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Allium cepa
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Arctostaphylos uva-ursi
Ammi majus
Ammi visnaga
Anethum graveolens
Arnica montana
Azadirachta indica



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Ammi majus L. (Apiaceae)

Apium ammi Crantz, Selinum ammoides E.H.L. Krause. Apiaceae are also known as Umbelliferae

Local names
Aatrilal, ammi commun, bishop’s weed, bullwort, crow’s foot, cumin royal, devil’s carrot, gazar el-shitan, greater ammi, habab, herb william, hirz al-shayateen, khella shaitani, khellah shitany, mayweed, nounkha, qciba, rejl el-ghorab, rijl al-tair, zfenderi el maiz

An annual, 0.9–1.5 m high with striated subglaucous stems. Leaves acutely serrulate, alternate, bipinnate, lobes oblong. Inflorescence a compound umbel with slender primary rays up to 5 cm long, scattered secondary rays 2–5 cm long, minute reticulate points; involucre of bracts 1.5–2.5 cm long; flowers bisexual, polygamous, bracteate; calyx teeth obsolete or small; petals obovate with an inflexed point, exterior petals frequently longer; stamens epigynous; ovary inferior, two-locular, stigma capitate. Fruit laterally compressed, oblong, mericarps of the cremocarp separated by a carpophore. Seed small, pendulous, albuminous

Plant material used
dried ripe fruits

Chemical assays
Contains not less than 0.5% xanthotoxin, 0.3% imperatorin and 0.01% bergapten, determined by spectrophotometry. A high-performance liquid chromatography method is also available for quantitative analysis

Major chemical constituents
The major constituents are furanocoumarins, the principal compounds being xanthotoxin (methoxsalen, 8-methoxypsoralen (8-MOP) ammoidin; up to 1.15%), imperatorin (ammidin; up to 0.75%) and bergapten (heraclin, majudin, 5-methoxypsoralen (5-MOP), up to 1.88%). Other coumarins of significance are marmesin (up to 0.25%), isoimperatorin (0.01%), heraclenin (0.07%) and isopimpinellin (0.01%). Other constituents of interest are acetylated flavonoids

Medicinal uses
Uses supported by clinical data
Treatment of skin disorders such as psoriasis and vitiligo (acquired leukoderma).

Uses described in pharmacopoeias and well established documents
Treatment of vitiligo

Uses described in traditional medicine
As an emmenagogue to regulate menstruation, as a diuretic, and for treatment of leprosy, kidney stones and urinary tract infections

Proven pharmacological activity
Animal studies
Antimicrobial and antischistosomal, Photosensitizing

Human studies
Vitiligo, psoriasis and hypopigmentation tinea versicolor

Intoxication due to the simultaneous ingestion of ergot alkaloids from Claviceps purpurea sclerotia and furanocoumarins from Ammi majus
seeds was reported in pigs after ingestion of contaminated feed. Nervous system intoxication was fi rst observed 5–7 days after the initiation of feeding of the suspect rations. This was followed by cutaneous irritation, including snout ulcers, eyelid oedema and conjunctivitis. Ten days after the feeding, eight abortions were observed and, in nursing sows, udder oedema and teat cracking were observed. Examination of the adulterated feed indicated that it contained 2.2% A. majus seeds and 0.14% C. purpurea sclerotia. Quantitative analysis showed the presence of 3.2 g of xanthotoxin and 0.65 g of imperatorin per 100 g of A. majus seeds, and 0.73 g of ergot alkaloids per 100 g of C. purpurea sclerotia

