Dysphania ambrosioides

Scientific name: Dysphania ambrosioides (L.) Mosyakin & Clemants

Synonym: Chenopodium ambrosioides L.

Synonym 2: Chenopodium ambrosioides var anthelminthicum (L.) W. A. Weber

Botanical family: AMARANTHACEAE

Vernacular names

(In territories with significant traditional TRAMIL use)

Mexico:

apazote
epazote

Guatemala:

apazote
epazote

Honduras:

apazote
epazote

Dominican Republic:

apazote, epazote

Haiti:

feuilles à vers
simen-kontra

Martinique:

herbe à vers
simen-kontra
zèb avè

Colombia:

paico
yerba santa

Panama:

paico

Venezuela:

pazote

Guadeloupe:

simen-kontra

Trinidad and Tobago:

worm grass

Dominica:

wormweed

Geographical distribution

Originally from tropical America, naturalised in the Old World, frequently cultivated.

Botanical description

Annual or perennial herb, upright, up to 1.5 m, very aromatic. Lanceolate to elliptic, sinuate-dentate, acute, up to 13 cm, glandular leaves. Flowers in dense clusters or in spikes; 3 to 5 sepals, ovate; petals absent. Small fruit inside the calyx with black seeds.

Voucher(s)

Cénesca,38&40,SOE
Cogollo,21892,CUVC
Girón,228,CFEH
Delaigue,6,NHTT
Delens,3&300,VEN
Giménez,275675-05,VEN
Jiménez,1511,JBSD
Medina&Méndez,14,CICY
Suazo&Cardona,19,HPMHV
Merlo&Tinoco,17,HPMHV
Longuefosse&Nossin,11,HAVPM
Rueda,1644,HULE
Boulogne,TH,7,UAG
Boulogne,TB,4,UAG
Picking,35476,UWI

diarrhoea

leaf and/or aerial parts, infusion or decoction, orally^1-2

stomach pain

aerial parts, infusion or decoction, orally^1,3-4

intestinal parasites

aerial parts, infusion or decoction, orally^2,5-^13,49-50,52

cutaneous ulcers

aerial parts, crushed, applied locally⁴

For diarrhoea or stomach pain caused by intestinal parasites (ascaris), pinworms or hookworms:
prepare a decoction or infusion with 7 grams of aerial parts (leaves, flowers and stems) in 1 cup (250 millilitres) of water. For decoctions, boil for 5 minutes in a covered vessel; for the infusion add the boiling water to the 7 grams of aerial parts, cover and leave to cool for 10 minutes. For both preparations strain (filter) and drink 1 cup (250 millilitres) for adults, ½ cup (125 millilitres) for people weighing 35 kg, and 1/3 cup (80 millilitres) for children over 5 years old. Drink once a day only for 3 days in a row⁵³ and do not repeat this treatment until 6 months have passed.

It is recommended to take a saline laxative (e.g. magnesium sulfate) after the last dose, but oily laxatives should not be used¹⁸.

For skin ulcers:
wash the wound with boiled water and soap. Adequately wash the aerial parts of the plant, press or crush them and apply to the affected area. Cover with a clean cloth and change twice a day.

Preparations must never be stored for more than 24 hours, even if refrigerated.

According to the information available:

The use for diarrhoea and stomach pain (only for those caused by the following intestinal parasites: ascaris, pinworms and hookworms) is classified as REC based on the significant traditional use documented in the TRAMIL surveys, the toxicity studies and the scientific information published.

Under no circumstances should the specified preparation and dosage form be altered.

The use of this resource in cases of diarrhoea should be considered complementary to oral rehydration therapy.

If the diarrhoea persists for more than 2 days or if deterioration is observed in the patient (dehydration with dry tongue, decreased skin turgor, oliguria or crying without tears), seek immediate medical attention.

If deterioration is observed in the patient or if the stomach pain persists for more than 3 days in adults or 2 days in children over 5 years of age, seek medical attention.

Oral use is contraindicated in individuals with liver disease, kidney failure¹⁸, weak or elderly patients.

The use for skin ulcers is classified as REC based on the significant traditional use documented in the TRAMIL surveys, the dermal toxicity trials and the scientific information available and the dermal irritability trials.

If deterioration is observed in the patient or the skin ulcer persists for more than 5 days, seek medical attention.

All topical application must follow strict hygiene measures in order to prevent contamination or additional infection.

Not for use during pregnancy because it can cause miscarriage, nor while breastfeeding or in children under 5 years of age.

TRAMIL Work¹⁹
The lethal dose of ascaridole estimated from its concentration in the essential oil was 0.075 ml/kg in mice.

