Rosmarinus – Rosemary leaf (Rosmarini folium)
|Latin name of the genus:||Rosmarinus|
|Latin name of herbal substance:||Rosmarini folium|
|Botanical name of plant:||Rosmarinus officinalis l.|
|English common name of herbal substance:||Rosemary leaf|
Latin name of the genus: Rosmarinus
Latin name of herbal substance: Rosmarini folium
Botanical name of plant: Rosmarinus officinalis L.
English common name of herbal substance: Rosemary leaf
- 1. Introduction
- 2. Historical data on medicinal use
- 3. Non-Clinical Data
- 3.1.1. Assessor’s overall conclusions on pharmacology
- 3.2.1. Assessor’s overall conclusions on pharmacokinetics
- 3.3.1. Assessor’s overall conclusions on toxicology
- 4. Clinical Data
- 4.1. Clinical Pharmacology
- 4.2. Clinical Efficacy
- 4.2.1. Dose response studies
- 4.2.2. Clinical studies (case studies and clinical trials)
- 4.2.3. Clinical studies in special populations (e.g. elderly and children)
- 4.3. Overall conclusions on clinical pharmacology and efficacy
- 5. Clinical Safety/Pharmacovigilance
- 5.1. Overview of toxicological/safety data from clinical trials in humans
- 5.2. Patient exposure
- 5.3.Adverse events and serious adverse events and deaths
- 5.3.1.Adverse events
- 5.3.2. Serious adverse events and deaths
- 5.4. Laboratory findings
- 5.5. Safety in special populations and situations
- 5.5.1. Intrinsic (including elderly and children)/extrinsic factors
- 5.5.2. Drug interactions
- 5.5.3. Use in pregnancy and lactation
- 5.5.4. Overdose
- 5.5.5. Drug abuse
- 5.5.6. Withdrawal and rebound
- 5.5.7. Effects on ability to drive or operate machinery or impairment of mental ability
- 5.6. Overall conclusions on clinical safety
- 6. Overall conclusions
Rosemary (Rosmarinus officinalis L.) belongs to the family Lamiaceae (Labiatae) and has been an important medicinal plant since earliest times. It is also a commonly used spice and flavouring agent. Its essential oil is used therapeutically, in particular in balneology.
It was recognised for its medicinal and cosmetic properties in ancient Greece and by the Romans. In the middle ages, Rosemary oil was distilled for medical purposes and the alcoholic distillate was probably the first popular perfume.
The plant is native to the Mediterranean regions but has spread to all parts of the world. The leaves are sessile, tough, linear to
There is extensive consumption of the plant. It is mentioned in the literatures that, for the period
The name is derived from the Latin ros (roris), meaning dew, and marinus, meaning the sea, being known as the ‘dew of the sea’.
In the Mediterranean area, it blooms throughout the year and flowering is most abundant in spring. Rosemary is mentioned in
1.1. Description of the herbal substance(s), herbal preparation(s) or combinations thereof
Whole or cut dried leaf of Rosmarinus officinalis L. (Ph. Eur. monograph ref.:01/2008:1560)
Herbal preparation(s) Comminuted herbal substance Liquid extracts
Expressed juice Essential oil
Combinations of herbal substance(s) and/or herbal preparation(s) including a description of vitamin(s) and/or mineral(s) as ingredients of traditional combination herbal medicinal products assessed, where applicable.
1.2. Information about products on the market in the Member States
Rosmarinus Aetheroleum (Rosemary Essential oil)
Regulatory status overview
MA: Marketing Authorisation TRAD: Traditional Use Registration
Other TRAD: Other national Traditional systems of registration Other: If known, it should be specified or otherwise add ’Not Known’
This regulatory overview is not legally binding and does not necessarily reflect the legal status of the products in the MSs concerned.
RP: registered products
1.3. Search and assessment methodology
2. Historical data on medicinal use
2.1. Information on period of medicinal use in the Community
Rosemary was used in traditional Greek and European medicine as a tonic, stimulant, and carminative for dyspepsia, headache, and nervous tension. The ancient Greeks used rosemary to strengthen the memory.
In different regions of the world, the use varies.
In traditional Chinese medicine, rosemary was used for headaches.
In the Indian Materia Medica (Nadkarni, 1999), rosemary oil it is described to have a carminative and stimulant action.
Rosemary was used topically to treat cancer in ancient Greece and South America (Hartwell, 1982). The Eclectic physicians used the oil of rosemary in 2 to 10 drop doses for colic, nervous disorders, and painful or delayed menses (Felter and Lloyd, 1983). Women have used rosemary for minor menstrual complaints.
Rosemary is used as an abortive agent in Brazilian folk medicine. It is traditionally referred to as an emmenagogue and is generally avoided during pregnancy. It is claimed to stimulate bile. Rosemary is said to prevent baldness when used as a hair tonic.
The following uses are reported in the literature: as an antiseptic, diuretic, antidepressant and antispasmodic, as well as for cold, influenza, rheumatic pain. The oil is reported to have antimicrobial properties and to have a relaxing effect on tracheal smooth muscles. (Erenmemisoglu, 1997; Chandler, 1995).
In folk medicine, rosemary is put on dressings for healing wounds and for eczema. It is also used as an insecticide, as a preservative and antioxidant for meals and fats (Wichtl, 2004).
Rosemary oil was notified for Generally Recognized as Safe (GRAS) status by the Fragrance and Essence Manufacturers Association of the USA (FEMA) in 1965 and has been listed by the U.S. Food and Drug Administration (FDA) for food use (GRAS). In 1970 the Council of Europe included rosemary oil in the list of substances, spices and seasonings deemed admissible for use, with a possible limitation of the active principles in the final product (EFSA, 2008 citing Opdyke, 1974).