Adverse reactions
One case of phototoxic dermatitis was reported in a patient with vitiligo after ingestion of Fructus Ammi Majoris. One case of allergic rhinitis and contact urticaria due to exposure to the fruits was reported. Phototoxic reactions were reported in subjects who handled the fruits and were subsequently exposed to sunlight. Erythema developed within 48– 72 hours and persisted for several days. Skin that had been protected from sunlight for 30 days after exposure still had many erythematous areas and became irritated again when re-exposed to the sun. Small areas of darker pigmentation developed in the skin of some subjects. Prolonged use or overdose may cause nausea, vertigo, constipation, lack of appetite, headache, allergic symptoms and sleeplessness. Photochemotherapy combining administration or application of xanthotoxin with UV-light treatment can be repeated many times (four times a week), and after about 14 days of therapy, a clear dilution of the epidermis results, cornifi cation norm alizes and the infl ammation fades away. However, overdosage may result in severe erythema and blistering. This can partly be prevented through the application of ß-carotene. A 5-year prospective study of ophthalmological fi ndings in 1299 patients treated with oral xanthotoxin plus UV photochemotherapy for psoriasis failed to demonstrate a signifi cant dose-dependent increase in the risk of developing cataracts. Other adverse reactions reported after treatment with xanthotoxin include itching, nausea, oedema, hypotension, nervousness, vertigo, depression, painful blistering, burning and peeling of the skin, pruritus, freckling, hypopigmentation, rash, cheilitis and erythema. Contraindications Fructus Ammi Majoris is contraindicated in diseases associated with photosensitivity, cataract, invasive squamous-cell cancer, known sensitivity to xanthotoxin (psoralens), and in children under the age of 12 years. The fruits are also contraindicated in pregnancy, nursing, tuberculosis, liver and kidney diseases, human immunodefi ciency virus (HIV) infections and other autoimmune diseases.

Care should be taken where there is a familial history of sunlight allergy or chronic infections; lotions should be applied only under direct supervision of a physician and should not be dispensed to the patient; for use only if response to other forms of therapy is inadequate. Serious burns may result from exposure to UV-A light or sunlight, even through glass, if the correct dose and exposure schedule is not maintained. If burning, blistering or intractable pruritus occurs, discontinue therapy until side-effects subside. Do not sunbathe for at least 24 hours prior to therapy and 48 hours after. Avoid direct and indirect sunlight for up to 8 hours after oral and 12–48 hours after topical treatment. If sunlight cannot be avoided, protective clothing and/or sunscreen must be worn. Following oral therapy, sunglasses must be worn for 24 hours. Avoid the ingestion of foods that contain furanocoumarins, such as limes, fi gs, parsley, celery, cloves, lemons, mustard and carrots.

Drug interactions
The toxicity of Fructus Ammi Majoris may be increased when the fruits are administered with other photosensitizing agents such as coal tar, dithranol, griseofulvin, nalidixic acid, phenothiazines, sulfanilamides, tetracyclines and thiazides.

Carcinogenesis, mutagenesis, impairment of fertility
A 95% ethanol extract of Fructus Ammi Majoris, 10.0 mg/plate, was not mutagenic in the Salmonella/microsome assay using S. typhimurium strains TA98 and TA102. Furthermore, an infusion of the fruits (concentration not specifi ed) had antimutagenic effects against ethyl methanesulfonate- or 2-amino-anthracene-induced mutagenicity in S. typhimurium strains TA98 and TA100. A study of 4799 Swedish patients who received xanthotoxin/UV-A photochemotherapy in the period 1974–1985 showed a dose-dependent increase in the risk of squamous-cell cancer of the skin. Male patients who had received more than 200 treatments had over 30 times the incidence of squamous-cell cancer compared with the general population. Increases in the incidence of respiratory cancer, pancreatic cancer and colon cancer were also found.

Pregnancy: non-teratogenic effects
See Contraindications.

Nursing mothers
See Contraindications.

Paediatric use
See Contraindications.

Other precautions
No information available on general precautions or precautions concerning drug and laboratory test interactions; or teratogenic effects in pregnancy.

Dosage forms
Powdered dried fruits for oral use. Store in a tightly sealed container away from heat and light.

(Unless otherwise indicated)
Average daily dose: Fructus Ammi Majoris 0.02–0.04 g orally in divided doses (dosage schedule not specifi ed); xanthotoxin 0.25–0.7 mg/kg bw. Clinical treatment requires management by a health-care provider.


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