TRAMIL Work³⁹
The essential oil applied to the skin of 18 clinically healthy young and adult male albino rabbits showed no signs of toxicity assessed at 24 and 72 hours.

TRAMIL Works^40-41
The aqueous extract (30% decoction) from fresh leaves (0.6 ml, equivalent to 0.18 g of fresh plant material) and the fresh leaves crushed in a patch were applied topically on the skin in an area of approximately 6 cm2 in male New Zealand rabbits. The patch was removed after 4 hours and observations were made for erythema and oedema readings at 24, 48 and 72 hours, with no clinical signs evident, and therefore the freshly crushed leaves and their decoction are in the non-irritant category.

TRAMIL Work⁴²
The aqueous extract (infusion and decoction separately) of aerial parts (5 g/kg/day) was administered orally to 24.68 ± 1.85 g Hsd:ICR mice (5 males and 5 females), during 5 days with 12 additional days of observation, according to the EPA.OPPTS 870.1100 protocol. There was no mortality, nor were there any signs of toxicity (Irwin multidimensional test). The macroscopic autopsy showed no alterations in the organs.

The aqueous extract (10% infusion or decoction) from dried aerial parts in human lymphocyte culture (1, 10, 100, 1000 μl of extract/ml) showed a genotoxic and cytotoxic effect, expressed by increasing the percentage of cells with chromosomal aberrations and the frequency of sister chromatid exchange; furthermore, it decreased the mitotic index, but did not modify the values of cell proliferation kinetics⁴³.

Almost 90% of the nematicidal activity of the infusion is due to hydrophilic compounds, which are different from ascaridole (the major component responsible for the toxic effects of the essential oil), and it is suggested that the traditional form in infusion as an antiparasitic is safer than the essential oil⁴⁴.

The LD₅₀ of the essential oil via the oral route was 0.38 ml/kg in mouse and 0.255 g/kg in rat⁴⁵.

The dried leaf methanolic extract, orally in mice (1 g/kg) showed no external signs of toxicity⁴⁶.

The LD₅₀ of the hydroalcoholic extract (50%) of whole plant, intraperitoneally in mice in an acute general toxicity study was higher than 1 g/kg⁴⁷.

The essential oil can produce toxic effects, particularly in weak individuals: nausea, vomiting, depression of the nervous system, liver and kidney damage, deafness, visual disorders, heart and respiratory problems^18,44. The administration of a single oral dose of 5 ml in adults has been reported to be lethal⁴⁸.

The literature cites numerous human intoxications by the essential oil, some of which have resulted in death^48-52.

There is no data available documenting the safety of medicinal use during pregnancy, breastfeeding or in children.

TRAMIL Work¹⁹
The amount of essential oil in the plant is lower in dry climate regions (0.55 ml/50 g dry plant) than in wet regions (0.77 ml/50 g dry plant).

The whole plant is rich in an essential oil called “essence of chenopodium”. The leaf and the inflorescence contain 0.35%, the fruit 0.6 to 3%. Numerous studies are related to the composition of this essential oil, whose main constituents are: monoterpenes: ascaridole (terpenic peroxide, which makes up 42 to 90% of the essence), carvacrol, caryophyllene oxide, (Z)-ascaridole, (E)-ascaridole, ascaridole-glycol, 4-carene, benzyl alcohol, p-cresol, 2-carene, aritasone, pinene, limonene, myrcene, p-cymene, p-cimen-8-ol, phellandrene, camphor, α-terpineol, α-terpineol, p-mentha-1,3,8-triene, (E)-piperitol acetate, (Z)-carvyl acetate, associated with small amounts of methyl salicylate and butyric acid^20-25.

The aerial part contains flavonoids, organic acids: citric, tartaric and succinic²⁶.

The fruit contains flavonoids: quercetin, kaempferol and derivatives, isorhamnetin²⁷.

Proximate analysis of 100 g of leaves²⁸: calories: 42; water: 85.5%; protein: 3.8%; fat: 0.7%; carbohydrates: 7.6%; fibre: 1.3%; ash: 2.4%; calcium: 340 mg; phosphorus: 52 mg; iron: 5.2 mg; carotene: 2420 μg; thiamine: 0.06 mg; riboflavin: 0.28 mg; niacin: 0.60 mg; ascorbic acid: 11 mg.

TRAMIL Work²⁹
The aqueous leaf extract (25 and 100 mg/kg) orally administered to Wistar rats with pylorus ligation (Shay model) significantly decreased the number of gastric ulcers and the rate of ulceration; without changing the volume of gastric fluid or the amount of free acid.

The aqueous extract from dried leaves, in vitro (200 μl/disc) showed activity against Staphylococcus albus³⁰.