2.2.Information on traditional/current indications and specified substances/preparations
2.3.Specified strength/posology/route of administration/duration of use for relevant preparations and indications
A) Pharmacopée Française – Préparation Officinale, 1980 (Romarin)
Justified by the use:
Infusion or decoction – 5 to 10 g/l; Infusion for 15 m. Decoction for 30 min 200 to 400 ml/day
Liquid extract – 3 to 5 g/day
Essential oil – 3 to 4 drops,
2.Antiseptic and wound healing
Alcoholic solution 2 % V/V essential oil
Justified by the pharmacological properties:
3.Spasmolytic, cholagogic, choleretic
Extracts, tinctures, essential oil: several pharmaceutical specialties
B) British Herbal Pharmacopoeia – 1983
1.Carminative, spasmolytic, Thymoletic, Sedative, Diuretic, Antimicrobial
2.Topically: rubefacient, mild analgesic, parasiticide
3.Specific indications: Depressive states with general debility and indications of
4.Combinations used – May be used with Avena, Cola and Verbena in depression; with Salvia, Gelsemium and Valerian in migraine
5.Preparations and dosage: dried leaves and twigs
C) ESCOP – 1997
Preparations and posology
Fluid extracts (1:1, 45 % ethanol v/v):
Tincture (1:5, 70 % ethanol):
External use Ethanolic extract (1:20)
Essential oil (2 % V/V) in ethanol, as an antiseptic
1 litre of decoction (1:20) added to bath water (twice weekly)
D) Blumenthal (The Complete German Commission E Monographs, 1998)
Oral use – Dyspeptic complaints
External use – Supportive treatment for rheumatic diseases; Circulatory problems
Internally – Daily dose
Ed. Note: The essential oil dosage appears excessive and possibly unsafe. A more reasonable dosage for internal use would be 2 drops (1 ml).
50 g to a full bath;
Assessor’s comments (oral use):
Comparing both proposals for the posology, the editor’s note seems more reasonable:
Daily dosage: 4 – 6 g herb containing 1.2 % (V/m) essential oil; Corresponding: 48 – 72 µl essential oil/day (equal to 0.048 – 0.072 ml essential oil).
In the European Pharmacopoeia, the density of rosemary essential oil is reported as 0.895 to 0.920 (M/V)
Considering that comparable essential oils weigh 19 mg per drop, the following calculation should be correct:
Minimum: 48 µL x 0.9 (dens.) = 43.2 mg
Maximum: 72 µL x 0.9 (dens.) = 64.8 mg
(e.g. primary pharmacodynamics, secondary pharmacodynamics, safety pharmacology, pharmacodynamic interactions)
Rosemary leaves contain
A diterpene, rosmariquinone, has been isolated from a methanolic extract of Rosmarinus officinalis L. (Houlihan et al., 1985).
The leaves contain 0.5 to 2.5 % of a volatile oil, consisting of
The essential oil is a colourless or pale yellow liquid with a camphoraceous taste and contains monoterpenes, phenols, sesquiterpenes, monoterpenoid ethers, monoterpenoid ketones, monoterpernoid alcohols, and monoterpenoid esters, camphor, eucalyptol,
During an investigation period of 17 months, the shoot culture of rosemary accumulated varying amounts of carnosic acid and carnosol, which were also present in callus culture but about 20- to 80- fold lower than in the shoot culture. In suspension culture, only carnosic acid and no carnosol could be detected. The level of carnosic acid in suspension culture was threefold less than detected for the callus culture on average. The amount of rosmarinic acid produced in shoot culture and callus culture were comparable, whereas in suspension culture higher concentrations of rosmarinic acid could be measured than in shoot and callus culture. Thus, the content of carnosic acid, carnosol, and rosmarinic acid in the extracts depended on the differentiation grade of the cell culture type (Kuhlmann et al., 2006).
Methanolic extracts from the leaves of Rosmarinus officinalis harvested from different locations of Turkey at four different times of the year were analyzed by HPLC, and their radical scavenging capacities and antioxidant activities were studied by various assays. The amounts of carnosol, carnosic acid and rosmarinic acid, active constituents of rosemary, varied in different geographical regions of
growth, and also showed a seasonal variation. The levels of the constituents were higher in the warm months of June 2004 and September 2004
The principal antioxidative components of the extracts are the phenolic diterpenes carnosol (molecular
The amount and nature of the oil vary with the subspecies, part of the plant used, the geographic source and the method of preparation. Phenolic diterpenes, flavones and rosmarinic acid distribution may also vary during the development of leaves, flowers, stems and roots of Rosmarinus officinalis (del Baño et al., 2006).
1.In vitro studies
A study was performed to test the antispasmodic activity of 2.5 and 10.0 ml/l of alcoholic extracts of some medicinal plants, including Rosemary, prepared from 1 part of the plant and 3.3 parts of ethanol (31% w/w). The guinea pig ileum was employed and acetylcholine and histamine were used as spasmogens. In
Three essential oils (Mentha piperita L., Salvia officinalis L., Rosmarinus officinalis L.) were investigated for their spasmolytic action on the longitudinal musculature of
In another study, these three plant emulsions were tested in doses between 0.1 and 1 mg/kg i.v., in male guinea pig, using the experimental method of Boissier and Chivot’s. Oddi’s sphincter, contracted by morphine hydrochloride (1 mg/kg i.v.) prolapses following injection of the three plants. The time to
return to normal of Oddi’s sphincter is accelerated in relation to the dose of the various essences (Giachetti et al., 1988).
The spasmolytic activity (against BaCl2 and acetylcholine) of the major components of the essential oils of several aromatic plants was studied. Camphor revealed no agonistic activity against either of the two spasmogens studied (Cabo et al., 1986).
A mixture of
Four diterpenoids (carnosic acid, rosmanol, carnosol and epirosmanol) isolated from the leaves of Rosmarinus officinalis by
Inhibition of the growth of 6 strains of food associated bacteria and yeasts by carnosol and ursolic acid, was achieved at concentrations of 150 g
A study on the variability of rosemary and sage and their volatile oils on the British market has been performed. The antioxidative properties of the various samples were determined and found to be variable based on the geographical location and type of processing (Svoboda, 1992).
