Fumitory

Other Names

Ackerrautebaglatulmulkbeggarybukslatulmulikcharmaahvyacharmakantakachatarasichaturasigidecommon fumitorydrug fumitoryearth smokeEchter ErdrauchErdgallefine-leaved fumitoryfumariaFumaria angustifoliaFumaria capreolata subsp. mediaFumaria comuneFumaria diffusaFumaria gaspariniiFumaria hybridaFumaria mediaFumaria officinalisFumaria officinalis L.Fumaria officinalis subsp. mediaFumaria officinalis subsp. officinalisFumaria officinalis subsp. wirtgeniiFumaria officinalis var. alpestrisFumaria officinalis var. elegansFumaria officinalis var. floribundaFumaria officinalis var. mediaFumaria officinalis var. prehensibilisFumaria officinalis var. pycnanthaFumaria officinalis var. scandensFumaria officinalis var. tenuifloraFumaria officinarumFumaria petteriFumaria vulgarisfumée de terrefumesfumes terraefumeterre officinalfumeterre officinalefumewortfumus terraeGemeiner ErdrauchGewöhnlicher Erdrauchhedge fumitoryherbe à la veuvehomairajordrökjordrøgjordrøykkallu sabasigekapnoskavachaKratzheilparpataparpatakaparpatakamuparpatupeltoemäkkipitpaparapitpapdapitpaprapittaharapittapapadapittapapadorajorenurenureykjurtshaatirajshahatrashahatrajashahtarshahtarashahtarajshahtarakshahtrahshatarashatrashaturujshotarasooksmapatrasuksmapatraTraubenkerbeltzu hua ti tingvanshulfavaporvaratiktawax dollsyavakantakayavana parpata

Synopsis

Fumitory (Fumaria officinalis L.): A Comprehensive Reference

1. Identity and Botanical Classification

1.1 Nomenclature and Taxonomy

Fumaria officinalis L., the common fumitory, drug fumitory, or earth smoke, is a herbaceous annual flowering plant in the poppy family Papaveraceae. It is the most common species of the genus Fumaria in Western and Central Europe. The genus name derives from the Latin fumus terrae (smoke of the earth), a reference both to the plant's misty, gray-green appearance and to the acrid smoke-like quality of its juice. In French the plant is known as fumeterre; in German as Erdrauchkraut; in the official pharmacopoeial designation as Fumariae herba. Additional common names include common fumitory, drug fumitory, earth smoke, fumaderm (Germany), fumitory, and pitpapara.

There are approximately 46 different Fumaria species, including Fumaria occidentalis, Fumaria parviflora (syn. Fumaria indica), Fumaria vaillantii, and Fumaria reuteri, which are difficult to differentiate. Several species such as F. densiflora, F. indica, F. officinalis, F. parviflora, and F. vaillantii are well-known ethnomedicines in South and West Asia and Europe. The present article focuses primarily on F. officinalis, the species covered by European regulatory monographs, while noting significant medicinal relatives where documented evidence exists.

1.2 Morphology and Distribution

F. officinalis is an herbaceous annual plant that grows weakly erect and scrambling, with stalks about 10–50 cm long. It has slender green leaves. Its pink 7–9 mm flowers appear from April to October in the northern hemisphere. They are two-lipped and spurred, with sepals running a quarter the length of the petals. It contains alkaloids, potassium salts, and tannins and is also a source of fumaric acid.

It is native to temperate regions of North Africa, Europe, and parts of Western Asia. It is found in North Africa, within Macaronesia, the Canary Islands, Algeria, Egypt, Libya, Morocco, and Tunisia. Within Western Asia it is found in the Caucasus, Cyprus, Iraq, Israel, Lebanon, Siberia, Syria, and Turkey. In eastern Europe it is found within Belarus, Estonia, Latvia, Lithuania, and Ukraine. In middle Europe it is in Austria, Belgium, Germany, Hungary, the Netherlands, Poland, Slovakia, and Switzerland.

1.3 Pharmacopoeial Identity and Common Preparations

This herbal drug by definition consists of dried aerial parts of Fumaria officinalis L. Studies with its main characteristic constituents — isoquinoline alkaloids of the protopine, spirobenzylisoquinoline, protoberberine, benzophenanthridine and indenobenzazepine types, also fumaric and malic acids — are included in the ESCOP monograph.