Demonstrated biological activities of the essential oil:

An ethnopharmacological study reported the use of the decoction or infusion (300 mg/kg of dry plant) of inflorescence and leaves in adults to be useful for the treatment of ascaridiasis. A clinical field study in adults (6 g/kg) was not effective against Necator americanus, Trichuris trichiura or Ascaris lumbricoides. The relief traditionally referred to may be related to the expulsion of senescent worms after treatment³⁷.

The juice from aerial parts (1 ml/kg in children under 10 kg and 2 ml/kg in older children), orally, single dose before breakfast, for 3 consecutive days, in a randomised clinical trial with 30 children (3-14 years old) per group, positively diagnosed with Ascaris lumbricoides or Hymenolepis nana in stools, compared with albendazole (200 mg/child up to 5 years old and 400 mg over 5 years old). The juice showed an antiparasitic effect, evaluated by elimination of eggs in the faeces and reduction of the parasitic load, carried out at the time of diagnosis for inclusion and 15 days after treatment. The eradicating effect of Ascaris from the juice was 59.5% and from albendazole it was 58.3%; the effect of the juice was 100% for children infested with H. nana, better than those treated with albendazole. The frequency of observed adverse reactions was 23.3% in both treatment groups³⁸.

The aerial parts are said to have antihelminthic properties, especially against ascaris and hookworm, but less so against pinworms¹⁸.

The antihelminthic active ingredient (ascaridole) contained in the essential oil exerts a paralyzing and narcotic action on the ascaris, pinworms and hookworms, but is ineffective against tapeworms and trichocephalus^32-34.

Pharmacopoeia

Ed.3

References

1 GIRON L, 1988
Encuesta TRAMIL (Costa atlántica). Centro Mesoamericano de Tecnología CEMAT, Guatemala, Guatemala.

2 DELENS M, 1990-92
Encuesta TRAMIL. Centro de Estudios Sociales y Acción Popular CESAP, Caracas, Venezuela.

3 CHARLES C, 1988
TRAMIL survey. Movement for Cultural Awareness MCA, Roseau, Dominica.

4 WENIGER B, 1987-88
Encuesta TRAMIL. enda-caribe, Santo Domingo, Rep. Dominicana.

5 HERRERA J,1994
Encuesta TRAMIL (Costa atlántica). Laboratorio de fitofarmacología, Departamento de Farmacología, Facultad de Salud, Universidad del Valle, Cali, Colombia.

6 MENDEZ M, MEDINA ML, DURAN R, 1996
Encuesta TRAMIL en Quintana Roo. Unidad de recursos naturales, Centro de Investigación Científica de Yucatán CICY, Mérida, México.

7 WENIGER B, ROUZIER M, 1986
Enquête TRAMIL. Service Oecuménique d'Entraide SOE, Port au Prince, Haïti.

8 LAGOS-WITTE S, 1988-89, 1996
Encuesta TRAMIL. Laboratorio de Histología Vegetal y Etnobotánica, Departamento de Biología, Universidad Nacional Autónoma de Honduras UNAH, Tegucigalpa, Honduras.

9 LONGUEFOSSE JL, NOSSIN E, 1990-95
Enquête TRAMIL. Association pour la valorisation des plantes médicinales de la Caraïbe AVPMC, Fort de France, Martinique.

10 SOTOMAYOR U, RUEDA R, 1990
Encuesta TRAMIL. Centro nacional de la medicina popular tradicional CNMPT, Ministerio de Salud, Estelí, Nicaragua.

11 SolIs PN, Espinosa A, De Gracia J, Martínez L, Gupta MP, 2003
Encuesta TRAMIL (Ngöbe-Buglé). Centro de Investigaciones Farmacognósticas de la Flora Panameña, Facultad de Farmacia, Universidad de Panamá, Panamá, Panamá.

12 SolIs PN, Espinosa A, De Gracia J, Martínez L, Gupta MP, 2003
Encuesta TRAMIL (Emberá-Wounaann). Centro de Investigaciones Farmacognósticas de la Flora Panameña, Facultad de Farmacia, Universidad de Panamá, Panamá, Panamá.

13 GOMEZ H, GAITAN R, DIAZ F, 2003
Encuesta TRAMIL (Norte del departamento de Bolívar). Grupo de Productos Naturales, Facultad de Ciencias Químicas y Farmacéuticas. Universidad de Cartagena, Cartagena de Indias, Colombia.