The concentration of phenolic diterpenes in commercially available extracts of Rosmarinus officinalis determined by HPLC with electrochemical detection ranged from 2.8 to 22.5 %. Antioxidant activity of extracts under simultaneous storage and thermal stress depended directly on the concentration of phenolic diterpenes. Differences in rates of degradation of individual phenolic diterpenes at different temperatures were obtained (Schwarz et al., 1992).
In a sardine oil model system, a mixture of
To test in vitro conditions the action of R. officinalis L. infusion and ethyl acetate extract against hydroxyl radicals, which may be implicated directly or indirectly in cell damage, two different methods were performed and the results expressed as IC50. Both the infusion and ethyl acetate extract have a lower activity as a scavenger of OH+. The antioxidant activity of the infusion is probably related to the content in flavonoids, as a major group of the polyphenols. In the ethyl acetate extract, this activity is probably related to the enrichment in phenolic acids, namely rosmarinic acid, as major group of polyphenols (Guerreiro and Cunha, 1994).
Tateo et al. (1988) made the comparison of the antioxidant power between two dry rosemary extracts obtained by a simplified extraction process, a commercial rosemary extract and BHA, and an evaluation of the mutagenic effect of four different dry rosemary extracts. Four conclusions were reached by the authors: the antioxidant activity of the extracts was comparable; the extraction treatment by supercritical CO2, which is as efficient for deodorizing as the traditional method of steam flow distillation, gives an antioxidant product with an activity comparable to the product deoleated by
steam flow distillation; the antioxidant activity of rosemary extracts in general is less evident in regards to soy oil, even at considerably higher concentrations than those active in solid fat; the antimutagenic activity is higher for the rosemary extract obtained by hydroalcoholic extraction (ethyl alcohol 50 % v/v).
Various experimental models were used for the characterisation of the antioxidant activity of four commonly consumed herbs belonging to the Lamiaceae family, i.e. oregano (Origanum vulgaris L.), rosemary (Rosmarinus officinalis L.), sage (Salvia officinalis L.) and thyme (Thymus vulgaris L.), including iron reduction capacity,
The DPPH radical scavenging method,
On other study, Kuhlmann et al. (2006) were able to demonstrate that the DPPH
R. officinalis L. essential oil showed greater activity than three of its main components
The results of a study performed with methanolic extracts from the leaves of Rosmarinus officinalis harvested from different locations of Turkey at four different times of the year, were analyzed by HPLC, and their radical scavenging capacities and antioxidant activities were studied by various assays. The results indicated that the plants harvested in September possess higher levels of active constituents and had superior antioxidant capacities compared to those collected at other times (Yesil- Celiktas et al., 2007).
The effects of the volatile oil of R. officinalis on the tracheal smooth muscle of rabbit and guinea pig were tested in vitro using tracheal strips. The contractions of rabbit tracheal smooth muscles induced by acetylcholine were inhibited as well the contractions of guinea pig tracheal muscle, induced by histamine stimulation. The oil also inhibited contractions of both tracheal muscles induced by high potassium solution, which was dose dependent and reversible. It inhibited the contractions of both tracheal muscles induced by acetylcholine and histamine in Ca2+ free solution. This result suggests possible calcium antagonistic properties of rosemary oil (Aqel, 1991).
Rosemary extract, carnosol, carnosic acid
Some of the molecular mechanisms involved in the chemopreventive action were investigated using in vitro human liver and bronchial cell models. Rosemary extract and some of its active components,
carnosol and carnosic acid, are potent inhibitors of DNA adduct formation induced by benzo(α)pyrene or aflatoxin B1. According to the authors, two mechanisms among others are involved in the anticarcinogenic action: the inhibition of the metabolic activation of the procarcinogens catalysed by the phase I cytochrome P450 enzymes and the induction of the detoxification pathway catalysed by the phase II enzymes such as glutathione
A study has been performed to investigate if rosemary and its constituents affect the contractility of isolated guinea pig atria and if there are quantitative differences when compared with the guinea pig ileum. The rosemary oil used consisted of 40.9 %
In another study, the effect of the oil was investigated on the vascular smooth muscle of rabbit, using isolated aortic segments (rings). The oil inhibited the contractions induced by norepinephrine stimulation in Ca2+ containing and free solution and high K+ solutions. The effects were shown to be
The potential effects of an aqueous extract of the leaves of R. officinalis on certain cardiovascular parameters on isolated rabbit heart, such as left ventricular pressure, coronary flow and heart rate, were investigated. In conclusion, some of the active constituents were shown to be associated with coronary vasodilatation and positive inotropic effects (Khatib et al., 1998).
The effects of caffeetannins and related compounds isolated from medicinal plants were investigated on the arachidonate metabolism in human peripheral polymorphonuclear leukocytes
The phenolic compound, rosmarinic acid, obtains one of phenolic rings from phenylalanine via caffeic acid and the other from tyrosine via
Rosmarinic acid and fragments of human gamma globulins, an inhibitor of complement activation, were tested on
effects were compared with complement depletion by cobra venom factor (CVF)
An in vitro study suggested that rosmarinic acid, a constituent of rosemary, may prevent mesangial cell proliferation. Glomerular mesangial cell proliferation is one of the major histological findings in various renal diseases and is mediated by various humoral factors. Murine mesangial cells were isolated from mice glomeruli and incubated. Quiescent cells were stimulated for 24 hours with 10 nanograms per millilitre
Carnosic acid, carnosol, rosmanol
Two compounds, carnosic acid and carnosol isolated from rosemary and rosmanol, as well semi synthetic derivatives
The activity of some rosemary extracts and four fractions derived from rosemary against HVS2 replication by plaque reduction assay, showed 50 % of inhibition of virus plaque formation for the extract. The results indicate that one fraction has antiviral activity without significant signs of cytotoxicity in tissue cultures (Romero et al., 1989).
Antimicrobial, fungicide and insecticidal action
Essential oils from Satureja montana L., Rosmarinus officinalis L., Thymus vulgaris L. and Calamintha nepeta were chemically analysed and their antimicrobial and fungicide activities evaluated on the basis of their minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Rosmarinus was the least effective, but all showed a wide spectrum of action (Panizzi et al., 1993).