The EMA's Committee on Herbal Medicinal Products (HMPC) recognizes preparations including: (a) comminuted herbal substance; (b) powdered herbal substance; (c) dry extract (DER 3.5–5:1), extraction solvent water; (d) liquid extract (DER 1:1), extraction solvent ethanol 25% V/V; and (e) tincture (ratio of herbal substance to extraction solvent 1:5), extraction solvent ethanol 45% V/V. Fumaria is included in the British Herbal Pharmacopoeia and in the Complete German Commission E Monographs. It is on the United Kingdom General Sales List (GSL) and is approved by the German Commission E Monograph.

2. Traditional and Historical Use

2.1 Classical Antiquity

Fumitory has been known since antiquity and was described in herbals from the Middle Ages. The herb has been used as an herbal medicine since the time of the Roman Empire or even before, and from the Middle Ages to the 18th century it played a prominent part in traditional herbal medicine. The Greek physician and pharmacologist Pedanius Dioscorides (40–90 AD) mentions the herb in his De Materia Medica, and Pliny the Elder (23–79 AD) wrote in his Naturalis Historia that rubbing the eyes with the sap or latex of fumitory produces tears in the same manner as acrid smoke.

2.2 Medieval and Early Modern Europe

In herbal medicinal literature from the 15th and 16th centuries the herb was recommended for arthritis, liver and spleen disorders, and wound and rash healing. Both Nicholas Culpepper (1616–1654), an English botanist and herbalist, and Maud Grieve (1858–1941), also an English herbalist, valued it highly for serious conditions such as liver disease. In traditional European medicine, fumitory was a staple in formulations for treating liver ailments, gallbladder dysfunction, and even skin conditions. Its use was well documented in medieval herbal manuscripts and later in the works of renowned herbalists such as John Gerard.

Fumitory has been used for centuries in European traditional medicine as a remedy for skin conditions, digestive issues, and liver ailments. In medieval times it was believed to "purify the blood" and was also used as a diuretic and mild laxative. Traditional preparation involved expressing the juice and evaporating it.

The most common traditional uses were as a digestive aid and a diuretic, but various folk traditions throughout Europe ascribed to it a multitude of uses: constipation, cystitis, arteriosclerosis, rheumatism, arthritis, as a blood purifier.

2.3 Turkish and Near Eastern Folk Medicine

Fumaria species are used in Turkish folk medicine as a blood purifier and an anti-allergic agent. Previous ethnobotanical studies showed that they are used in a similar manner across regions, including as anthelmintic, antidyspeptic, blood purifier, cholagogue, diaphoretic, diuretic, laxative, stomachic, sedative, and tonic.

2.4 Ayurvedic and South Asian Traditions

Fumitory has a long history of use as a blood purifier in traditional medicine, including the Ayurvedic system, and has been investigated for its therapeutic potential in the management of cardiovascular and hepatobiliary disorders, psoriasis, eczema, and other dermatologic conditions, as well as a laxative and diuretic. The closely related species Fumaria indica (syn. F. parviflora) holds a prominent place in the Indian subcontinent. Fumaria parviflora, referred to as "Pitpapra" in Ayurveda and "Shahatra" in Unani medicine, is widely known for several therapeutic properties such as diuretic, laxative, antihelmintic, antimicrobial, stomachic, and blood purifier properties.

Fumaria indica is used in aches and pains, diarrhoea, fever, influenza, liver complaints, vomiting, constipation, dyspepsia, blood purification, leucoderma, and as an anthelmintic, diuretic, and diaphoretic, and in combination with black pepper, for jaundice. The plant is sold under the name pitpapra in Ayurvedic bazaars and used in the preparation of various traditional formulae such as parpatadya kawatha and parpatadya arista. It is also used in the Unani system of medicine and incorporated into trifala shahtara.

