Fumitory - Uses and Side Effects

Fumitory has been known since antiquity and was described in herbals from the Middle Ages. The dried or fresh flowering plant the above-ground part is used medicinally. Active components include hydroxycinnamic acid derivatives, flavonoids such as rutin and fumaric acid, and isoquinoline alkaloids such as scoulerine, protopine, fumaricine, fumariline, and fumaritine.

Isoquinolone alkaloids may contribute to the herb's antispasmodic effects on the gallbladder, bile ducts, and GI tract. Cinnamic acid has a choleretic effect. Fumaric acid works as an antioxidant, a flavoring agent, and a chelating agent. Flavonoids and their derivatives may improve capillary function by decreasing abnormal leakage. Available as leaves, liquid extract, powder, and tincture.

Reported uses

In traditional medicine, fumitory is used to treat eczema and other dermatologic conditions. It's also used as a laxative and a diuretic, and to relieve liver, gallbladder, and GI complaints. Fumitory is used to treat cystitis, atherosclerosis, rheumatism, arthritis, hypoglycemia, and infections, and as a blood purifier. Fumitory is also used topically to treat skin diseases such as chronic eczema and psonasls.

Administration

For gallbladder complaints: Infusion is prepared by pouring boiling water over 2 to 3 g of fumitory, and then straining after 20 minutes. Dosage is 1 cup warmed and taken before meals

Internal use: Dosage is 6 g by mouth or 1 cup of tea several times a day

Liquid extract (1:1 preparation in 25% alcohol USP): Dosage is 2 to 4 ml by mouth three times a day

Tincture (1:5 preparation in 45% alcohol USP): Dosage is 1 to 4 ml by mouth three times a day.

Hazards

Fumitory may increase intraocular pressure and reverse the effects of antiglaucoma drugs. Increased hypotension may be seen with antihypertensives. Tinctures and extracts contain significant levels of alcohol, increasing the risk for a disulfiram-like reaction. Fumaric acid is classified as a chelating agent; it may bind to other drugs and alter absorption. Increased CNS effects may be noted with alcohol use.

Patients with glaucoma or pregnant and breast-feeding women should avoid use. Because fumaric acid may cause renal failure, those with renal dysfunction should also avoid use.

Safety Risk Side effects associated with fumitory include hypotension, increased intraocular pressure, and acute renal failure.

Clinical considerations

Monitor patients for renal dysfunction serum creatinine and BUN levels because fumaric acid may cause renal failure.

Because tinctures and extracts contain significant levels of alcohol, they may be unsuitable for children, alcoholics, those with a previous history of alcohol abuse, those with preexisting liver disease, and those taking disulfiram or metronidazole.

If patient is pregnant or breast-feeding or is planning to become pregnant, advise her not to use fumitory

Inform patient of the potential for hypotension when using fumitory with an antihypertensive, and instruct him to report feelings of weakness, dizziness, or light headedness to his health care provider.

Remind patient not to take fumitory with any drug; instruct him to separate administration times by 2 hours.

Caution patient not to use fumitory with alcohol.

Instruct patient to report feelings of increased eye pressure or pain and to stop taking the herb immediately if he experiences such symptoms.

Tell patient to remind pharmacist of any herbal or dietary supplement that he's taking when obtaining a new prescription.

Advise patient to consult his health care provider before using an herbal preparation because a treatment with proven efficacy may be available.

Research summary

Fumitory has been investigated for its therapeutic potential in the management of cardiovascular and hepatobiliary disorders. Preliminary animal and human data suggest that the plant has pharmacologic activity, which requires further elucidation. Fumitory has not been associated with significant toxicity.

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