A modified method of
Rosmarinus officinalis oil showed an appreciable activity in inhibiting bacterial growth in a study using also Inula helenium oil, which possesses a higher activity compared to Rosmarinus, against Gram- positive Staphylococcus aureus and Streptococcus pyogenes (Boatto et al., 1994).
The chemical composition of 10 essential oils (including rosemary oil) and their antimicrobial activity have been investigated. The antimicrobial activity was evaluated by agar diffusion and atmospheric methods with respect to Gram+ and Gram- bacteria, hypomycetes and Saccharomyces (a total of 40 microorganisms). It was found that the oils were Gram+ selective, as the oil of Artemisia dranunculus, type 19 of Tanacetum vulgare, T. patula and one of Rosmarinus officinalis oils resulted in 100 % inhibition in the multiplication of strains (Héthelyi et al., 1989).
Essential oils from eleven aromatic plants belonging to the Lamiaceae family were examined on three different development stages of Drosophila auraria. All showed insecticidal effects, either by preventing egg hatching, or by causing the death of larvae and adult flies. Malformation and/or prohibition of puparium formation were also observed (Konstantopoulou et al., 1992).
The effect of essential oils from three common herbs of the family Lamiaceae, Lavandula officinalis,
Melissa officinalis and Rosmarinus officinalis, on the morphology of Candida albicans was examined by scanning electron microscopy. The results showed significant inhibitory effects on Candida albicans by
Melissa officinalis (100 %) but Rosmarinus officinalis oil did not inhibit C. albicans (Larrondo and Calvo, 1991).
A methanol extract containing 30 % of carnosic acid, 16 % of carnosol and 5 % of rosmarinic acid was found to be the most effective antimicrobial against Gram positive bacteria (MIC between 2 and 15 mg/ml), Gram negative bacteria (MIC between 2 and 60 mg/ml) and yeast (MIC of 4 mg/ml). By contrast, a water extract containing only 15 % of rosmarinic acid showed a narrow activity. MIC value of the methanol and water extracts is in a good correlation with the values obtained with pure carnosic acid and rosmarinic acid, respectively (Moreno et al., 2006).
Antimutagenic and hepatoprotective effect
Administration of rosemary ethanolic extract (0.15 g/100 g body weight
Carnosic acid and carnosol against chromosomal damage induced by γ
2.In vivo studies
Choleretic and diuretic action
One of the main traditional indications of rosemary is related with the hepato and kidney axes, particularly the hepatobiliary problems. A study was performed to evaluate the influence of rosemary and compare its different parts on the rat bile secretion and its hepatoprotective effect. The authors conclude that Rosemary presents choleretic, diuretic and hepatoprotective activity. The new sprouts are choleretic at doses of 500, 1000 and 2000 mg/kg and diuretic at 50 mg/kg. The solvent hydro- alcoholic is needed for the diuretic effect. The others parts of the plant stimulates the biliary flux. The entire plant at 1500 mg/kg didn’t show hepatic protection or diuretic effect (Fleurentin et al., 1986).
After the administration of the essential oil (donated by the company of Drey’s Italia of Calderara di
Two medicinal plants used in Morocco, Rosmarinus officinalis L. and Centaurium erythraea L., reported for the treatment of urinary ailments, were tested for their diuretic effect. Aqueous extracts of both plants were administered orally to Wistar rats for 1 week. The urinary volume, the excretion of sodium, potassium and chloride were determined, as well the concentration of electrolytes and urea in plasma and creatinine clearance. The dose of 10 mg/kg of 8 or 16 % extract in distilled water enhanced diuresis in rats compared with the control group from the day five. R. officinalis at the dose of 8 % reached at the day six the peak of urinary excretion of sodium, potassium and chloride (p<0.01). At 16 %, it induced slight increases of sodium and chloride excretion on day seven and potassium on day six (p<0.05) (Haloui. et al., 2000).
For the evaluation of the choleretic and protective activities in the rat, lyophilised and aqueous extracts of Rosmarinus officinalis young sprouts and total plant were tested. R. officinalis ethanol extracts prepared from young sprouts and total plant show a significant
An aqueous alcoholic extract (15 %) of R. officinalis in blossom has been investigated by experimental biliary fistula in guinea pig. The increase of the biliary flux happens because of a rapid cholagogic activity and a slowest choleretic activity. An acute toxicity in mice and rats did not reveal any signs of toxicity at the dose used (2 g/kg i.p.) (Mongold et al., 1991).
Rosemary extract exhibited an antioxidative effect in mice. The hexane extract of rosemary (containing about 1.5 % carnosol) was fed to a group of 18 mice. Another 18 mice (eating a normal diet) served as controls. At the end of one week, the animals were fasted overnight and heparinized blood was withdrawn from 6 mice in each group. The animal’s livers were weighed and homogenized. Phosphatidylcholine hydroperoxide and phosphatidylethanolamine hydroperoxide in the plasma, red blood cells (RBC), and livers were determined by
injury in membranous phospholipids layer in the plasma, RBC, and liver of mice. An aliquot of the liver homogenate was incubated with ferrous sulphate and ascorbic acid and PLOOH and thiobarbituric acid reactive substances (TBARS) measured. The addition of rosemary did not affect food intake or liver weight and did not change the in vitro liver lipid peroxidizability compared to controls. However, the α- tocopherol concentrations in plasma, RBC, and liver were significantly lower in mice fed rosemary. Rosemary resulted in a lower level of PLOOH in RBC but did not affect PLOOH levels in plasma or the liver compared to controls. The authors stated that the decrease in
The crude hydroalcoholic (70 %) extract (CHE) of Rosmarinus officinalis L. decreased the ulcerative lesion index in different experimental models in rats, produced by some ulcerogenic products like indomethacin, ethanol and reserpine. The pharmacological mechanism seemed not related with nitric oxide, or with prostaglandins. The results of the experiments suggested that the CHE increases the mucosal nonprotein sulphydryl group’s content or, as another hypothesis, the activity of the antioxidant compounds of the CHE react with
In preliminary studies, at short term, ebselen and rosmarinic acid were effective by reducing both gingival inflammation and plaque accumulation when topically applied in the Rhesus monkey model (Van Dyke et al., 1986).
