Preparati

BILJNI PREPARATI BIBERA:

TINKTURA – hidroetanolni tečni ekstrakt sušenog nezrelog ploda, BIBER HSS, DER 1:5 Ph.Eur.  i

MATIČNA TINKTURA – hidroetanolni tečni ekstrakt sušenog nezrelog ploda, BIBER TM, DER 1:10.  

Piperi tinctura DER 1:5.

Piperi immaturi fructus extractum ethanolicum liquidum DER 1:10.

ATC:

– A15 – stimulans apetita, antibakterik, stomahik, promoter motiliteta. adjuvans, (pojačava dejstvo ostalih komponenata)

MeSH Data: Black Pepper, Piperine

U skladu sa:

Piperis fructus 2477 (European Pharmacopoeia 8.0 (8 th  edition) 1 July, 2015.)

Piper nigrum (USDA 1995, CNF 2009, API 2001) USP36 BPh.

Piper nigrum  Natural Health Products Ingredients Database

Piper nigrum HPUS88 Class C

HAB34: Piper nigrum ad praeparationes homoeopathicas

(Piper nigrum pour preparations homeopathiques).

a) Piper nigrum L.,fructus (Black pepper, the dried unripe fruit of Piper nigrum) method 1.1.10 (2371).

Biljni preparati u tečnom obliku (nerazblaženi ili razblaženi) za oralnu i lokalnu upotrebu.

Sastav:

a) tečni ekstrakt (DER 1:5), ekstrakcioni rastvarač etanol 65% (v/v),

b) tečni ekstrakt (DER 1:10), ekstrakcioni rastvarač etanol 65% (v/v),

Piper nigrum L., sadrži 404 istraženih hemijskih jedinjenja koja ispoljavaju 742 dejstava *(podaci ažurirani januara 2021.).

Sadržaj:

a) minimalno 0,0015% m/m, piperina (piperine) (MF: C₁₇H₁₉NO₃, MW: 285,33766 g/mol⁻¹),

b) u većoj koncentraciji sadrži BETA-CARYOPHYLLENE, Sabinene

Chemical Composition of Piper nigrum

Piperine Some of the compounds are Brachyamide B, Dihydro-pipericide, (2E,4E)-N-Eicosadienoyl-pereridine, N-trans-Feruloyltryamine, N-Formylpiperidine, Guineensine, pentadienoyl as piperidine, (2E,4E)-Nisobuty- ldecadienamid, isobutyl-eicosadienamide, Tricholein, Trichostachine, isobutyl-eicosatrienamide, Isobutyl-octadienamide, Piperamide, Piperamine, Piperettine, Pipericide, Piperine, Piperolein, Sarmentine, Sarmentosine, Retrofractamide

The different pharmacological activities were reported due to the presence of these phytochemicals

c) više od svih biljaka sadrži n-pentadekan (N-PENTADECANE), CAR-3-ENE, n-tridekan ( N-TRIDECANE), N- Heptadecane, Myrcene, Piperine

d) plod sadrži do 10,7 % vode.

Indikacije: biljni preparati su namenjeni poboljšanju opšteg stanja organizma kroz razna naučno dokazana dejstva.

Upotreba kod Medical use: abortifacient, ache(head), cholera, colic, gonorrhea, It has much pharmacological action such as antifungal, antiinflammatory, antioxidant and anti cancer effect (Atal et al., 1985) and it is known to have insecticidal activity against mosquitoes and flies (Miyakado et al., 1989). Pressure Headache

The present study is well correlated with previous reports on cancer suppressing activity and anticarcinogenic activityand antitumour potential and also confirm the presence of alkaloid piperine and piperidine by HPTLC analysis.

