American pennyroyal
Natural Standard evidence-based flashcard. Copyright © 2008 (www.naturalstandard.com). Commercial distribution prohibited. This flashcard is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. 		Image
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Summary:
The essential oil of pennyroyal is considered toxic. Death has been reported after consumption of half an ounce (15ml) of the oil.

Uses
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Grade*
Abortion C
Increased menstrual flow C
*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Safety:
Avoid pennyroyal if you have a known allergy to pennyroyal or any of its components, including pulegone. Pennyroyal has been associated with numerous toxicities and death. Dangerous reactions may occur if pennyroyal is taken by mouth or is used on the skin. Use cautiously with prescription drugs that control blood sugar levels.

Possible side effects:
Upset stomach, nausea, stomach cramping, burning in the throat, vomiting (sometimes containing blood), lung damage, rash or hives when used on the skin, loss of consciousness, coma, confusion, dizziness, fatigue, stiff muscles, fever, agitation, delirium, nerve pain, seizures, shock, death, vision abnormalities, hallucinations, low blood pressure or slow, irregular heartbeats, breathing difficulties, urinary tract irritation, menstrual bleeding, abnormally low numbers of red blood cells, spontaneous abortion may also occur, increase the risk of bleeding, brain, kidney and liver and damage. Signs of overdose include nausea, vomiting, sweating, chills, fever, headache, ringing in the ears, dizziness, low blood pressure, difficulty swallowing, extreme thirst, rapid heartbeats, muscle spasms, restlessness, drowsiness, fatigue, tremor, excessive talkativeness, hallucinations, mania, seizures, and coma.

Possible interaction:
Drugs and herbs that lower blood sugar levels such as antidiabetic drugs and bitter melon (Momordica charantia) products broken down by the liver, acetaminophen (like Tylenol®), antihistamines such as diphenhydramine (like Benadryl®). Many tinctures contain high levels of alcohol and may cause nausea or vomiting when taken with metronidazole (like Flagyl®) or disulfiram (like Antabuse®).

Dosing:
No dose of pennyroyal has been determined to be safe. There are no standard or well-studied doses of pennyroyal, and many different doses are used traditionally.

Adults (18 years or older):
Pennyroyal has been used as an extract, tincture, oil, tea, and skin cream. However, because of known toxicity and the risk of death, no specific doses can be recommended.

Children (younger than 18 years):
There is not enough scientific data to recommend pennyroyal for use in children, and pennyroyal is not recommended because of a high risk of toxicity and death.
Natural Standard Monograph (www.naturalstandard.com)
Copyright © 2008 Natural Standard Inc. Commercial distribution or reproduction prohibited.
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.