In a study on normo- and hyperglycaemic mice, the effect of a hot infusion of R. officinalis leaves (two handful of leaves in 1 l of boiling water) was investigated, as well the chronic toxicity. The mixture was cooled to the temperature room and 200 ml was drunk
In alloxan diabetic rabbits, R. officinalis volatile oil increased fasting plasma glucose levels by 17 % (p<0.05) above those of untreated animals 6 h after administration. The author concludes that these data suggest that the volatile oil of R. officinalis has hyperglycaemic and insulin inhibitory effects in rabbits
Rosemary may only have an immune enhancing effect in vivo in stressed conditions, such as protein or antioxidant deficiency. Male rats were fed an experimental diet for 8 weeks. Test diets contained either 10 % or 20 % casein with rosemary (0, 100, 200, or 400 parts per million (ppm)) or BHT, 400 ppm, as a positive control. The mitogenic reactivity of isolated splenic mononuclear cells from the test animals against concanavalin A (Con A), phytohemagglutinin (PHA), and lipopolysaccharide (LPS) were assessed as were plasma uric acid and tocopherol levels in blood and liver. Rosemary treatment had no effect on feed consumption or growth of the animals and did not affect uric acid or tocopherol levels. Rosemary only had a significant effect on mitogenic reactivity to Con A and PHA in rats fed a 10 %
casein diet with 200 ppm rosemary (p<0.05 compared to controls). Rosemary had no impact on mitogenic reactivity to LPS. The authors conclude that rosemary may not have any significant immunopotentiation in healthy situations but that its effectiveness in a more oxidative stressed model, such as decreased dietary antioxidants and/or severe protein insufficiency, deserves further study (Babu et al., 1998).
This study was performed to evaluate the activity of rosemary extract, carnosol and ursolic acid in inhibiting the in vivo formation of mammary 7,
An extract of rosemary was given to female A/J mice for 4 weeks at concentrations of
A methanol extract of the leaves of Rosmarinus officinalis L. was evaluated for its effects on promotion and initiation of mouse skin tumour. Rosemary extract application to the mouse skin inhibited the covalent biding of benzo (α) pyrene B (a) P to epidermal DNA and inhibited tumour initiation by B (a) P and DMBA. It also inhibited
Topical application of carnosol or ursolic acid isolated from rosemary inhibited
According to Ho et al. (Ho et al., 1994), studies of the effects of a fraction of green tea polyphenols, an extract of leaves of rosemary and the pure phytochemicals on the carcinogenic process in
After 13 weeks,
Antimutagenic and hepatoprotective effect
Administration of rosemary ethanolic extract (0.15 g/100 g BW) to rats during 3 weeks produced a hepatoprotective effect, using carbon tetrachloride and cyclophosphamide as mutagenic and hepatotoxic compounds. This effect was comparable to silymarin (reference), and there were amelioration of the serum and liver parameters, confirmed by histopathological examination of the liver tissue. Rosemary oil (1.1 mg/g BW) used as
effect is due to the high percentage of phenolic compounds with antioxidant activity (Fahim et al., 1999).
A well expressed direct cytotoxic effect on L1210 leukaemia cells in
Rosmarinus officinalis, Geranium macrorrhisum and Urtica dioica grown in Bulgaria. It was concentration and time of incubation dependent.
To study the effects of the aqueous extracts of leaves and stems of Rosmarinus officinalis, Pimpinella anisum, Matricaria chamomilla, Artemisia vulgaris, Origanum vulgare, Lapinus albus and Olea europea, on the
The effect of the aqueous and ethanol extracts of Rosmarinus officinalis aerial parts on morphine withdrawal syndrome was investigated in mice. The aqueous and ethanol extracts induced a significant antinociceptive activity in the writhing test. This activity was inhibited by naloxone pretreatment. Phytochemical study indicated that only the aqueous extract of R. officinalis has an alkaloid component. The authors concluded that the aqueous and ethanol extracts of R. officinalis aerial parts could diminish morphine withdrawal syndrome (Hosseinzadeh and Nourbakhsh, 2003).
Rodent studies suggest the possibility of the induction of CYP1A, CYP2B, CYP2E1, and CYP3A along with some phase II enzymes (e.g. glutathione
3.1.1. Assessor’s overall conclusions on pharmacology
The essential oil content of rosemary and the pharmacological effects of the constituents support the claims for carminative and digestive ailments, such as flatulence and feelings of distension. Documented antibacterial and
Antihepatotoxic action and diuretic activity have been shown with young sprouts of Rosmarinus officinalis, in vivo. The diuretic action was achieved with traditional doses but the hepatoprotection needed very high doses.
The antioxidant properties of rosemary results primarily from the actions of phenolic diterpenes, such as carnosic acid, carnosol and rosmanol. The in vitro studies indicate that the main diterpene
antioxidant is carnosic acid. The concentration of carnosic and rosmarinic acid depends on drying techniques and distillation processes.
Rosemary leaf diterpenes have been shown to have lipid peroxidase inhibiting activity and to exert an influence on glucose levels in mice. They also appear to have an antitumour effect and may increase the accumulation of chemotherapeutic agents in drug resistant mammary tumour cells in vivo and in vitro.
(e.g. absorption, distribution, metabolism, elimination, pharmacokinetic interactions with other medicinal products)
In ex vivo experiments, permeation of rosmarinic acid (RA) across excised rat skin was about 8 times higher from alcoholic solution than from water. After topical application, RA concentration in muscle and bone tissue beneath the application site was comparable to those after systemic administration. Upon intravenous administration, the classical
Rosmarinic acid (i.v.) produced moderate inhibition of
In mice, inhalation of 0.5 ml of volatile oil released into the breathing air resulted in detectable levels of
Camphor’s cyclic terpene structure makes it highly lipophilic, explaining both its rapid movement across mucous membranes and large volume of distribution. Once absorbed, it is rapidly oxidized to camphorol, which is then conjugated in the liver to the glucuronide form. As a result of their lipophilic nature, active metabolites are stored in fat deposits and cleared over a prolonged period of time. Most camphor is ultimately excreted in the urine (Sage leaf AR, HMPC, 2008).