Following these studies, it confirms the potential of piperidine that can be used as anticancer drug,

Ekstrakt inhibira rast E. coli, Aerobacter aerogenes, L. casei, Staph. faecalis, Staph. aureus, Sraph. sonnei.Vib. cholerae, Stapk. albus, C. diphtheriae, Sh. dysenteriae, Sar. lutea, Strept. faecalis, B. pumilus,  Ps. pyogenes,  Strept. pyogenes, Micrococcus spp., Ps. solanacearum, B. subtilis, Salmonella typhi, Sal. paratyphi, Pestalotia spp.,  ,

Dr. Džems Djuk (Dr. James Duke) u Handbook of Medicinal Herbs, 2nd Ed. (2002). CRC Press, navodi sledeće: 

– ima jako dejstvo kod: sekrecije želudačnog soka, iritant, poboljšava cirkulaciju, u terapiji bola 

– delotvoran kod: It has much pharmacological action such as antifungal, antiinflammatory, antioxidant and anti cancer effect (Atal et al., 1985) and it is known to have insecticidal activity against mosquitoes and flies (Miyakado et al., 1989).

They have several uses such as they help in pain relief, rheumatism, chills, flu, colds, muscular aches and fever.

Externally it is used for its rubefacient and as a local application for relaxed sore, throat and some skin disorder. It has antimicrobial (Dorman and Deans, 2000), antimutagenic (El-Hamss et al., 2003), antioxidant and radical scavenging property (Gulcin, 2005) and inhalation of black pepper oil increase the reflexive swallowing movement (Vijayakumar et al., 2004). 

– u narodnoj medicini kod: fever, stimulant, carminative, cholera, stomachic, tonic, Ca., digestive, abortifacient, ache(Head), ache(Head), antidote(Fish), antidote(mushroom), antidote(Shellfish), antioxidant, apertif, bactericide, Ca.(face), Ca.(nose), Ca.(stomach), colic, coma, corn, craw-craw, dhobi Itch, diarrhea, dysentery, dysuria, fungicide, gonorrhea, groin, malaria, nausea, perfume, piles, poison, pungency, rubefacient, skin, sore, sore(throat), spice, sterilizant, swelling, Tu.(abdomen), vertigo, wen, 

– spoljašnja primena (topikalno) kod:

 – upotrebljava se kao jak: pesticide, flavor, antibacterial, perfumery, Cancer-preventive, antiinflammatory, antioxidant, fungicide, insectifuge, antiseptic,  zatim kao antispasmodic, allergenic, Irritant, sedative, nematicide, antiviral, hypotensive, aldose-reductase-Inhibitor, antitumor, antiulcer, hypocholesterolemic, antimutagenic, antifeedant, herbicide, insecticide, analgesic, diuretic,

used as a condiment, diaphoretic, stimulant, and carminative, and locally as a counterirritant.

antihypertensive,  anti-asthmatic, cognitive action and fertility, antimicrobial, antioxidant, anti-cancer, activity

anti-inflammatory, hepatoprotective, anti-diarrheal, digestive, antidepressant, Immunomodulatory, anticonvulsant, analgesic, effect of piperine on metabolism

Black pepper (Piper nigrum L.) piperine has been shown to have fundamental effects on p-glycoprotein and many enzyme systems, leading to biotransformative effects including chemoprevention, detoxification, and enhancement of the absorption and bioavailability of herbal and conventional drugs. Based on modern cell, animal, and human studies, piperine has been found to have immunomodulatory, anti-oxidant, anti-asthmatic, anti-carcinogenic, anti-inflammatory, anti-ulcer, and anti-amoebic properties, insekticid

Monografija nemačke E komisije (Commission E Monographs), terapijski vodič za biljne lekove, preporučuje Piper nigrum  za tretman gubitka apetita, dispeptične tegobe, spazme GIT-a, nadimanja i gasova..

Doziranje i način primene:

do 2 mL (80 kapi) podeljeno u 2 do 4 doze.

Biljni preparat BIBER HSS i TM:

pojedinačna doza: 0,5- 1,0 mL,

maksimalna preporučena dnevna doza (MPDD): 2 mL.

Oralna (15 do 30 minuta pre obroka) i lokalna primena.

Upotreba na koži: aplicirati na obolelo mesto u tankom sloju ili obliku impregniranog flastera.

Napraviti pauzu posle 4 nedelje neprekidne upotrebe (oralna upotreba).

Po preporukama, preparat postiže najbolje efekte pri upotrebi od 8 do 12 nedelja, duža upotreba je bezbedna uz pauze. 

Kontraindikacije: preosetljivost na aktivne supstance, preosetljivost na biljke porodice (genus Piper, family Piperaceae).

The acute toxicity (LD50 ) of the ethanol extract of Piper nigrum not toxic up to 5000mg/kg. 

