HERBAL
MEDICINAL
PLANT
---------------------------------------
FUMITORY
Fumaria
officinalis L. (Fumariaceae)
BY
RETTODWIKART
THENU
--------------------------------------
FUMITORY
(fyew’muh-toe-ry)
Fumaria
officinalis L. (Fumariaceae)
SUMMARY AND PHARMACEUTICAL COMMENT
Fumitory
is characterised by isoquinoline alkaloids which represent the principal active
ingredients. Animal studies support some of the traditional uses, but there is
a lack of rigorous clinical research assessing the effects of preparations of
fumitory. Fumitory should not be used in home-made ophthalmic preparations. In view
of the active constituents and the lack of safety data, excessive ingestion of
fumitory should be avoided.
SPECIES (FAMILY)
Fumaria officinalis L.
(Fumariaceae)
SYNONYM(S)
Common Fumitory, Fumitory
DESCRIPTION
MEDICINAL PARTS: The
medicinal parts are the dried herb and the aerial parts of the fresh flowering
plant.
FLOWER AND FRUIT: The
short pedicled flowers are in erect, dense, terminal racemes opposite the
leaves and are 5 to 8 mm long. The outer petals are rounded at the front and
are crimson to pink. But like the inner petals they are dark-red to black at
the tip and have a green keel. The fruit, which appears in the flowering
season, is nut-like, globular, slightly flattened at the side, green and has a
dent in the top.
LEAVES, STEM AND ROOT: The
plant is 10 to 50 cm high and ^ has a tender, erect, angular, branched, hollow
and glabrous stem which, like the leaves, is bluish green. The leaves are alternate
and divided into 3-pinnate sections. They are petiolate, double pinnate, soft
with petioled palmate or pinnatifid pinna.
CHARACTERISTICS: The
herb has a bitter, salty taste.
HABITAT: The
plant is indigenous to the Mediterranean region to northern Africa and in all of
Europe and Siberia. The herb has been introduced into North and South America.
Fumitory is an annual bush or shrub found in Africa, Europe,
the United States, Canada, Asia, and Australia.
PRODUCTION: Common
Fumitory herb consists of the dried, above ground parts of Fumaria officinalis,
gathered during the flowering season.
NOT TO BE CONFUSED WITH: The
very similar species F. vaillanti and F. schleicheri.
OTHER NAMES: Earth Smoke,
Hedge Fumitory, Beggary, ^Fumus, Vapor, Wax Dolls,
Figure 1. Fumitory Flower and Herba
PHARMACOPODIAL AND OTHER MONOGRAPHS
BHC 1992(G6)
BHP 1996(G9)
BP 2007(G84)
Complete German Commission E(G3)
Martindale 35th edition(G85)
Ph Eur 2007(G81)
LEGAL CATEGORY (LICENSED PRODUCTS)
GSL(G37)
CONSTITUENTS
The
following is compiled from several sources, including General References G2 and
G6.
Alkaloids
Isoquinoline-type. Protopines including protopine (fumarine) as the major
alkaloid and cryptopine,(1, 2) protoberberines including aurotensine,
stylopine, sinactine and Nmethylsinactine,( 3) spirobenzylisoquinolines
including fumaritine, fumaricine and fumariline,(4, 5) benzophenanthridines
including sanguinarine,(6) and indenobenzazepines including fumaritridine and
fumaritrine.(6, 7) Flavonoids Glycosides of quercetin including isoquercitrin,
rutin and quercetrin-3,7-diglucoside-3-arabinoglucoside.(8, 9) Acids Chlorogenic,
caffeic and fumaric acids.(8)
COMPOUNDS
Flavonoids: including rutin
Hydroxycinnamic
acid derivatives: including
caffeoylmalic acid
Isoquinoline
alkaloids: some
of them include
-Protoberberine-type:
including (-)-scoulerine
Protopine-type:
including protopine; main alkaloid
Spirobenzylisoquinoline-type:
fumaricine, (+)-fumariline
Indenobenzazepine-type:
including fumaritine, fumarofine
Organic acids: fumaric acid
USES
Fumitory is taken internally as a laxative, a diuretic,
and a treatment for biliary illness. Topically, it may be used to treat various
skin disorders such as eczema, psoriasis, acne, and scabies. Fumitory may be
used as an eyewash to ease conjunctivitis.