Scientific evidence for the safe use of rosemary during lactation is not available. Neither the German Commission E nor the American Herbal Products Association note any contraindications to its use during lactation (Blumenthal et al., 2000; McGuffin et al., 1997).
3.2.1. Assessor’s overall conclusions on pharmacokinetics
Just some aspects of the pharmacokinetics of rosmarinic acid, rosemary oil and camphor are known, depending on the preparation used.
There are no data on the transfer into human milk.
(e.g. single/repeat dose toxicity, genotoxicity, carcinogenicity and reproductive and developmental toxicity, local tolerance, other special studies)
In a study to evaluate the acute toxicity, in Wistar rats, two representative rosemary leaf extracts were used, with different concentrations of phenolic diterpenes, representing medium and high values found in commercial supercritical extracts. At a single dose of 2.0 mg/kg of BW, no deaths or negative clinical signs were observed during the 2 weeks observational period, with no significant differences in weight gain, food and water consumption, clinical chemistry parameters or histological changes (Anadón et al., 2008).
A 15 % alcoholic extract showed no signs of toxicity when i.p. administered to rats at doses of 2 g, 7 kg (Wichtl, 1994).
Antioxidant rosemary extracts have low acute and
The results from the study of the action of rosemary essential oil, eucalyptol and camphor on the cortex of mice in vitro showed an inhibition of O2 consumption and the lost of electrolytic gradient of Na+ and K+ (Steinmetz et al., 1987).
With the ingestion of large amounts of rosemary oil, there is a danger of gastroenteritis and nephritis (Wichtl, 1994)
Rosemary extract showed no mortality at intragastric doses up to 1.2 g/100 g of BW in rats, classified as a very low lethality. Essential oil of rosemary had a lethal dose 50 (LD50) of 5.5 g/kg BW intragastrically in rats, and a lethal effect on all animals at an intragastric dose of 0.9 g/100 g BW (Fahim et al., 1999).
Rosemary extract, carnosic acid and carnosol
A rosemary extract with carnosic acid and carnosol as the two major active ingredients were shown to exhibit strong antimutagenic effects in Ames tester strain TA102. This property was attributed to their antioxidant capacity. Carnosic acid was held responsible for the antimutagenic effect (Minnunni et al., 1992).
According to EFSA report (EFSA, 2008) four of the five rosemary extracts considered (rosemary extract produced from dried rosemary leaves by acetone extraction; rosemary extract prepared by extraction of dried rosemary leaves by means of supercritical carbon dioxide; rosemary extract prepared from a partially deodorized ethanolic extract of rosemary; extract prepared from a deodorized ethanolic extract of rosemary; extract which is a decolorized and deodorized rosemary extract obtained by a
Camphor did not show mutagenic activity in Salmonella typhimurium strains TA 1535, TA 1538, TA 98 and TA 100 with and without S9 activation. No mutagenic effect was found with
Several studies reported that rosemary may be protective at various stages of carcinogenesis in animal models in vivo.
No oral studies on chronic toxicity or carcinogenicity from camphor are available. In a pulmonary tumour response test
In Central America, a tea prepared with R. officinalis and “ocean Artemisia” is used to control fertility, producing temporary sterility. To assess if rosemary induces abortion or interferes with the normal development of the conception, an aqueous extract of R. officinalis was given to pregnant rats during the preimplantation period, as the same dose as used by women to induce abortion (doses of 26 mg of a 30% w/v aqueous extract – 13 mg solids/ml, made with leaves, flowers and stems, administered by gavage during two different periods of Wistar rats pregnancy). One group (N=12) received the extract from days 1 to 6 of pregnancy (preimplantation period) and another group (N=14) received the same extract from days 6 to 15 of pregnancy (organogenic period), against control groups (N=12) which received saline solution. The animals were sacrificed at term. The results suggest that rosemary extract may present an
A methanolic extract (2 %) from the leaves of Rosmarinus officinalis L. was given to female
The EFSA panel (EFSA, 2008) reports the recently Nusier et al. (2007) published results from a study on the effects of a 70 % ethanol: 30 % water extract of rosemary on reproductive function in adult male Sprague Dawley rats, ingesting rosemary extracts dissolved in water at levels of 250 and 500 mg/kg BW/day for 63 days. Body weight and absolute and relative testes weights were not affected, but in the highest dose group the average weight of the epididymides, ventral prostates, seminal vesicles, and preputial glands significantly decreased. A significant decline in spermatogenesis in testes due to a decrease in the number of primary and secondary spermatocytes and spermatids in the high dose group was observed and attributed to a significant decrease in testosterone. In rats of the highest dose group, sperm motility and density were also significantly decreased in the caudal epididymis and in the testes. For the high dose group the treatment also markedly increased the number of foetal resorptions in female rats impregnated by the high dose males, thereby reducing their fertility. For the 250 mg/kg BW dose groups no statistically significant decreases in these parameters were observed and it can therefore be concluded that
250 mg extract/kg BW/day is the NOAEL in this study. Analytical details on the extract used in the study were not provided.
Rosemary did not interfere with normal foetal development after implantation in rats. Mated female rats were randomly assigned to groups, and treated either during the preimplantation or postimplantation period. Either, 26 mg daily of a 30 % (w/v) boiled aqueous extract of rosemary (stems, leaves, and flowers) or an equal amount of saline solution was administered either from the 1st to 6th day (preimplantation) or the 6th to 15th day (organogenic period). On day 21, the rats were sacrificed and the foetuses were examined for external malformations. No differences were noted in the term foetuses and the rate of postimplantation loss was the same in both groups (Lemonica et al., 1996).