Čuvanje: na tamnom, suvom i hladnom mestu do 20˚C, van domašaja dece i izlaganja EM zračenju,  u dobro zatvorenoj originalnoj ambalaži.

Rok upotrebe: 5 godina, posle prvog otvaranja 6 meseci. Neograničen rok upotrebe uz adekvatno čuvanje.

Pakovanje: 50 mL i 100 mL, standardne farmaceutske braon bočice; 250 mL, 500 mL, 1L i 5 L na zahtev. 

Nutritivne informacije, CRNI BIBER HSS i TM:
energetska vrednost u 100 mL: 1504 kJ/ 360 kcal,
u preporučenoj dnevnoj dozi (PDD) 2 mL: 30 kJ/ 7,2 kcal,
suve materije (DR) od 1,07 do 1,58 % (HAB 34).RD 0,897- 0,900
Bez konzervanasa, proteina, masti i ugljenih hidrata

 CRNI BIBER HSS i TM su rukom rađeni proizvodi. 

CENOVNIK 

TINKTURA – hidroetanolni tečni ekstrakt sušenog nezrelog ploda, BIBER HSS, DER 1:5, 

RSD 750,00/ 50 mL, 1500,00/ 100 mL (Eur. Ph.) i

MATIČNA TINKTURA – hidroetanolni tečni ekstrakt sušenog nezrelog ploda, BIBER TM, DER 1:10, 

RSD 600,00/ 50 mL, 1200,00/ 100 mL (HPUS).

Piper nigrum (Piperaceae)  Common names: Lada sula (Decorticated pepper; Wei Fu Chic; Hu Chiao; Maricha; White Peppercorn; Lada hitam (Black pepper); Karabiber; Pepper; Pepper,Black; Kosho; Pfeffer; Black Pepper

Total Uses: 67

Use: fever, stimulant, carminative, cholera, stomachic, tonic, Ca., digestive, abortifacient, ache(Head), ache(Head), antidote(Fish), antidote(mushroom), antidote(Shellfish), antioxidant, apertif, bactericide, Ca.(face), Ca.(nose), Ca.(stomach), colic, coma, corn, craw-craw, dhobi Itch, diarrhea, dysentery, dysuria, fungicide, gonorrhea, groin, malaria, nausea, perfume, piles, poison, pungency, rubefacient, skin, sore, sore(throat), spice, sterilizant, swelling, Tu.(abdomen), vertigo, wen,

Reference:

Leung, Albert Y. 1980. Encyclopedia of common natural ingredients. John Wiley and Sons, N.Y.

Ayensu, Edward S. 1978. Medicinal plants of West Africa. Reference Publications, Inc.

Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.

Shih-chen, Li. 1973. Chinese medinal herbs. Georgetown Press, San Francisco.

Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.

Hartwell, J.L. 1967-71. Plants used against cancer. A survey. Lloydia 30-34.

Keys, J.D. 1976. Chinese Herbs. Charles E. Tuttle Co., Tokyo.

Lewis and Elvin-Lewis, Medical Botany, ca 1977

ANON. 1978. List of Plants. Kyoto Herbal Garden, Parmacognostic Research Lab., Central Research Division, Takeda Chem. Industries, Ltd., Ichijoji, Sakyoku, Kyoto, Japan.

Tackholm, Vivi and Gunnar. 1973 (reprint). Flora of Egypt. Vol. 1-4. Originally published in Foriad I Univ. Bulletin of the Faculty of Science, vol. 17, Cairo, 1941.

Data by National Agricultural Library NAL Home | USDA.gov | Agricultural Resea

X X X X X 

Inhibitory effects of black pepper (Piper nigrum) extracts and compounds on human tumor cell proliferation, cyclooxygenase enzymes, lipid peroxidation and nuclear transcription factor-kappa-B.

X X X X X

 https://examine.com/supplements/black-pepper/

http://www.webmd.com/vitamins-supplements/ingredientmono-800-black%20pepper%20and%20white%20pepper.aspx?activeingredientid=800&

X X X X X

Piper nigrum ethanolic extract rich in piperamides causes ROS overproduction, oxidative damage in DNA leading to cell cycle arrest and apoptosis in cancer cells.