2.5 Summary of Traditional Preparations

Traditional preparation by expressing the plant juice and evaporating it
Herbal tea (infusion of the dried aerial parts)
Mixed with wine to strengthen the stomach and improve appetite
External application as a wash for skin complaints
Applied externally in leucoderma and as a fomentation for swollen joints
Tinctures and liquid extracts in later European herbal pharmacy

3. Phytochemistry: Key Constituents and Active Compounds

3.1 Overview of Chemical Classes

The main constituents of the whole plant are alkaloids (mainly protopine), carbohydrates, phenolic compounds, flavonoids, glycosides, terpenoids, phytosterols, proteins, amino acids, saponins, fixed oils, steroids, and tannins. The alkaloid content is approximately 0.87% to 1.27%, with protopine comprising 0.18% to 0.25% and fumoficinaline ranging from 0.16% to 0.2%. In addition, phospholipids and organic acids, including caffeic and fumaric acids, have been described.

Advanced chromatographic and spectroscopic techniques — such as HPLC, GC-MS, and LC-MS/MS — have enabled detailed analysis of its complex chemical profile, with a particular focus on isoquinoline alkaloids and phenolic compounds.

3.2 Alkaloids

Phytochemical studies on Fumaria species revealed the presence of numerous alkaloids, flavonoids, saponins, and terpenoids. Phthalideisoquinolines (PTIs), protoberberines, and spirobenzylisoquinolines (SBIs) are the major alkaloids in the genus Fumaria.

The principal unique chemical constituents in Fumaria are SBI and PTI alkaloids. SBIs are found almost exclusively in the genera Fumaria and Corydalis. Protopine was isolated from 22 of the 24 investigated Fumaria species.

Specific alkaloids identified and quantified in F. officinalis include:

Protopine — the predominant alkaloid; alkaloids isolated from F. officinalis include protopine at 42 mg/100g dry weight, cryptopine at 11 mg/100g; the weight of protopine alone can reach 230 mg/100 g of F. officinalis dry weight.
Fumariline (fumarilin) — found at 1.728 g/kg dry matter in one quantitative analysis.
Parfumine (fumarilicine) — found at 0.884 g/kg dry matter.
Sinactine, adlumine, spirobenzyl alkaloids — sinactine at 6 mg/100g, adlumine at 2 mg/100g, parfumine at 2 mg/100g, fumariline at 3 mg/100g.
Canadine, dicentrine, sanguinarine, cheilanthifoline, chelidonine, allocryptopine, fumaritine — identified as isoquinoline alkaloids, including canadine, dicentrine, fumaricine/fumarine, and sanguinarine, as well as protopine and berberine-like alkaloids.
Steroids — steroids including sitosterol, stigmasterol, and campesterol have been described from all plant parts, including the root and seed.

3.3 Phenolic Compounds and Flavonoids

The plant also contains acids: chlorogenic, caffeic, and fumaric acids, as well as bitter principles. Polyphenolic compounds present include caffeic acid, rosmarinic acid, and apigenin. Rutin and quercetin are also present.

4. Established Mechanisms of Action

4.1 Protopine: The Primary Bioactive Alkaloid

Protopine, identified as the predominant alkaloid, together with several phenolic constituents, is implicated in the plant's reported anti-inflammatory, hepatoprotective, and antioxidant activities.

Pharmacology of protopine has been investigated, and it protected oxidative stress-induced cells from death and showed in vivo antiarrhythmic, antithrombotic, anti-inflammatory, and hepatoprotective activities. It was also studied for its muscle relaxant, hydrocholeretic, and antiviral effects, revealing the mechanism associated with inhibiting calcium, sodium, and potassium channels.

Protopine exhibits several pharmacological effects such as antispasmodic and relaxant activities, hepatoprotective activity, anticholinesterase activity, and anticancer activity, in addition to its well-known analgesic and anti-inflammatory activities. Previous studies have shown that protopine attenuates inflammatory symptoms via suppression of the mitogen-activated protein kinase (MAPK)/nuclear factor kappa B (NF-κB) signaling pathways in RAW264.7 cells.

Fumitory also has an antihistaminic action due to the presence of protopine, a major alkaloid of the Fumariaceae family. The main alkaloid of fumitory, protopine, has antihistaminic, hypotensive, bradycardic, and sedative activity in small doses, but can cause excitation and convulsions at high doses.

