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Calamus

Scientific Name(s): Acorus calamus L.
Common Name(s): Acore calame, Calamo aromatic, Calamus, Kalmus, Rat root, Shi chang pu, Sweet flag, Sweet myrtle, Sweet root, Sweet sedge, Vasambu, Vash vaj

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

Clinical Overview

Use

Clinical studies are lacking due to concerns of toxicity. Animal and/or in vitro data describe antioxidant, anti-inflammatory, antimicrobial, and cardiovascular effects, as well as activities in epilepsy, diabetes, and Alzheimer disease. However, because of toxicity and a lack of clinical trial data, calamus cannot be recommended for any use. Use of calamus and its extracts is prohibited in the United States.

Dosing

Use of calamus and its extracts is prohibited in the United States. Clinical studies are lacking to provide dosing recommendations.

Contraindications

Contraindications have not been identified, but use in the United States is prohibited.

Pregnancy/Lactation

Avoid use. Adverse effects (emmenagogic and genotoxic activity) have been documented.

Interactions

None well documented.

Adverse Reactions

Clinical studies are lacking due to concerns of toxicity.

Toxicology

Avoid use. Case reports of toxicity describe nausea, prolonged vomiting (up to 15 hours), and tachycardia. Mutagenicity attributed to various extracts and chemical constituents has been reported. Moderate reproductive toxicity has been reported. One study reports 3 neonates died following complications of vasambu consumption.

Scientific Family

Botany

Calamus is a semi-evergreen, perennial, hairless herb native to much of Asia and also found throughout North America and Eastern Europe. Calamus is found in damp, swampy areas. The leaves are bright green and sword shaped, with wavy margins that thicken in the middle. The plant is similar in appearance to the iris and grows to approximately 2 m in height. The hermaphroditic flowers are pollinated by insects. The creeping rhizome is pale yellow to pinkish brown on the outside and white to pinkish on the inside.Khan 2010, Rajput 2014, USDA 2020 Synonyms include A. calamus L. var. americanus (Raf.) H.D. Wulff. and Acorus americanus (Raf.) Raf.

History

Acorus calamus is derived from the Greek words "ákoros," meaning a plant with aromatic rhizomes or iris, and "kálamos," meaning cane or reed.Olas 2018, Rajput 2014 The fragrant underground portion (the rhizome) has been used medicinally since Biblical times. Popular European books on medicinal plants tout calamus as a "wonder drug"; however, because asarones (active components of calamus) are associated with the development of tumors in animals, use of calamus and its extracts is prohibited in the United States. Maximum limits for beta-asarone content in food and beverages have been set by the European Commission.Björnstad 2009, Khan 2010, Rajput 2014, Widmer 2005 Calamus has been used in traditional medicine for the treatment of digestive disorders and childhood colic. Infusions of the rhizome have been suggested for the treatment of fever; chewing the rhizome has been said to relieve irritated throats and remove the odor of tobacco. Calamus rhizome is central to the Ayurvedic medical system as an aromatic, stimulant, bitter tonic, and expectorant, and has been used as an emmenagogue. In Ayurvedic medicine, A. calamus undergoes "sodhana," a process of detoxification. Calamus has been used by American Indians to soothe toothache and headache. The Zeliangrong tribe of Manipur, India has used A. calamus for treatment of cough, headache, jaundice, gastritis, and stomachache, and to drive out evil spirits.Panmei 2019 A. calamus has also been used most often for cough by the Irula tribes in the Walayar valley of India.Venkatachalapathi 2018 Calamus has been promoted on the internet as a hallucinogen. The ground rhizome is used as a spice and as commercial flavoring in drinks, cosmetics, and toothpastes.

Chemistry

Calamus leaves and rhizomes contain 1.5% to 3.5% of a volatile oil responsible for the plant's characteristic odor and taste. The most characteristic constituent of the oil is asarone; concentrations can vary considerably among calamus varieties. The tetraploid variety of A. calamus found in India contains a larger amount of beta-asarone (75% to 96%). The diploid plant grows in North America and is beta-asarone free. The European triploid plant is a different chemotype of calamus, with oil containing less than 10% asarone. Alpha-asarone has also been identified; alpha- and beta-asarone are trans- and cis-isomer forms, respectively.Gholkar 2013, Zaugg 2011 More than a dozen additional compounds have been identified in the oil and extracts, including saponins, lectins, sesquiterpenoids, lignans, and steroids. Hydrocarbons, carbonyl compounds, alcohols, phenols, furans, and other compounds have also been described. Ethanolic extracts and acetone, hydroalcoholic, and methanolic extracts have been studied, and high-pressure liquid chromatography methods for determining asarone content have been published.Du 2008, Hao 2012, Kim 2011, Rajput 2014, Widmer 2005 The chemical composition of the plant varies according to geographic location, plant age, climate, species variety, and plant part used.Kumari 2010, Rajput 2014

Uses and Pharmacology

Clinical studies of calamus use for any indication are lacking due to concerns of toxicity (see Toxicology).