CONCLUSION:

The ethanolic extract has cytotoxic and antiproliferative effect on MCF-7 cells and antitumor effect in vivo probably due to ROS overproduction that induced oxidative stress affecting key proteins involved in cell cycle arrest at G1/S and triggering apoptosis. Finally, the overall data from this study are well in line with the traditional claims for the antitumor effect of Piper nigrum fruits.

X X X X X

Anti-cancer effects of Piper nigrum via inducing multiple molecular signaling in vivo and in vitro.

PFPE may possess anti-cancer and cancer prevention effects; hence, it deserves further investigation as a novel candidate for breast cancer treatment.

X X X X X

Synonyms / Common Names / Related Terms

Bisalkaloids, black pepper oil, Brazilian black pepper, dipiperamide D, dipiperamide E, green pepper, pink pepper, Piperaceae (family), piperine, piptigrine, red pepper, white pepper, wisanine.

Note: Black pepper, white pepper, green pepper, pink pepper, and red pepper are all differently preserved berries or seeds of the Piper nigrum plant.

Mechanism of Action

Pharmacology:

• Constituents: Black pepper has been found to contain piperine¹, alkamides⁹, piptigrine⁷, wisanine⁷, dipiperamide D¹⁰, and dipiperamide E¹⁰.
• Acetylcholinesterase inhibitory activity: In an in vitro study, an extract of Piper nigrum L. seeds showed 50-65% inhibitory activity on acetylcholinesterase.²
• Antibacterial effects: In an in vitro study using 12 different genera of bacterial populations isolated from the oral cavity of 200 individuals, an aqueous decoction of black pepper (Piper nigrum L.) exhibited 75% antibacterial activity as compared to aqueous decoction of bay leaf (53.4%) and aqueous decoction of aniseed (18.1%), at the concentration of 10mL/disc.⁴
• Anti-inflammatory effects: Based on animal study, a polyherbal formulation (Aller-7/NR-A2) containing extracts from seven medicinal plants including Phyllanthus emblica, Terminalia chebula, Terminalia bellerica, Albizia lebbeck, Piper nigrum, Zingiber officinale, and Piper longumdemonstrated 31.3% inhibition against carrageenan-induced acute inflammation in Wistar Albino rats, while ibuprofen (50 mg/kg orally) exerted 68.1% inhibition.³ Aller-7 also exhibited a dose-dependent (150-350mg/kg) anti-inflammatory effect against Freund’s adjuvant-induced arthritis in Wistar Albino rats; an approximately 63% inhibitory effect was observed at a dose of 350mg/kg.
• Antilarval activity: Piptigrine, isolated from the dried ground seeds of Piper nigrum Linn., exhibited toxicity of 15.0ppm against fourth instar larvae of Aedes aegypti Liston.⁷
• Antioxidant effects: Based on animal study, a polyherbal formulation (Aller-7/NR-A2) containing extracts from seven medicinal plants includingPhyllanthus emblica, Terminalia chebula, Terminalia bellerica, Albizia lebbeck, Piper nigrum, Zingiber officinale, and Piper longum exhibited concentration-dependent scavenging activities toward biochemically generated hydroxyl radicals (IC₅₀ 741.73mcg/mL); superoxide anion (IC₅₀24.65mcg/mL by phenazine methosulfate-nicotinamide adenine dinucleotide [PMS-NADH] assay and IC₅₀ 4.27mcg/mL by riboflavin/nitroblue tetrazolium [NBT] light assay), nitric oxide (IC₅₀ 16.34mcg/mL); 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical (IC₅₀ 5.62mcg/mL); and 2,2-azinobis-ethyl-benzothiozoline-sulphonic acid diammonium salt (ABTS) radical (IC₅₀ 7.35mcg/mL).⁵ Aller-7 inhibited free radical-induced hemolysis in the concentration range of 20-80mcg/mL. Aller-7 also significantly inhibited nitric oxide release from lipopolysaccharide-stimulated murine macrophages.
• Cytochrome P (CYP) 450 effects: In in vitro studies, constituents isolated from Piper nigrum, including piperine and dipiperamides D and E, potently inhibited some CYP450 metabolic pathways, including CYP2D6⁹ and CYP3A4^8,10.
• Gastrointestinal effects: In a clinical study of intestinal peristalsis in 16 healthy volunteers, consumption of 1.5g of black pepper in capsules increased the orocecal transit time from 90 ± 51 minutes to 122 ± 88 minutes (p=0.09).¹¹ In an in vitro study, piperine inhibited digoxin and cyclosporine A transport in Caco-2 cells with IC₅₀ values of 15.5 and 74.1mcM, respectively.⁸ The bactericidal and anti-adhesive properties of black pepper have also been investigated against Helicobacter pylori, however, aqueous extracts did not show bactericidal effect on any of the isolates.⁶
• Neural effects: In an in vitro study using whole-cell patch-clamp electrophysiology, piperine, a pungent alkaloid found in black pepper, had similar agonist effects on the human vanilloid receptor TRPV1 as capsaicin.¹ However, piperine could induce greater receptor desensitization and exhibit a greater efficacy than capsaicin.