INVESTIGATIONAL
USES
Researchers are experimenting with the usefulness of
fumitory in the treatment of arrhythmias.
FOOD USE
Fumitory
is listed by the Council of Europe as a natural source of food flavouring
(category N3). This category indicates that fumitory can be added to foodstuffs
in the traditionally accepted manner, although there is insufficient
information available for an adequate assessment of potential toxicity.(G16)
HERBAL USE
Fumitory
is stated to possess weak diuretic and laxative properties and to act as a
cholagogue. Traditionally, it has been used to treat cutaneous eruptions,
conjunctivitis (as an eye lotion) and, specifically, chronic eczema.(G2, G6,
G7, G8,G64)
ACTIONS
A review of the literature reveals very few studies supporting
the use of fumitory as a diuretic, a laxative, or for treatment of skin disorders.
In Germany, fumitory is approved for treatment of colicky pain in the gallbladder
or biliary system. Only two studies have evaluated the possible use of fumitory
in the treatment of cardiac disorders. The fi rst study, using dogs, evaluated
the effi cacy of its alkaloid components in treating temporary disorders of
coronary blood fl ow. The injected alkaloids signifi cantly reduced ischemic
shifts (Gorbunov et al, 1980). The second study evaluated a number of different
plant species grown in Bulgaria. Results showed that fumitory exerted a healing
effect on ischemic heart disease, atherosclerosis, and hypertension (Petkov,
1979). Another study (Rao et al, 1998) showed Fumaria indica, a different Fumaria sp. from that used for the preparations that are
typically available, to be hepatoprotective. When used for irritable bowel
syndrome (IBS), there was no noticeable benefi t over a placebo (Brinkhaus et
al, 2005).
PHARMACOLOGICAL ACTIONS
IN VITRO AND ANIMAL STUDIES
In
in vivo (rats) studies, preparations of the herb had no effect on normal
choloresis but modified bile flow that had been artificially increased or
decreased.(10) Antispasmodic activity on smooth muscle has been reported.(11) Extracts
inhibited formation of gallbladder calculi in animals.(12) The major alkaloid
protopine has antihistaminic,(13) hypotensive, bradycardic and sedative
activities in small doses,(14) whereas larger doses cause excitation and convulsions.(14)
Bactericidal activity against the Gram-positive organisms Bacillus anthracis and
Staphylococcus have been reported.(14)
CLINICAL STUDIES
There
is a lack of clinical research assessing the effects of fumitory and rigorous
randomised controlled clinical trials are required. Clinical studies involving
105 patients with biliary disorders claimed favourable results.(15) However,
the methodological limitations of these studies do not allow the reported
effects to be attributed to administration of fumitory.
Figure 2. Dried Fumitory dan Powder Fumitory
ACTIVITIES
Amphicholeretic (1; BRU;
HHB; PHR; PH2); Anesthetic (1; HHB); Antiarrhythmic (1; BRU); Anticholinergic
(1; BRU); Antihistaminic (1; CAN); Antiinflammatory (f; MAD; PNC); Antilithic
(1; CAN); Antiseptic (1; PNC); Antispasmodic (2; APA; KOM; PH2; SHT);
Aphrodisiac (f; MAD); Bradycardic (1; CAN); Cholagogue (f; CAN; SHT);
Cholekinetic (SHT); Choleretic (1; PH2; SHT); Depurative (f; HHB; PHR; PH2);
Diaphoretic (f; MAD); Diuretic (f; APA; CAN; MAD; PNC); Emetic (f; MAD);
Hypertensive (1; HHB); Hypotensive (1; CAN; HHB); Laxative (f; APA; CAN; PNC);
Litholytic (f; MAD); Poison (1; HHB); Sedative (1; CAN); Stomachic (f; HHB);
Tonic (f; PNC).
