be fatal. Examples include:
Mechanism of Interactions: Most interactions occur via the inhibition of CYP3A4 and P-glycoprotein. By 'turning off' these defense mechanisms in the gut and liver, Black Pepper allows more of the 'victim' drug to enter the bloodstream and stay there longer.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Black Pepper extracts must NEVER be used in the following circumstances:
Conditions requiring a careful risk-benefit analysis include:
Patients allergic to black pepper may show cross-reactivity with other members of the Piperaceae family. There is also a documented clinical phenomenon known as 'Celery-Mugwort-Spice Syndrome.' Patients who are allergic to mugwort pollen or celery may also react to black pepper due to shared allergenic proteins (profilins or Bet v 1-related proteins). If you have a known allergy to celery, cumin, or coriander, you may be at a higher risk of reacting to Black Pepper extract.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Black Pepper.
> Important: Special populations require individualized medical assessment.
Black Pepper's pharmacology is driven by Piperine (1-Piperoylpiperidine).
| Parameter | Value |
|---|---|
| Bioavailability | ~25% (Highly variable) |
| Protein Binding | 90-95% (Albumin) |
| Half-life | 1.2 - 2.1 Hours |
| Tmax | 1 - 2 Hours |
| Metabolism | Hepatic (CYP3A4, CYP2C9) |
| Excretion | Renal (70%), Fecal (30%) |
Black Pepper extract is a Non-Standardized Plant Allergenic Extract. It belongs to the broader category of Biologicals and Diagnostic Antigens. In the supplement world, it is classified as a Bioavailability Enhancer or Thermogenic Agent.
Common questions about Inflamex
Clinically, Black Pepper is primarily used as an allergenic extract for diagnostic skin testing to identify individuals with a specific allergy to the Piper nigrum plant. This is crucial for patients who experience severe allergic reactions or anaphylaxis after eating spiced foods. Additionally, its active component, piperine, is used in clinical formulations to enhance the absorption of other nutrients and medications. Some research also explores its use in metabolic health and as a topical analgesic. Always consult your doctor before using it for any medical purpose.
The most common side effects include gastrointestinal irritation, such as heartburn, stomach upset, or a burning sensation in the throat. When used for allergy testing, a localized itchy red bump (wheal) is expected at the site of administration. If inhaled, it can cause immediate sneezing, coughing, and nasal congestion. In high doses, some people may experience nausea or abdominal cramping. These effects are usually mild and temporary, but you should report any persistent symptoms to your healthcare provider.
It is generally advised to avoid or limit alcohol when taking concentrated Black Pepper or piperine supplements. Alcohol can irritate the stomach lining, potentially worsening the gastric side effects of piperine. Furthermore, alcohol may increase the absorption of piperine and other medications, leading to unpredictable drug levels. If you are undergoing allergy testing, you should avoid alcohol for at least 24 hours as it can interfere with the test results and the management of any potential allergic reactions. Discuss your alcohol consumption with your doctor.
While using black pepper as a spice in food is considered safe during pregnancy, concentrated extracts and high-dose piperine supplements are generally not recommended. There is insufficient clinical data to confirm the safety of high-dose piperine on fetal development. Some traditional evidence suggests that very high doses might stimulate the uterus, which could pose a risk. Allergy testing with the extract is usually postponed until after pregnancy. Always seek medical advice from your obstetrician before starting any new supplement during pregnancy.
The 'onset' of Black Pepper depends on the desired effect. For allergy diagnostic testing, a reaction typically appears on the skin within 15 to 20 minutes. When taken orally as a bioenhancer, piperine begins to affect intestinal absorption within 30 to 60 minutes. The peak concentration of piperine in the blood is usually reached within 1 to 2 hours. If you are using it for its metabolic or thermogenic effects, it may take several weeks of consistent use to notice any significant physiological changes. Your doctor can provide more specific timelines based on your use case.
Yes, you can generally stop taking Black Pepper supplements suddenly without experiencing withdrawal symptoms. However, if you have been taking it specifically to increase the absorption of another essential medication, stopping it could cause the levels of that medication to drop significantly. This could result in the other medication becoming less effective for your condition. It is important to discuss your plan to discontinue the supplement with your healthcare provider to ensure your other treatments remain at therapeutic levels. Never stop a prescribed medical regimen without professional guidance.
If you miss a dose of a Black Pepper supplement, take it as soon as you remember. However, if it is nearly time for your next scheduled dose, skip the missed dose and continue with your regular timing. Do not take two doses at once to make up for the one you missed, as this increases the risk of stomach irritation and drug interactions. Consistency is important for bioenhancement, but safety should always come first. If you are unsure, contact your pharmacist or healthcare provider for instructions tailored to your specific regimen.
There is no clinical evidence to suggest that Black Pepper causes weight gain. In fact, most research focuses on its potential to support weight management. Piperine, the active alkaloid, has been shown in some studies to have thermogenic properties, meaning it may slightly increase the body's metabolic rate. It may also interfere with the formation of new fat cells in laboratory models. However, these effects are modest and should not be viewed as a primary treatment for obesity. If you notice unexpected weight changes, you should discuss them with your healthcare provider.
Taking Black Pepper with other medications requires extreme caution. Piperine is a potent inhibitor of the CYP3A4 enzyme and P-glycoprotein, which are responsible for metabolizing and transporting many common drugs. This can lead to significantly higher levels of drugs like theophylline, phenytoin, and certain blood pressure medications in your system, increasing the risk of toxicity. Always provide your doctor with a full list of all prescriptions, over-the-counter drugs, and herbal products you are using before starting Black Pepper. Monitoring by a professional is often necessary.
Black Pepper itself is a natural substance, and piperine supplements are available from many different manufacturers under various brand names and as generic formulations. In the clinical setting, allergenic extracts of Black Pepper are produced by specialized laboratories (such as ALK-Abelló or Greer Laboratories) and are typically referred to by their standardized or non-standardized extract names rather than brand names. While the active ingredients are the same, the concentration and purity can vary between products, so it is best to use a consistent source recommended by your healthcare provider.
Other drugs with the same active ingredient (Black Pepper)