Pharmacodynamics/Kinetics:

• Pharmacokinetics: In an animal study, piperine from black pepper was shown to enhance the bioavailability of EGCG, a polyphenol constituent from green tea (Camellia sinensis).¹² Intragastric coadministration of 163.8mcM/kg EGCG and 70.2mcM/kg piperine to male CF-1 mice increased the plasma C_max and area under the curve (AUC) by 1.3-fold compared to mice treated with EGCG only. The authors report that piperine appeared to increase EGCG bioavailability by inhibiting glucuronidation and gastrointestinal transit. Piperine (100mmM/L) inhibited EGCG glucuronidation in mouse small intestine (by 40%), but not in hepatic microsomes. Piperine (20mcM/L) also inhibited production of EGCG-3″-glucuronide in human HT-29 colon adenocarcinoma cells. Small intestinal EGCG levels in CF-1 mice following treatment with EGCG alone had a C_max = 37.50 ± 22.50nM/g at 60 min that then decreased to 5.14 ± 1.65nM/g at 90 min; however, cotreatment with piperine resulted in a C_max = 31.60 ± 15.08nM/g at 90 min, and levels were maintained above 20nM/g until 180 min. This resulted in a significant increase in the small intestine EGCG AUC (4,621.80 ± 1,958.72 vs. 1,686.50 ± 757.07 (nM/g·min)). EGCG appearance in the colon and the feces of piperine-cotreated mice was slower than in mice treated with EGCG alone.
• Pharmacodynamics: Based on animal study, a polyherbal formulation (Aller-7/NR-A2) containing extracts from seven medicinal plants including Phyllanthus emblica, Terminalia chebula, Terminalia bellerica, Albizia lebbeck, Piper nigrum, Zingiber officinale, and Piper longumexhibited concentration-dependent scavenging activities toward biochemically generated hydroxyl radicals (IC₅₀ 741.73mcg/mL); superoxide anion (IC₅₀ 24.65mcg/mL by phenazine methosulfate-nicotinamide adenine dinucleotide [PMS-NADH] assay and IC₅₀ 4.27mcg/mL by riboflavin/nitroblue tetrazolium [NBT] light assay), nitric oxide (IC₅₀ 16.34mcg/mL); 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical (IC₅₀5.62mcg/mL); and 2,2-azinobis-ethyl-benzothiozoline-sulphonic acid diammonium salt (ABTS) radical (IC₅₀ 7.35mcg/mL).⁵
• In an in vitro study, piperine inhibited digoxin and cyclosporine A transport in Caco-2 cells with IC₅₀ values of 15.5 and 74.1mcM, respectively.⁸