Allergic reactions

Animal and in vitro data

In vivo, a pectic polysaccharide isolated from the rhizomes of A. calamus downregulated immunoglobulin G and immunoglobulin E concentrations.Belska 2010 Prevention of mast cell degranulation has been shown in mice,Kim 2012 and an antihistaminic effect was shown in isolated guinea pig tissue.Vijayapandi 2012

Anthelmintic effects

Animal data

In a study of rats infected with Hymenolepis diminuta, a rhizome extract of A. calamus showed dose-dependent activity against intestinal tapeworm based on reduction in egg per gram counts, as well as reduced worm counts. Beta-asarone extracts showed slightly better improvement in H. diminuta infection compared with crude extracts from the plant.Nath 2016

Anti-inflammatory effects

Animal and in vitro data

In animal and in vitro studies, the immunomodulatory and anti-inflammatory actions of A. calamus extracts were attributed to observed neuroprotective, analgesic, and wound-healing properties. Interference with cytokines (interleukins and tumor necrosis factor alpha) and immunoglobulins has been demonstrated.Belska 2010, Jain 2010, Khan 2012, Kim 2009, Muthuraman 2011, Muthuraman 2012

Antimicrobial/Insecticidal activity

Animal and in vitro data

Calamus leaf and rhizome extracts, as well as calamus oil, have shown antibacterial activity against some human pathogens, including weak activity against Neisseria gonorrhoeae. Antifungal activity against both human and plant pathogens has been demonstrated in vitro.Cybulska 2011, Ghosh 2006, Kim 2011, Rajput 2013, Rajput 2014 The methanolic extract from A. calamus was tested in vitro against 2 gram-positive and 11 gram-negative pathogens known to be contributors of urinary tract infections. In comparison with 14 other spice extracts, A. calamus showed the greatest antioxidant and antibacterial activity.Mickymaray 2019

A. calamus proved to be a good inhibitor of Helicobacter pylori biofilms by exhibiting considerable antibacterial activity in mucosal biopsy specimens obtained from male and female patients.Prasad 2019

Activity against the larvae of insects has been demonstrated in vitro and in animals such as cattle.Ghosh 2011, Liu 2013, Rajput 2014, Sharma 2008 An in vitro study showed beta-asarone extracts inhibited growth and viability of, and induced apoptosis in, a Spodoptera frugiperda insect cell line.Yooboon 2019

Antispasmodic effects

In vitro data

Results of a study in isolated rabbit jejunum suggest that the spasmolytic effect of an A. calamus extract was mediated through the presence of calcium channel blockade-like constituent(s) concentrated in the n-hexane fraction, providing a strong mechanistic basis for its traditional use in GI disorders.Gilani 2006

Antiviral activity

In vitro data

Tatanan A, isolated from the roots of A. calamus, showed antiviral activity against dengue virus type 2 (DENV2)Yao 2018 and decreased DENV2-induced low-density lipoprotein levels, plaque numbers, and mRNA levels. Results suggest tatanan A inhibits flavivirus genus replication through a mechanism independent of activation of glucokinase. A methanolic extract of A. calamus also showed antiviral effects against DENV without a cytotoxic effect.Rosmalena 2019

Bronchodilatory effects

In vitro data

In studies of isolated guinea pig trachea and atria, a crude extract of A. calamus demonstrated dual inhibition of calcium channels and phosphodiesterase, suggesting a pharmacological basis for its use in disorders of airways in traditional medicine.Shah 2010

Cancer

Animal and in vitro data

Antioxidant activity of A. calamus has been described and may be responsible for observed effects in cancer cell lines. In vitro, essential oil extracts from the rhizomes within the fresh leaves of A. calamus expressed antioxidant activity. Collection of oils from leaves during the late summer months proved to be more fruitful.Parki 2017 Protection against irradiation-induced DNA strand breaks and chemotherapy-induced hepatotoxicity and nephrotoxicity has been attributed to antioxidant activity.Hazra 2007, Ilaiyaraja 2011, Kumari 2009, Sandeep 2010, Sandeep 2010, Sandeep 2012 Induced senescence in colorectal cancer cells and upregulation of capases have also been described as mechanisms by which the extracts may decrease proliferation and induce apoptosis in cancer cells.Antony 2017, Liu 2013, Zou 2012 Activity has been attributed to beta-asarone, sesquiterpenoids, and the lectin content of the plant.Bains 2005, Hao 2012, Rajput 2014 One study showed that A. calamus extract effectively inhibited proliferation and viability, induced apoptosis, and suppressed vascular endothelial growth factor A expressions in prostate LNCaP cancer cells in a dose- and time-dependent manner.Koca 2018 In another study, an aqueous rhizome extract of A. calamus showed in vitro anticancer activities based on apoptosis and decreased cell viability in all cancer cell lines tested.Nakkala 2018 Another study resulted in lower tumor volume and lower areas of metastases in the lungs, reflecting antitumor and antimetastatic effects.Lopantina 2017 These results were accompanied by a decrease in the numbers of CD326+ and CD274+ cells in the tumor node. Also in vitro, essential oil extracts showed inhibition of human gastric cancer cell growth by causing G1 phase arrest and downregulation of Oct4 and NS posttreatment in a time- and dose-dependent manner. Longer exposure at higher doses produced a more clinically important cytotoxic effect.Rahamooz Haghighi 2017 In rodents, both alpha- and beta-asarone have been shown to be mutagenic.Rajput 2014