3.3.1. Assessor’s overall conclusions on toxicology
Serious poisoning by rosemary or its oil is not reported. The potential problems of gastroenteritis and nephritis, after the ingestion of large amounts of the oil are mentioned in the literature, but do not relate to actual cases. Acute toxicity by rosemary extract was not observed in animal tests.
Teratogenicity data on rosmary oil is not available. One study of rats showed no foetotoxic effects from the administration of a rosemary aqueous extract at various stages of pregnancy.
Rosemary may have an
The existing data on rosemary extracts are insufficient to establish a numerical ADI. The absence of effects in the
However, as the minimum required data on mutagenicity (Ames’ test) are not available for herbal preparations of rosemary leaf and rosemary oil, inclusion in the Community list of herbal substances, preparations and combinations thereof for use in traditional herbal medicinal products is not recommended.
4. Clinical Data
4.1. Clinical Pharmacology
A study was performed in 40 adults to assess the EEG activity, the alertness and the mood after 3 min of aromatherapy, with lavender and rosemary. The lavender group showed increased beta power, less depressed mood and felt more relaxed performing the math computations faster and accurately. The rosemary group showed decreased frontal alpha and beta power, suggesting increased alertness, lower state anxiety scores and was faster but not accurate on the math computations (Diego et al., 1998).
A study was performed to determine the effect of
A hydrophilic fraction (Rosm1) from an alcoholic extract of rosemary had strong antioxidant activity and inhibited oxidative alterations to skin surface lipids. The effectiveness of Rosm1 was tested in humans to assess its ability to prevent lipid peroxidation of skin surface lipids with vitamin E used as a control. Thirty adult males were randomly divided into 5 groups, and a sample of skin surface lipids was obtained from the forehead of each volunteer as an internal control. Group 1 applied the vehicle for one week; groups 2 through 5 applied a 3 ml 5 % ethanol solution containing 50, 100 or 500 µg/ml of Rosm1 fraction. Samples of skin lipids were taken the morning after the last day of treatment and resistance to oxidative stress was assessed by chemiluminescence. The rosemary extract dose- dependently protected the skin lipids from oxidative stress in vitro in a test of the skin samples from volunteer foreheads. Lipids extracted after topical treatment with the rosemary extract showed a significantly higher resistance towards lipoperoxidative chain reactions than did lipids from the controls. The authors suggested that the hydrophilic rosemary extract may be an important natural antioxidant that may prove beneficial as an
18.104.22.168. Assessor’s overall conclusions on pharmacodynamics
Some authors conclude that rosemary extract may be an important natural antioxidant that may prove beneficial as an
Some studies conclude that the
The lack of human data limits conclusions regarding the clinical relevance of the potential interactions.
There are no clinical pharmacokinetic data.
4.2. Clinical Efficacy
4.2.1. Dose response studies
4.2.2. Clinical studies (case studies and clinical trials)
Topical application of a combination of essential oils, including rosemary oil, significantly improved the symptoms of alopecia areata in a randomized,
essential oil treatment caused no adverse events and showed a better therapeutic ratio compared to other available treatments for alopecia (Hay et al., 1998).
4.2.3. Clinical studies in special populations (e.g. elderly and children)
Paediatric use requires a careful assessment as often medical advice and supervision should be sought, for safety reasons.
4.3. Overall conclusions on clinical pharmacology and efficacy
A single clinical study suggested that rosemary applied topically may protect skin cells from oxidative stress and another single clinical study showed that rosemary essential oil combined with other essential oils might be a moderately effective treatment for alopecia areata.
These studies are not sufficient to support therapeutic indications on the basis of WEU. The therapeutic indications can therefore only be based on traditional use.
5. Clinical Safety/Pharmacovigilance
5.1. Overview of toxicological/safety data from clinical trials in humans
Commission E: Leaf permitted for oral use. No contraindications (CI), adverse events (AE), interactions
(I) BAnz nr. 223 30.11.85 .
Standardzulassungen: Leaf permitted as herbal tea. CI: pregnancy. No AE, I.
French Guideline: Leaf and flowering top permitted for oral use (toxicological category 1 for powder, herbal tea, aqueous extract, low strength
Germany (essential oil) – External use – urges to cough, bronchial and laryngeal spasm, local hypersensitive reactions.
Regarding the adverse reactions reported by Germany, these can be considered as a form of hypersensitivity to the medicinal product.
5.2. Patient exposure
Rosemary has a long history of consumption in the human diet. Rosemary extract is a component of some perfumes, disinfectants and insecticides. Rosemary leaves are widely used as a seasoning for meat dishes, sauces and salami.
Carnosol and carnosic acid
The main potential sources of exposure to rosemary extracts used as antioxidants were reported as ‘fine bakery wares’, ‘dehydrated soups and broths’ and ‘seasonings and condiments’ in UK adults and ‘fine bakery wares’ and ‘meat, poultry and fish/seafood products
Dietary exposure to carnosol plus carnosic acid has been estimated for adults and
percentiles and 97.5th percentile values of 0.12 and 0.23 mg carnosol plus carnosic acid/kg bw/day (EFSA, 2008).
On the EFSA panel report, it is noted that the margin between the NOAEL range in the
The EFSA Panel (2008) was of the opinion that the margin of safety is high enough to conclude that dietary exposure resulting from the proposed uses and use levels are not of safety concern. To achieve these levels of dietary exposure, high level consumers would need to select a diet that was entirely composed of foods containing rosemary extracts for those food categories in which it was permitted. In reality not all processed foods will contain added antioxidants and it seems unlikely that these extracts would be used at the maximum usage level in all the proposed food in each category or that some consumers would systematically always choose all foods containing rosemary extract.
Dietary exposure to camphor arises from the consumption of foods flavoured by using herbs, their essential oils or the chemically defined flavouring substance
According to the EFSA report, exposure to camphor should not exceed 2 mg/kg BW on a single day in any age group.