References

1. McNamara, F. N., Randall, A., and Gunthorpe, M. J. Effects of piperine, the pungent component of black pepper, at the human vanilloid receptor (TRPV1). Br J Pharmacol2005;144(6):781-790. 15685214
2. Ingkaninan, K., Temkitthawon, P., Chuenchom, K., Yuyaem, T., and Thongnoi, W. Screening for acetylcholinesterase inhibitory activity in plants used in Thai traditional rejuvenating and neurotonic remedies. J Ethnopharmacol2003;89(2-3):261-264. 14611889
3. Pratibha, N., Saxena, V. S., Amit, A., D’Souza, P., Bagchi, M., and Bagchi, D. Anti-inflammatory activities of Aller-7, a novel polyherbal formulation for allergic rhinitis. Int J Tissue React<.em> 2004;26(1-2):43-51. 15573692
4. Chaudhry, N. M. and Tariq, P. Bactericidal activity of black pepper, bay leaf, aniseed and coriander against oral isolates. Pak J Pharm Sci2006;19(3):214-218. 16935829
5. D’Souza, P., Amit, A., Saxena, V. S., Bagchi, D., Bagchi, M., and Stohs, S. J. Antioxidant properties of Aller-7, a novel polyherbal formulation for allergic rhinitis. Drugs Exp Clin Res2004;30(3):99-109. 15366786
6. O’Mahony, R., Al Khtheeri, H., Weerasekera, D., Fernando, N., Vaira, D., Holton, J., and Basset, C. Bactericidal and anti-adhesive properties of culinary and medicinal plants against Helicobacter pylori. World J Gastroenterol12-21-2005;11(47):7499-7507. 16437723
7. Siddiqui, B. S., Gulzar, T., Begum, S., and Afshan, F. Piptigrine, a new insecticidal amide from Piper nigrum Linn. Nat Prod Res2004;18(5):473-477. 15248617
8. Bhardwaj, R. K., Glaeser, H., Becquemont, L., Klotz, U., Gupta, S. K., and Fromm, M. F. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther2002;302(2):645-650. 12130727
9. Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med2006;72(6):527-532. 16808005
10. Tsukamoto, S., Tomise, K., Miyakawa, K., Cha, B. C., Abe, T., Hamada, T., Hirota, H., and Ohta, T. CYP3A4 inhibitory activity of new bisalkaloids, dipiperamides D and E, and cognates from white pepper. Bioorg Med Chem 2002;10(9):2981-2985. 12110320
11. Vazquez-Olivencia, W., Shah, P., and Pitchumoni, C. S. The effect of red and black pepper on orocecal transit time. J Am Coll Nutr1992;11(2):228-231. 1578101
12. Lambert, J. D., Hong, J., Kim, D. H., Mishin, V. M., and Yang, C. S. Piperine enhances the bioavailability of the tea polyphenol (-)-epigallocatechin-3-gallate in mice.J Nutr 2004;134(8):1948-1952. 15284381

Data by: www.sigmaaldrich

Piper nigrum Bundesanzeiger Nr. 242 a vom 28.12.1988 Monographie BGA/BfArM (Kommission D)

Schwarzpfeffer

Poivre noir
Plante médicinale avec un effet digestif indiqué en cas de troubles digestifs.

Constituants:
– Alcaloïdes
– Pipérine
– Pinène
– Limonène

​Effets:
– Digestif, carminatif, stimulant, antiseptique
Indications
– Coliques, diarrhée, choléra, flatulence, manque d’appétit, nausée, rhumatismes, fièvre, surpoids et obésité (effet selon une étude parue en mai 2012.).
– Une étude parue en mai 2012 Journal of Agricultural and Food Chemistry a montré comme résultat que le poivre noir aurait un effet protecteur dans la formation de nouvelles cellules graisseuses.
La pipérine (un composant du poivre noir) serait responsable de cet effet.
Le poivre noir pourrait ainsi être utilisé contre le surpoids ou l’obésité.

X X X X X X

Medicinal Action and Uses—Aromatic, stimulant, carminative; is said to possess febrifuge properties. Its action as a stimulant is specially evident on the mucous membrane of the rectum, and so is good for constipation, also on the urinary organs; externally it is a rubefacient, useful in relaxed conditions of the rectum when prolapsed; sometimes used in place of cubebs for gonorrhoea; given in combination with aperients to facilitate their action, and to prevent griping. As a gargle it is valued for relaxed uvula, paralysis of the tongue. On account of its stimulant action it aids digestion and is specially useful in atonic dyspepsia and torbid condition of the stomach. It will correct flatulence and nausea. It has also been used in vertigo, paralytic and arthritic disorders. It is sometimes added to quinine when the stomach will not respond to quinine alone. It has also been advised in diarrhoea, cholera, scarlatina, and in solution for a wash for tinea capititis. Piperine should not be combined with astringents, as it renders them inert.