4.2 Choleretic and Antispasmodic Activity

Existing data show pharmacological activities that are choleretic, amphocholeretic, and mildly antispasmodic on smooth muscle, as well as mildly diuretic and laxative, supporting the traditional use of Fumaria officinalis and preparations thereof. The term "amphocholeretic" is significant: it describes an effect that both increases bile output when it is reduced and decreases bile output when it is excessive — a bidirectional, normalizing action on the biliary system.

Protopine is an isoquinoline alkaloid contained in Fumaria officinalis that presents choleretic and hepato-protective action.

4.3 Anti-inflammatory and Antioxidant Mechanisms

Alkaloids are an important class of compounds with an anti-inflammatory capacity via the inhibition of expression of cytokines, lipid mediators, histamine, and enzymes in the inflammatory response. In vivo studies of protopine have revealed a broad spectrum of biological activities, including antiarrhythmic, antithrombotic, anti-inflammatory, and hepatoprotective effects.

Flavonoid glycosides also show anti-inflammatory activity by inhibiting LPS-induced NO production in a macrophage cell line.

4.4 Acetylcholinesterase Inhibition

F. officinalis appeared among the most potent acetylcholinesterase (AChE) inhibitors among many Fumaria species, on a plant dry weight basis (IC50 = 4.7 ±0.2 mg dry weight/ml), and the acetylcholinesterase inhibitory effects were correlated to the amount of protopine contained in 1 g of complex alkaloid isolated from the species.

4.5 Sedative and Muscle Relaxant Activity

The muscle relaxant and sedative activities of ethanolic extract of Fumaria officinalis were evaluated in experimental animal models. Fumaria officinalis at 100, 200, and 500 mg/kg body weight (i.p.) was evaluated for muscle relaxant activity using Rota rod, Traction test, and fall-off time. The results revealed significant (p<0.001) and dose-dependent muscle relaxant and sedative potentiating effects of ethanolic extract of Fumaria officinalis, demonstrating its depressant action on the central nervous system.

4.6 Antimicrobial Activity

Fumitory has anti-infective, notably bactericidal, activity thanks to the presence of allocryptopine, sanguinarine, chelidonine, and berberine. Reports of protopine's antibacterial activity against Gram-positive Staphylococcus and Bacillus anthracis have been noted. However, the antibacterial activity against both Gram-positive and negative bacteria confirmed that Fumaria officinalis has limited efficacy.

5. Scientific Evidence by Area of Use

5.1 Gastrointestinal and Hepatobiliary Uses

5.1.1 Regulatory Assessment

The EU HMPC classifies fumitory as a "traditional herbal medicinal product used to increase bile flow for the relief of symptoms of indigestion (such as sensation of fullness, flatulence and slow digestion)." The EMA explicitly states that the efficacy of this traditional herbal medicinal product is only plausible but not proven by clinical data.

The EMA assessment report on F. officinalis (2011) identified eight clinical studies in 617 patients as well as one double-blind placebo trial (30 patients) and two open studies in 63 patients, conducted between 1968 and 1992, that fully support the traditional use with intended choleretic and digestive effects of the plant. It also recognized that the existing data on amphocholeretic, mild antispasmodic on smooth muscle, mild diuretic and laxative antispasmodic activity, from studies between 1966 and 1992, supported the traditional use to increase bile flow for the relief of symptoms of indigestion.

The ESCOP monograph lists the therapeutic indications as digestive complaints (e.g., stomach ache, nausea, vomiting, feeling of fullness, flatulence) due to hepatobiliary disturbance.

5.1.2 IBS: The Brinkhaus Randomized Controlled Trial

The most rigorous and well-cited clinical study of oral fumitory is a randomized, double-blind, placebo-controlled trial published in the Scandinavian Journal of Gastroenterology (Brinkhaus et al., 2005; PMID 16173134). IBS patients were randomly assigned to one of three treatment groups: (1) Curcuma xanthorriza 60 mg daily (curcuma group, n=24); (2) Fumaria officinalis 1500 mg daily (fumitory group, n=24); and (3) placebo (n=58). The study treatment was applied three times a day for 18 weeks.