5.3.Adverse events and serious adverse events and deaths
A case of contact dermatitis to carnosol, the main constituent of Rosmanox®, made from the leaves of rosemary, developed in a
A rosemary leaf plaster caused contact dermatitis in a
Further case reports related to allergic contact dermatitis show, from patch testing, that carnosol (CAS RN:
Rosemary oil contains
According to EFSA (EFSA, 2008), in humans, the intoxication of camphor includes central nervous stimulation, oral and gastric irritation, nausea and vomiting, excitement, hallucinations, delirium, muscular excitability, tremors, convulsions and urinary retention. Locally, it can produce irritation of the skin, eyes and mucous membranes of the respiratory tract.
In the same report, it is mentioned that the intoxications present in the literature, in general, involve accidental intake of camphorated oil (20 % camphor in cottonseed oil).
No acute toxicity was reported after doses lower than 2 mg/kg BW. Clinically insignificant signs of toxicity may be seen in sensitive individuals at doses of 5 mg/kg BW and higher. Clinical manifest signs in these individuals require doses higher than 30 mg/kg BW (EFSA, 2008).
5.3.2. Serious adverse events and deaths
The report of a hepatic abscess secondary to ingestion of a rosemary twig was considered to be serious (Karamarkovic et al., 2007). However, this case is considered to be not relevant for the safety assessment of authorised medicinal products containing rosemary.
20 children aged 1 to 4 years became ill with seizures, after ingestion of 1 to 1.5 tablespoons of camphorated oil equivalent to about 3 to 4.5 g of camphor (EFSA, 2008).
In a literature review of 64 cases, 6 reports of death were found. In a
In a recent published case report, a
The American Academy of Paediatrics concluded that although adults recovered from ingestion of up to 43 g of camphor, the ingestion of 2 g generally produces dangerous effects. In children, ingestion of 0.7 to 1.0 g of camphor has proved fatal.
On the basis of the data reviewed, a probable lethal dose was estimated to be in the range of 50 to 500 mg/kg BW, with a large variation on the sensitivity of humans to the acute toxicity of camphor.
5.4. Laboratory findings
5.5. Safety in special populations and situations
5.5.1. Intrinsic (including elderly and children)/extrinsic factors
Not to be used in cases of hypersensitivity to the active substance.
5.5.2. Drug interactions
Limited data available. Cineol induction of CYP450 enzymes is possible.
The lack of human data limits conclusions regarding the clinical relevance of these potential interactions (Barceloux, 2008).
5.5.3. Use in pregnancy and lactation
Therapeutic doses are not recommended for use during pregnancy (McGuffin et al., 1997).
Preparations of rosemary should not be used during pregnancy due to the toxic effects of some components (Wichtl, 1994).
The data available are not sufficient to conclude the safety or the danger of rosemary preparations used during pregnancy and lactation. The only conclusion possible is that the safety during pregnancy and lactation has not been established and thus rosemary preparations should be avoided.
5.5.5. Drug abuse
5.5.6. Withdrawal and rebound
5.5.7. Effects on ability to drive or operate machinery or impairment of mental ability
5.6. Overall conclusions on clinical safety
In general, it can be concluded that rosemary preparations are safe and devoid of toxic effects if taken in recommended doses.
Use must be avoided during pregnancy and lactation, as the safety has not been established. Use is contraindicated in hypersensitive patients.
Although rosemary preparations contain variable quantities of camphor, there are no human data to support the development of seizures as a complication of the ingestion of rosemary extracts.
Hot and full baths are contraindicated in cases of open wounds, large skin injuries, acute skin diseases, high fever, severe infections, severe circulatory disturbances and cardiac failure.
With regard to oral use, rosemary preparations are contraindicated in cases of obstruction of the bile duct, cholangitis, liver disease, gallstones and any other biliary disorders that require medical supervision and advice.
With regard to cutaneous use, the warning to avoid contact with the eyes and mucous membranes is included in the monograph of Rosmarinus aetheroleum, due to potential irritation of the essential oil.
Where symptoms such as articular pain accompanied by swelling of the joint, redness or fever occur medical advice should be sought.
6. Overall conclusions
Rosemary (Rosmarinus officinalis L.) belongs to the family Lamiaceae and has been an important medicinal plant since earliest times. It is also a commonly used spice and flavouring agent for foods and its essential oil is used therapeutically, in particular in balneology.
It was mentioned for its medicinal and cosmetic properties in ancient Greece and by the Romans. In the middle ages, rosemary oil was distilled for medical purposes and also used as a perfume.
The pharmacological studies reported in the literature give plausibility to the traditional indications set out in the monographs:
Traditional herbal medicinal product for symptomatic relief of dyspepsia and mild spasmodic disorders of the gastrointestinal tract.
Cutaneous use and use as a bath additive
Traditional herbal medicinal product as an adjuvant in the relief of minor muscular and articular pain and in minor peripheral circulatory disorders.
A single clinical study suggested that rosemary applied cutaneously may protect skin cells from oxidative stress and another clinical study showed that rosemary essential oil combined with other essential oils might be a moderately effective treatment for alopecia areata.
However, these studies are not enough to support the indication on the basis of WEU. The therapeutic indications are based solely on the traditional uses and are suitable for use without the need for medical diagnosis, prescription and supervision.
Some proposals for therapeutic indications from the interested parties (see the “overview of comments received during the public consultation”) were not accepted for safety reasons.
Due to the lack of sufficient data to assure the safety, the use in children (Rosmarini folium and preparations thereof including Rosmarini aetheroleum), in adolescents (Rosmarini aetheroleum) and during pregnancy and lactation are not recommended.
The preparations proposed in the monograph are based on those which are known to be on the market for 30 years. Some others are stated in the literature, but either information on the period of use or the posology for these preparations are missing or they do not comply with the requirement for 30 years of traditional use evidence.
As the minimum required data on mutagenicity (Ames’ test) are not available for herbal preparations of rosemary leaf and rosemary oil, inclusion in the Community list of herbal substances, preparations and combinations thereof for use in traditional herbal medicinal products is not recommended.