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

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