Cardiovascular effects

Animal and in vitro data

Extracts of A. calamus show antagonism of the calcium channel and effects on the nitric oxide pathway. Depending on the extraction method and fractions used, vasodilation and constriction and partial depressant effects on coronary flow and heart rate have been demonstrated in rats and in isolated heart studies.Shah 2009, Shah 2012

CNS effects

Animal and in vitro data

Anticholinesterase activity has been demonstrated in vitro and in animal studies, which may have implications for the management of Alzheimer disease.Oh 2004, Vijayapandi 2012 Studies have shown that beta-asarone and extracts of A. calamus exert antidepressant effects and improve cognitive function in rats with induced stress-related depression.Dong 2010, Geng 2010, Sundaramahalingam 2013, Tripathi 2010 Older studies and traditional uses suggest a sedative effect.Rajput 2014 Oral treatment with aqueous extracts derived from A. calamus roots prevented memory deficits and stress through controlled oxidative stress and inflammation processes in male Wistar rats. Higher doses (600 mg/kg) resulted in better performance in terms of less memory impairment, suggesting dose-dependent efficacy.Esfandiari 2018

Diabetes

Animal and in vitro data

A limited amount of research describes the hypoglycemic effects of various fractions of A. calamus extracts. Decreases in blood glucose, inhibition of alpha-glucosidase activity, and enhanced adipocyte differentiation have been demonstrated in vitro and in animal studies. However, beta-asarone has also been shown to exert an inhibitory effect on adipogenesis.Rajput 2014, Si 2010, Wu 2007, Wu 2009

Diuresis/Nephrolithiasis

Animal data

In one study of Wistar albino rats with ethylene glycol-induced urolithiasis and given an ethanolic extract of A. calamus (EEAC) rhizomes, diuretic action and protection from urolithiasis were observed due to suppression of urolithiatic promotors in serum, urine, and kidney tissue. EEAC increased urinary flow and dose-dependent excretion of sodium and potassium electrolytes. Finally, EEAC reduced oxalate levels and calcium in the urine and restored phosphate and uric acid levels in the serum and urine.Ghelani 2016

Epilepsy

Animal data

Limited studies in rats have shown that extracts of A. calamus, especially alpha-asarone and purified rhizome extracts, exert an anticonvulsant effect on induced seizures. Possible sites of action are the gamma-aminobutyric acid receptors and sodium channel.Bhat 2012, Hazra 2007, Katyal 2012, Wang 2014, Zaugg 2011

Dosing

Use of calamus and its extracts is prohibited in the United States. Clinical studies are lacking to provide dosing recommendations.

Pregnancy / Lactation

Avoid use. Adverse effects (emmenagogic and genotoxic activities) have been documented.Ernst 2002, Rajput 2014

Interactions

Case reports are lacking. Potentiation of calcium channel blockers (eg, amlodipine) and medications used in epilepsy is possible based on studies in rodents.Singh 2011, Wu 2009 Alpha-asarone and A. calamus extracts may also interfere with the CYP-450 enzyme system.Pandit 2011

Adverse Reactions

Clinical studies are lacking (see Toxicology). Cardiovascular effects, such as hypotension, are possible based on animal studies.

Toxicology

The Swedish Poisons Information Centre reported 30 cases of acute intoxication related to A. calamus abuse from 2003 through 2006 that involved nausea and prolonged vomiting (up to 15 hours), as well as tachycardia.Björnstad 2009 Acute toxicity tests in mice showed piloerection, decreased mobility, and respiratory distress leading to unconsciousness and death.Khan 2012 Long-term toxicity studies report the development of tumors and thrombosis in rat heart chambers. The median lethal dose in mice was reported to be greater than 2,000 mg/kg (oral), as there were no observable signs of toxicity or mortality at that dose.Nath 2016 The primary toxicological concern focuses on the carcinogenic effects of asarone. Both alpha- and beta-asarone showed mutagenicity in most studiesRajput 2014; feeding studies from the late 1960s provide evidence of the mutagenic potential of these compounds.Gholkar 2013, Khan 2010, Rajput 2014 Male rats treated with beta-asarone at a dose of 50 mg/kg of body weight exhibited moderate reproductive toxicity based on moderate amounts of degenerative changes in testis, reduced sperm count levels, and an increase in sperm count morphology.Benny 2017 Additionally, hormonal imbalances of testosterone, luteinizing hormone, and follicle-stimulating hormone levels were present, suggesting spermatogenesis interference.

Neonates exposed to vasambu (A. calamus) from traditional prelacteal feeds prevalent in South Indian culture were admitted to the hospital presenting with abdominal distension, tenderness, and seizures. Ten percent of the neonates had pneumonia, and 3 ultimately died due to necrotizing enterocolitis complications. Avoiding use in neonates is advisable.Tanigasalam 2017

Index Terms

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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