INDICATIONS
Acne
(f; PNC); Alopecia (f; MAD); Amenorrhea (f; MAD); Arrhythmia (1; BRU);
Arthrosis (f; PHR; PH2); Atherosclerosis (f; MAD; PHR; PH2); Bile-Duct Spasm
(2; KOM; PH2); Bladder Stone (f; MAD); Cancer (f; JLH; MAD); Cancer, colon (f;
JLH); Cancer, gut (f; JLH); Cancer, liver (f; JLH); Cancer, uterus (f; JLH);
Cardiopathy (1; APA; BRU); Cholecystosis (2; KOM; MAD; PH2); Colic (1; APA);
Conjunctivosis (f; CAN; MAD); Constipation (1; APA; CAN; PH2; PNC); Cramp (2;
APA; KOM; PH2; SHT); Cystosis (f; PHR; PH2); Dermatosis (1; APA; CAN; PHR;
PH2); Dropsy (f; MAD); Dyskinesia (1; APA); Eczema (f; CAN; HHB; PH2);
Enterosis (2; KOM; PH2); Exanthema (f; MAD); Fever (f; MAD); Gas (f; MAD);
Gastrosis (2; APA; KOM; PH2); Gout (f; MAD); Halitosis (f; MAD); Headache (1;
APA); Hepatosis (2; JLH; MAD; PHR; PH2); High Blood Pressure (1; APA; CAN;
HHB); Hypoglycemia (f; PHR; PH2); Infection (f; PHR; PH2); Inflammation (f;
MAD; PNC); Insomnia (1; CAN); Itch (f; PH2); Jaundice (f; MAD); Leprosy (f;
MAD); Low Blood Pressure (1; HHB); Melancholy (f; MAD); Nausea (1; APA);
Nervousness (1; CAN); Ophthalmia (f; MAD); Pain (1; HHB); Psoriasis (1; APA);
Rheumatism (f; PHR; PH2); Scabies (f; MAD); Sclerosis (f; JLH); Sore (f; MAD);
Sore Throat (f; MAD); Spasm (2; KOM); Splenosis (f; MAD); Stomachache (f; HHB;
MAD); Stone (f; MAD); Syphilis (f; MAD); Uterosis (f; JLH); Water Retention (f;
APA; CAN; MAD; PNC).
INDICATIONS AND USAGE
Approved by
Commission E:
Liver and
gallbladder complaints Spastic discomfort in the area of the gallbladder and
bile ducts, as well as the gastrointestinal tract.
Unproven Uses: In folk
medicine, the herb has been used for skin diseases, constipation, cystitis,
arteriosclerosis, rheuma tism, arthritis, as a blood purifier, hypoglycemia and
for infections.
Homeopathic
Uses: for
chronic, itching eczema resulting from liver disease.
PRODUCT AVAILABILITY
Dried herb, extract, tincture
Plant
Parts Used: Flowering parts, leaves
DOSAGES
Dosages
for oral administration (adults) for traditional uses recommended in standard
herbal reference texts are given below.
·
Herb 2–4
g as an infusion three times daily.(G6,G7)
·
Liquid extract 2–4mL (1 : 1 in 25% alcohol)
three times daily.(G6, G7)
·
Tincture 1–4mL
(1 : 5 in 45% alcohol) three times daily.(G6, G7)
DOSAGES
·
Adult PO dried herb: 6 g/day
(Blumenthal, 1998)
·
Adult PO fl uid extract: 2-4 ml
(1:1 dilution) in 25% alcohol, tid
·
Adult PO tea: 2-4 g tid
·
Adult PO tincture: 1-4 ml (1:5
dilution) in 45% alcohol, tid
·
Adult topical: apply dried herb
prn
DOSAGES
1.25–2
tsp (2–3 g) herb/cup water up to 2 ×/day (APA); 2–3 tsp (2.4–3.6 g) herb/cup
tea/day (MAD);
2–4
g herb, or in tea, 3 ×/day (CAN); 6 g herb/day, drink 1 cup warm tea (2–3
g/cup, steeped 20 minutes) 30 minutes before meals (PH2); 6 g/day (APA; KOM;
SHT);
2–4
ml liquid herb extract (1:1 in 25% ethanol) 3 ×/day (CAN); 2–4 ml liquid herb
extract (PNC);
2–4
g aqueous extract (HHB); 1–4 ml herb tincture (1:5 in 45% ethanol) 3 ×/day
(CAN); 3.65 g sap/day (MAD); 2–3 tsp (2.4–3.5 g) expressed juice in hot or cold
infusion (PH2).
DOSAGES
Mode of Administration:
Comminuted
drug and its galenic preparations for internal use.
Preparation: To prepare an infusion,
pour boiling water over 2 to 3 gm drug and strain after 20 minutes.
Daily Dosage: 6 gm of drug.
