Asafoetida

Scientific Name(s): Ferula assa-foetida L.
Common Name(s): Asa foetida, Asafetida, Asafoetida, Devil's dung, Gum asafoetida, Hing, Stinkasant

Medically reviewed by Drugs.com. Last updated on Dec 22, 2023.

Clinical Overview

Use

The gum resin asafetida is used as a flavoring, food preservative, and fragrance. Studies have been published comparing asafetida with dicyclomine for treatment of constipation-predominant irritable bowel syndrome (IBS-C), but the studies were of poor quality. No robust clinical data support therapeutic use for any indication.

Dosing

Clinical evidence is lacking to support dosing recommendations.

Contraindications

Contraindicated in children; severe methemoglobinemia has been reported in a 5-week-old child following ingestion of an undetermined quantity of glycerated asafetida solution.

Pregnancy/Lactation

Avoid use. Ethanolic extracts of F. assa-foetida have prevented successful implantation in rats. Asafetida has been used traditionally as an emmenagogue and abortifacient.

Interactions

None well documented.

Adverse Reactions

Localized eczematous lesions have been documented following topical application of asafetida oleo-gum-resin essential oil to the abdomen of infants.

Toxicology

Asafetida is potentially life-threatening to infants; however, ingestion has not been associated with severe toxicity in adults.

Scientific Family

• Apiaceae/Umbelliferae (carrot)

Botany

Indigenous to eastern Iran and western Afghanistan, asafetida is the gum resin obtained from the roots and rhizomes of F. assa-foetida. In Afghanistan, the plant grows wild at elevations of 0.61 to 1.22 km on plains that are arid in winter and where few other plants survive. The plant reaches a height of up to 2 m and bears clusters of pale, greenish-yellow flowers and an oval fruit. All parts of the plant have a distinctive fetid odor. Extraction of the gum begins just before flowering. After the stalks are cut close to the ground and the roots are exposed and slashed, a milky liquid oozes out; the liquid then dries to form a resin, and a fresh cut is made. The process is continued for about 3 months from the first incision; a single plant may yield up to 1 kg of resin before it dries out. The fresh gum is a soft, semiliquid mass that undergoes a gradual color change from shimmering yellowish white to reddish brown.(Carrubba 1979, Kurzyna-Mtynik 2008, USDA 2020) A synonym is Ferula foetida (Bunge) Regel.

History

The common name "asafetida" is derived from the Farsi word aza (resin) and the Latin foetidus (smelling, fetid). Many therapeutic claims have been made for the resin, most stemming from the belief that its fetid odor acts as a deterrent to germs; the shock of the sulfurous smell was once thought to calm hysteria, and in the American Wild West, asafetida was included in a mixture with other strong spices as a cure for alcoholism.

Asafetida has been used for abdominal tumors and as a carminative, intestinal spasmodic, abortifacient, aphrodisiac, diuretic, sedative, and stimulant. Use in respiratory conditions, such as asthma, bronchitis, and whooping cough, has also been documented; in 1918, asafetida was used in the Spanish influenza pandemic. Today, asafetida is commonly used as a fragrance component in perfumes and in minute quantities in Asian vegetarian cooking. Because of its antiflatulent qualities, asafetida is included in dishes containing large quantities of pulses such as beans or lentils. It is sold as a spice and food preservative and has been used at very low levels in candies, beverages, relishes, and sauces.(Duke 1985, Eigner 1999, Kandeler 2009, Lee 2009, Tyler 1988)

Chemistry

Asafetida is composed of approximately 4% to 20% volatile oil, 40% to 60% resin, and 25% gum. The most striking features of the gum are its putrid odor and bitter, acrid taste caused by organic, sulfur-containing compounds found in the essential oil. Isolated sulfur compounds include disulfides (eg, asadisulfide, symmetric tri- and tetrasulfides). Several sesquiterpene coumarins have been identified, including assafoetidnol A and B, hydroxyumbelliumprenin, asafoetidin, and saradaferin. Characteristically, the plant also contains glucuronic acid, galactose, arabinose, and rhamnose. Pinene, cadinene, and vanillin are found in the oil, and umbelliferone, asaresinotannol, foetidin, kamolonol, and ferulic acid are found in the resin. In addition, asafetida contains a number of terpenes and lipid-soluble substances that have not been well characterized. Caffeic acid cinnamyl ester with inhibitory actions on nitric oxide production and sesquiterpene dienones with cytotoxic activity have been identified.(Abd El-Razek 2007, Al-abbasi 2016, Appendino 2006, Bandyopadhyay 2006, Duan 2002, Eigner 1999)

Uses and Pharmacology

Antifungal activity

In vitro data

In preliminary assays in an experimental study, asafetida essential oil (1.25 to 10 mcL/mL) did not demonstrate adequate antifungal activity against Alternaria species, Bipolaris sorokiniana, or Acremonium sclerotigenum and was therefore excluded from further exploration.(Mafakheri 2018)

Antiprotozoal effects

Animal data

Asafoetida demonstrated some activity against cryptosporidiosis in mice, but its effects were less than with nitazoxanide.(Abdelmaksoud 2020)

Antispasmodic and hypotensive effects

Animal data

Antispasmodic and hypotensive effects of the gum extract have been demonstrated in animal experiments.(Fatehi 2004)