106 patients (mean age 48±12 years, 63% women) were included in the intention-to-treat group. IBS-related pain decreased by −0.9±11.5 mm in the fumitory group, −0.3±9.9 in the placebo group, and increased by 2.0±9.5 in the curcuma group (p=0.81). IBS-related distension decreased by −1.4±12.5 in the curcuma group, −2.12±9.2 in the placebo group, and increased by 0.3±9.3 in the fumitory group (p=0.48). Additionally, the global assessment of changes in IBS symptoms and psychological stress due to IBS did not differ significantly among the three treatment groups.

The conclusion of this trial was that neither Curcuma nor Fumaria had any therapeutic benefit over placebo in patients with IBS. The use of these herbs for the treatment of IBS cannot be recommended. Evidence level: one adequately powered RCT; result is negative.

5.2 Dermatological Uses

5.2.1 Eczema / Atopic Dermatitis: RCT Evidence

A randomized double-blind controlled clinical trial (published 2022, Iraji et al., Avicenna Journal of Phytomedicine; DOI: 10.22038/AJP.2022.19492) evaluated an herbal cream containing Fumaria officinalis and silymarin for treatment of eczema (atopic dermatitis) in Isfahan, Iran. 40 patients with mild to moderate eczema randomly received mometasone 0.1% or the herbal cream. Treatment course was 2 weeks and patients were examined before and after 2 weeks of treatment using the SCORAD system.

The reduction of SCORAD score was significant in both groups (p=0.04 in the herbal group and p=0.03 in the mometasone group) but no significant difference was observed between the groups. Evidence level: one small RCT (n=40) using a combination product (fumitory + silymarin cream), 2-week duration. Results suggest non-inferiority to a corticosteroid comparator, but the study cannot isolate fumitory's individual contribution. Evidence is preliminary.

5.2.2 Other Skin Evidence

Fumitory has a folk reputation for eczema and other itchy skin problems, but a clinical-applications review (Hentschel, 1995) found very little research supporting skin use. Fumaria parviflora has also been tested clinically for skin diseases such as eczema, uremic pruritus among hemodialysis patients, and hot flashes in breast cancer survivors.

One important distinction is worth noting: the prescription psoriasis drug is dimethyl fumarate, a manufactured fumaric acid ester — a synthetic derivative that shares the "fumaric" acid name but is not the same as the whole fumitory plant or its extracts.

5.3 Diuretic Activity

A 2017 study in Molecules tested six Fumaria species, including F. officinalis, and found the extract increased urine output in rats, supporting its old use as a mild diuretic, though the effect was weaker than a standard diuretic drug (Păltinean et al., 2017). The same work found moderate antioxidant activity. Evidence level: animal study; no clinical confirmation.

5.4 Hepatoprotective Activity

F. asepalae, F. densiflora, F. indica, F. officinalis, F. parviflora, and F. vaillantii are critically examined for their ethnomedicinal uses in hepatoprotection. A 2025 review in Fitoterapia links protopine and the plant's phenolics to anti-inflammatory, liver-protecting, and antioxidant effects in lab models (Prokopenko et al., 2025). Evidence level: in vitro and in vivo preclinical studies and a recent review; no dedicated clinical trials specifically for hepatoprotection with fumitory have been published as of the present date.

5.5 Cardiovascular Effects

Fumitory has a long history of use in traditional medicine and has been investigated for its therapeutic potential in the management of cardiovascular and hepatobiliary disorders. Animal studies support some of the traditional use in humans and have shown that the herb may have a certain blood pressure-lowering, slight diuretic, and laxative effect. Evidence level: animal studies only; no clinical cardiovascular trials identified.

5.6 Anticancer / Cytotoxic Activity

Protopine and QBA alkaloids have been studied for their antitumor activity. The antiproliferative activity results disclosed a significant inhibition of breast cancer cell proliferation in one laboratory study. Evidence level: in vitro only; no clinical oncology evidence.

5.7 Antidiabetic Activity

The antidiabetic, antidiarrheal, anti-inflammatory, antimicrobial, antispasmodic, and gastro-protective activities correlate with the traditional uses of Fumaria species. Preclinical data show high antioxidant activity and cytoprotective effect on the liver, kidney, and testicles, as well as anti-diabetic, analgesic, and anti-inflammatory activities. Evidence level: preclinical; no clinical diabetes trials.