14 DELAIGUE J, 2005
TRAMIL survey. UAG & PRDI, Tobago House of Assembly, Scarborough, Tobago.

15 ZAMBRANO LE, 2007
Encuesta TRAMIL en Guareguare, Miranda. UCV, Caracas, Venezuela.

16 BOULOGNE I, 2009
Enquête TRAMIL, (Terre-de-Bas et Terre-de-Haut) Les Saintes, UAG, Guadeloupe. (FWI).

17 PICKING D, MITCHELL S, DELGODA R, YOUNGER N, 2011
TRAMIL survey. Natural Products Institute, The Biotechnology Centre & Tropical Metabolic Research Institute, University of the West Indies, Mona, Jamaica.

18 CANIGUERAL S, VILA R, RISCO E, PEREZ F, PORTILLO A, FREIXA B, MILO B, VANACLOCHA B, RIOS JL, MORALES MA, ALONSO JR, BACHILLER LI, PERIS JB, STUBING G, 2002
Quenopodio. Vademecum de Fitoterapia, Barcelona, España, Editorial Masson. Nov.20,2003. URL: www.masson.es/book/fitoterapia.html

19 BOURGEOIS P, JOSEPH H, SAVARY H, 1989
Détermination d'huiles essentielles et dosage de l'ascaridole dans Chenopodium ambrosioides. Rapport TRAMIL. Laboratoire de phytochimie, Faculté des Sciences, Université des Antilles et de la Guyane UAG, Pointe à Pitre, Guadeloupe.

20 TAKEMOTO T, NAKAJIMA T, 1957
Study of the essential oils of Chenopodium ambrosioides. V. On the structure of aritasone. Yakugaru Zasshi 77:1157-1158.

21 BAUER L, BRASIL E, SILVA GA, 1973
Essential oils of Chenopodium ambrosioides and Schinus terebenthifolia from Rio Grande do Sul. Rev Brasil Farm 54:240.

22 MONZOTE L, STAMBERG W, STANIEK K, GILLE L, 2009
Oxic effects of carvacrol, caryophyllene oxide, and ascaridole from essential oil of Chenopodium ambrosioides on mitochondria. Toxicol Appl Pharmacol 240(3):337-347.

23 CHU SS, FENG HU J, LIU ZL, 2011
Composition of essential oil of Chinese Chenopodium ambrosioides and insecticidal activity against maize weevil, Sitophilus zeamais. Pest Manag Sci 67(6):714-718.

24 JARAMILLO B, DUARTE E, DELGADO W, 2012
Bioactividad del aceite esencial de Chenopodium ambrosioides colombiano/ Bioactivity of essential oil from Colombian Chenopodium ambrosioides. Rev Cuba Plantas Med 17(1):54-64.

25 JARDIM CM, JHAM GN, DHINGRA OD, FREIRE MM, 2008
Composition and antifungal activity of the essential oil of the Brazilian Chenopodium ambrosioides L. J Chem Ecol 34(9):1213-1218.

26 ARISAWA M, MINABE N, SAEKI R, TAKAKUWA T, NAKAOKI T, 1971
Studies on unutilized resources. V. The components of the flavonoids in Chenopodium genus plants. Yagugaku Zasshi 91:522.

27 JAIN N, LAM MS, KAMIL M, ILYAS M, NIWA M, SAKAE A, 1990
Two flavonol glycosides from Chenopodium ambrosioides. Phytochemistry 29(12):3988-3991.

28 DUKE JA, ATCHLEY AA, 1986
Handbook of proximate analysis tables of higher plants. Boca Raton, USA: CRC Press. p41.

29 CAMBAR P, 1988
Prevención de la producción de úlceras gástricas experimentales por algunos extractos de plantas. Informe TRAMIL. Unidad de Farmacología, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.

30 DESTA B, 1993
Ethiopian traditional herbal drugs. Part II: Antimicrobial activity of 63 medicinal plants. J Ethnopharmacol 39(2):129-139.

31 ROSS SA, EL-KELTAWI NE, MEGALLA SE, 1980
Antimicrobial activity of some Egyptian aromatic plants. Fitoterapia 51:201-205.

32 BUTZ LN, LA LANDE JR, 1937
Antihelmintics II. A comparison of certain ozonides, Chenopodium oil and diheptanol peroxide. J Am Pharm Assoc 26:114.

33 BLISS AR, 1925
A pharmacodynamic study on the antihelmintic properties of two oils of Chenopodium. J Am Pharm Assoc 14:93.
34 FERNAN-NUÑEZ M, 1927

A contribution of helmintic therapy. J Amer Med Assoc 88:903.
35 FEROZ H, KHARE AK, SRIVASTAVA MC, 1982
Review of scientific studies on anthelmintics from plants. J Sci Res Pl Med 3(1):6-12.