Antiviral activity

In vitro data

Antiviral activity by sesquiterpene compounds of F. assa-foetida has been demonstrated in vitro against influenza A virus (H1N1).(Lee 2009)

Cancer

Asafetida is a potent antioxidant(Saleem 2001) and ferulic acid, a component of the resin, has shown promise as a chemopreventive agent,(Mallikarjuna 2003) suggesting that asafetida may offer some protection against carcinogenesis. The mechanism through which asafetida may exert antitumor activity is unclear. Hypotheses include interception of free radicals, inhibition of natural killer cells, induction of enzymes such as glutathione S-transferase and quinone reductase, and inhibition of polyamine and DNA biosynthesis.(Appendino 2006, Saleem 2001)

Animal and in vitro data

In vitro studies have shown some cytotoxicity against lymphoma ascites, chronic myelogenous leukemia cells, liver cancer cells, and human lymphocytes.(Unnikrishnan 1988, Verma 2019) Apoptotic and antiproliferative qualities have been demonstrated in vitro with a dithiolane-rich essential oil and farnesiferol C extracts. Mechanisms included downregulation of nuclear factor kappa B and tumor growth factor-beta gene expression, followed by increases in caspase-3 and tumor necrosis factor-alpha expression, inhibition of cell cycle–related proteins, and attenuation of histone acetylation.(Jung 2019, Verma 2019) Protection against the mutagenicity induced by aflatoxin B₁ has also been demonstrated(Soni 1997); however, this effect was only evident against one strain of Salmonella typhimurium and was less than the effect observed with turmeric and garlic.

Administration of F. assa-foetida conferred considerable protection against chemically induced mammary carcinogenesis in young female rats.(Mallikarjuna 2003) The reduction in the mean number of mammary carcinomas per rat (regarded as the most reliable index of mammary tumorigenesis in experimental animals) was highly significant in rats receiving asafetida as part of their diet (1.25% or 2.5% w/w). Long-term studies showed a reduction in the multiplicity and size of palpable mammary tumors, as well as a delay in the mean latency period of tumor appearance. The addition of asafetida in the diet did not affect food intake.

Dental applications

Clinical data

A 0.5% asafoetida mouthwash was compared with a standard chlorhexidine mouthwash in 126 patients with dental plaque and gingivitis. Significant reductions in the plaque index and modified gingival index were observed in the asafoetida group; the reduction in plaque index was also significantly greater than that in the chlorhexidine group at study end.(Hashemi 2019)

Diabetes

Animal data

An ethyl acetate extract of asafoetida gum was associated with decreased glucose and lipids in diabetic rats, without significant weight loss.(Rafiee 2020)

Irritable bowel syndrome

Clinical data

A Cochrane systematic review and meta-analysis identified 2 small studies (N=129) of very low overall quality and high or unknown risk of bias that evaluated homeopathic use of asafetida versus placebo or usual treatment (dicyclomine) in patients with IBS-C. A statistically significant difference in global improvement was found for the intervention compared with placebo in one study, and no difference was observed between asafetida and usual care (high doses of dicyclomine). The authors concluded that no recommendations could be drawn due to the very low quality of the data. The 2019 updated review identified 2 additional studies (N=178) that confirmed the authors' initial conclusion.(Peckham 2013, Peckham 2019)

Pesticidal activity

Animal and in vitro data

Molluscicidal activity of F. asafetida plant parts and components has been demonstrated against snails, which act as intermediate hosts for the fasciola cattle fluke.(Kumar 2006, Kumar 2009)

Dosing

Clinical evidence is lacking to support dosing recommendations.

Pregnancy / Lactation

Avoid use. Asafetida has been used traditionally as an emmenagogue and abortifacient.(Ernst 2002)

Ethanolic extracts of F. assa-foetida were used in an experiment to determine the (non–estrogen-related) effect on pregnant rats. Pregnancy interceptive activities were established for the extract, possibly caused by interference in the energy metabolism of the uterus.(Keshri 2004)

Interactions

Several coumarin derivatives have been isolated from asafetida resin,(Abd El-Razek 2001) suggesting the possibility for potentiation of pharmacologic activity of anticoagulant drugs (eg, warfarin).(Heck 2000) Published reports of such interactions are lacking, and the clinical importance of such effects is unknown.

Adverse Reactions

Localized eczematous lesions were observed on the abdomens of 32 very young infants (1 to 6 months of age) after topical application of asafetida oleo-gum-resin essential oil to the abdominal area. Lesions varied from erythematous papules and macules to annular or bizarre-shaped plaques and were associated with xerosis of the skin. The duration of asafetida application ranged from 2 days to weeks; only 4 of the infants had a history of atopic dermatitis.(Tempark 2016)

Toxicology

Ingestion has not been associated with severe toxicity in adults. However, one case report described the development of severe methemoglobinemia in a 5-week-old child following ingestion of an undetermined quantity of glycerated asafetida solution (a mixture of asafetida, glycerol, propylene glycol, and calcium carbonate).(Kelly 1984) In vitro testing has found that asafetida gum exerts a strong oxidative effect on purified fetal hemoglobin, leading to the conclusion that this folk remedy be considered potentially life-threatening to infants.

Index Terms

• Ferula foetida (Bunge) Regel

References

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