5.8 Overall Summary of Evidence Strength

Although there are many papers describing the bioactivity of crude extracts of Fumaria species, few purified constituents have been studied in detail for their mechanism of action and safety. The lack of studies on pharmacological mechanisms, pharmacokinetics, clinical efficacy, quality control, and toxicology are identified as major gaps. The clearest regulatory consensus is that fumitory is accepted as a traditional herbal medicinal product for digestive and biliary complaints; its use for other conditions lacks clinical trial support.

6. Body Systems and Health Areas

Gastrointestinal system: Traditional herbal medicinal product used to increase bile flow for the relief of symptoms of indigestion (such as sensation of fullness, flatulence, and slow digestion).
Hepatobiliary system: Amphocholeretic activity (normalizing bile secretion); choleretic and hepato-protective action documented for protopine.
Dermatological system: Traditionally used for a variety of skin disorders including scabies, leprosy, eczema, and general itching, sores, and abscesses.
Cardiovascular system: Protopine has hypotensive and bradycardic activity in small doses.
Renal/urinary system: Mild diuretic activity documented in preclinical research.
Central nervous system: Dose-dependent muscle relaxant and sedative potentiating effects; depressant action on the central nervous system.
Immune/inflammatory system: Anti-inflammatory activities correlate with the traditional uses of Fumaria species.

7. Dosage Forms and Reported Dosages

Dosages reported in the literature and in official regulatory documents are as follows:

Oral extract (clinical trial): Fumaria officinalis 1500 mg daily, administered three times a day for 18 weeks in the Brinkhaus et al. RCT.
Oral extract (safety-assessed dose): Fumitory extract is possibly safe when used in doses up to 500 mg three times daily for up to 18 weeks.
Dry extract and herbal tea: Typical adult dose: dry extract 250 mg per dose (up to 1,000 mg/day) or herbal tea totaling 4.8–6.4 g/day.
Administration timing: The EMA monograph specifies that preparations are to be taken before meals.
Topical (clinical trial): A cream containing fumitory extract plus silymarin was applied to 40 patients with mild to moderate eczema for a 2-week treatment course.

8. Safety Considerations and Interactions

8.1 General Safety Profile

It has been used in Europe and worldwide as a traditional remedy for more than 30 years without safety problems. Toxicological studies of several Fumaria species have been conducted, and most of these investigations showed that these folk medicines exhibited no adverse effects.

Toxicological study on protopine showed that it was devoid of any acute toxicity up to a dose of 50 mg/kg (i.p.) in rats.

8.2 High-Dose Toxicity

Using large amounts of fumitory is possibly unsafe. It contains chemicals that might cause serious side effects in high doses, including trembling, convulsions, and death. The main alkaloid protopine can cause excitation and convulsions at high doses. Fumitory can be toxic in high doses due to the presence of protopine, and should be used under professional advice in this manner.

8.3 Pregnancy, Lactation, and Pediatric Use

Fumitory is not recommended in pregnancy, breastfeeding, or for children and adolescents (for extracts/tinctures). No fertility data are available, per the EMA monograph. This absence of safety data drives the contraindication rather than a documented harm signal.

8.4 Contraindications

Hypersensitivity to the active substance is a contraindication per the EMA monograph. Fumitory should also be avoided in patients with gallstones, bile duct obstruction, cholangitis, or active liver disease, as stimulation of bile flow in obstructed biliary tracts carries risk of complications.

8.5 Drug Interactions

The EMA monograph reports that no interactions have been reported, and none are known. However, given protopine's demonstrated effects on ion channels and its anticholinesterase activity, theoretical interactions with cardiovascular drugs (antihypertensives, antiarrhythmics) and cholinergic agents cannot be excluded, though no clinical interaction cases have been documented in the reviewed sources.

8.6 Overdose

No case of overdose has been reported, according to the EMA monograph.

8.7 Duration of Use

The current EU monograph recognizes fumitory as a traditional herbal medicinal product for short-term relief of digestive disturbances. Long-term continuous use is not sanctioned by current regulatory guidance due to the limited safety data available beyond 18 weeks.

References

Health Conditions

Health conditions that Fumitory may help support.

No conditions available.

Body Systems

Body systems that Fumitory may help support.

No body systems available.