Infusions for gallbladder complaints, drink 1 warm cup 30 minutes before meals.
Pressed juice—2
to 3 teaspoons (2.4 to 3.5 gm drug) daily as a cold or hot infusion.
Grated fresh
plant—1 teaspoon 3 times daily (about 50% plant material).
Homeopathic Dosage: 5 drops, 1
tablet or 10 globules every 30 to 60 minutes (acute) or 1 to 3 times daily
(chronic); parenterally: 1 to 2 ml sc acute: 3 times daily; chronic: once a day
(HAB34).
Storage: Protect from
light and moisture.
CONTRAINDICATIONS, INTERACTIONS, AND SIDE
EFFECTS
Not
listed (AHP). None reported (KOM). HH3 says protopine is spasmogenic; I’m more
inclined to believe BRU, which calls it antispasmodic.
SIDE-EFFECTS, ADVERSE
REACTIONS, TOXICITY
None
documented. However, there is a lack of clinical safety and toxicity data for
fumitory and further investigation of these aspects is required.
CNS: Seizures
(overdose)
CV: Decreased blood pressure, decreased pulse
EENT: Increased intraocular pressure
GI: Nausea, vomiting, anorexia
GU: Acute renal
failure
INTEG: Hypersensitivity reactions
CONTRA-INDICATIONS, WARNINGS
None
documented.
Drug
interactions None documented. However, the potential for preparations of
fumitory to interact with other medicines administered concurrently, particularly
those with similar or opposing effects, should be considered. Pregnancy and
lactation The safety of fumitory during pregnancy and lactation has not been
established. In view of lack of pharmacological and toxicity data, the use of
fumitory during pregnancy and lactation should be avoided. Until more research is available, fumitory should not
be used during pregnancy and breastfeeding. It should not be given to children.
Fumitory should not be used by persons with seizure disorders or increased intraocular
pressure, and it should not be used by those with hypersensitivity to it.
INTERACTIONS
Drug
Antiarrhythmics,
beta-blockers, cardiac glycosides: The
actions of fumitory may increase the effects of antiarrhythmics, beta-blockers,
cardiac glycosides; do not use concurrently.
CLIENT CONSIDERATIONS
Assess
·
Assess the reason the client is
using fumitory.
·
Assess for hypersensitivity
reactions. If present, discontinue use of fumitory and administer an
antihistamine or other appropriate therapy.
·
Assess the client’s cardiac
status, including blood pressure and pulse (character). Watch for decreasing
pulse.
·
Assess for other cardiovascular
drugs the client may be taking. Fumitory should not be taken concurrently with
antiarrhythmics, cardiac glycosides, or betablockers (see Interactions).
Administer
·
Instruct the client to store
fumitory products in a cool, dry place, away from heat and moisture.
Teach
Client/Family
·
Caution the client not to use
fumitory in children or those who are pregnant or breastfeeding until more
research is available.
PREPARATIONS
Proprietary
single-ingredient preparations
Austria:
Bilobene; Oddibil. Brazil: Oddibil. France: Oddibil. Germany: Bilobene. Hungary:
Bilobene.
Proprietary
multi-ingredient preparations
Austria:
Hepabene; Oddispasmol. Czech Republic: Hepabene. France: Actibil; Bolcitol;
Depuratif Parnel; Depuratum; Schoum. Hungary: Hepabene. Italy: Soluzione
Schoum. Russia: Hepabene (Гепабене). Spain: Natusor Hepavesical; Odisor;
Solucion Schoum. UK: Echinacea; Skin Cleansing.
REFERENCE
Barnes, J., Anderson, L. A., and
Phillipson, J. D. 2007. Herbal Medicines Third Edition. Pharmaceutical
Press. Auckland and London.
Duke, J. A. with Mary Jo
Bogenschutz-Godwin, Judi duCellier, Peggy-Ann K. Duke. 2002. Handbook
of Medicinal Herbs 2nd Ed. CRC Press LLC. USA.
Gruenwald, J., Brendler, T., Jaenicke,
Ch. 2000. PDR for Herbal Medicines. Medical
Economics Company, Inc. at Montvale, NJ 07645-1742. USA
Linda S-Roth. 2010. Mosby’s
Handbook Of Herbs & Natural Supplements, Fourth Edition. Mosby
Elsevier. USA
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