36 KISHORE N, DUBEY NK, SINGH SK, DIXIT SN, 1981
Fungitoxicity of some volatile natural products against human pathogenic fungi. Indian Perf 25(3/4):1-3.

37 KLIKS MM, 1985
Studies on the traditional herbal antihelmintic Chenopodium ambrosioides L.: ethnopharmacological evaluation and clinical field trials. Soc Sci Med 21(8):879- 886.

38 LOPEZ DE GUIMARAES D, NEYRA LLANOS RS, ROMERO ACEVEDO JH, 2001
Ascariasis; comparación de la eficacia terapéutica entre paico y albendazol en niños de Huaraz. Rev Gastroenterol Peru 21(3):212-219.

39 GONZALEZ A, 1990
Evaluación de la toxicidad dérmica de plantas TRAMIL en conejos. Centro Nacional de Salud Animal, La Habana, Cuba. TRAMIL III, La Habana, Cuba, MINSAP/ enda-caribe.

40 LOPEZ M, MARTINEZ MJ, MOREJON Z, BOUCOURT E, FERRADA C, FUENTES V, MORON F, 2005
Irritabilidad dérmica primaria de una decocción de hoja fresca de Chenopodium ambrosioides L. Informe TRAMIL. Laboratorio Central de Farmacología, Facultad de Medicina “Dr. Salvador Allende”, Cerro, C. Habana, Cuba.

41 LOPEZ M, MARTINEZ MJ, MOREJON Z, BOUCOURT E, FERRADA C, FUENTES V, MORON F, 2005
Irritabilidad dérmica primaria hoja fresca machacada de Chenopodium ambrosioides L. Informe TRAMIL. Laboratorio Central de Farmacología, Facultad de Medicina “Dr. Salvador Allende”, Cerro, C. Habana, Cuba.

42 PAZOS L, COTO T, CAIZA F, 2009
Toxicidad oral aguda, dosis repetida, en ratón, partes aéreas de Chenopodium ambrosioides. Informe TRAMIL. Laboratorio de Ensayos Biológicos, LEBi, Universidad de Costa Rica, San Pedro, Costa Rica.

43 GADANOA AB, GURNI AA, CARBALLO MA, 2006
Argentine folk medicine: Genotoxic effects of Chenopodiaceae family. J Ethnopharmacol 103(2):246–251.

44 MACDONALD D, VANCREY K, HARRISON P, RANGACHARI PK, ROSENFELD J, WARREN C, SORGER G, 2004
Ascaridole-less infusions of Chenopodium ambrosioides contain a nematocide(s) that is(are) not toxic to mammalian smooth muscle. J Ethnopharmacol 92(2- 3):215–221.

45 OPDYKE DLJ, 1976
Monographs on fragance raw materials. Chenopodium oil. Food Chem Toxicol 14(11):713-715.

46 OLAJIDE OA, AWE SO, MAKINDE JM, 1997
Pharmalogical screening of the mathanolic extract of Chenopodium ambrosioides. Fitoterapia 68(6):529-532.

47 BHAKUNI DS, DHAR ML, DHAR MM, DHAWAN BN, MEHROTRA BN, 1969
Screening of Indian plants for biological activity. Part II. Indian J Exp Biol 7:250-262.

48 MELE A, 1952
Acute poisoning with Chenopodium oil. Folia Med 35:955.

49 WOLF IJ, 1932
Fatal poisoning with oil of Chenopodium in a negro child with sickle-cell anemia. Arch Pediatr 52:126.

50 JELLIFFE DB, 1951
Oil of Chenopodium in the treatment of ascariasis. Report of 3 cases of fatal liver damage in African patients. J Trop Med Hyg 54:143.

51 ANDRIEN J, PARMENTIER PD, COMPERE J, BOUNAMEAUX Y, 1971
Study on Chenopodium oil encephalitis. Three fatal cases. A Soc Belge Med Trop 51:299.

52 CONTRERAS AA, ZOLLA C, 1982
Plantas tóxicas de México. México, México: Instituto Mexicano del Seguro Social.

53 DELENS M, Ed., 2000
Cuaderno de Fitoterapia Clínica (Afecciones respiratorias y digestivas). Mérida, Venezuela: CONAPLAMED. p151.

Disclaimer

The information provided is for educational purposes only for the benefit of the general public and health professionals. It is not intended to take the place of either the written law or regulations. Since some parts of plants could be toxic, might induce side effects, or might have interactions with certain drugs, anyone intending to use them or their products must first consult with a physician or another qualified health care professional. TRAMIL has no responsibility whatsoever towards the user for any decision, action or omission made in relation to the information contained in this Pharmacopoeia.

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