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Oleander

Oleander is a plant whose use as a poison is well known. Oleander is a favorite suicide poison in Sri Lanka, where oleander poisoning exceeds 150 cases per 100,000 people per year. About 10% of these poisonings are fatal. Despite the dangers, oleander seeds and leaves are used to make medicine. Oleander is used for heart disease, asthma, epilepsy, cancer, painful menstrual periods, leprosy, malaria, bark lichen, stomach upset and diseases of the veins, as well as to induce abortion. A combination of oleander leaf powder extract, adonis floret liquid extract, lily of the valley liquid extract and sea onion powder extract is used to treat mild heart failure.

Oleander is sometimes applied to the skin to treat skin problems such as warts.

How does oleander work?

Oleander contains chemicals called glycosides that can affect the heart. These chemicals can slow down the heart rate.

How effective is oleander?

There is not enough scientific data to make a statement about the effectiveness of oleander for heart problems, asthma, seizures, cancer and menstrual pain, when used as a poison, and when applied to the skin for skin problems and warts.

Further scientific research is needed to evaluate the effectiveness of oleander in these applications.

Safety and side effects

Oleander is not safe for anyone when taken orally. It can cause a burning sensation in the mouth, nausea, vomiting, diarrhea, weakness, headaches, stomach pain, serious heart problems and many other side effects. The ingestion of oleander leaves, a tea made from oleander leaves and oleander seeds has already led to fatal poisonings.

There is not enough information on whether it is safe and harmless to apply oleander to the skin, so it is best not to do so.

Precautions and warnings

Oral ingestion of oleander is not safe for anyone. However, it is particularly dangerous for certain groups of people:

Pregnancy and breastfeeding: taking oleander orally can cause abortion. There is not enough information to say whether it is safe for pregnant and breastfeeding women to apply oleander to their skin.

Too little potassium or too much calcium (electrolyte imbalance): Oleander affects the heart. An electrolyte imbalance also often affects the heart. It is especially dangerous to use oleander if you suffer from an electrolyte imbalance.

Heart disease: You should not use oleander to treat heart disease without medical supervision. Self-medication is too dangerous.

Interactions

Oleander should not be used in combination with the following medicines:

Antibiotics (macrolide antibiotics)

Oleander can affect the heart. Some antibiotics may increase the amount of oleander absorbed by the body. Taking oleander with macrolide antibiotics could increase the effects and side effects of oleander. The group of macrolide antibiotics includes erythromycin, azithromycin and clarithromycin.

Antibiotics (tetracyline antibiotics)

Taking certain antibiotics in combination with oleander could increase the risk of oleander side effects. Some antibiotics that interact with oleander include demeclocycline, minocycline and tetracycline.

Digoxin

Digoxin helps the heart to beat more strongly. Oleander also appears to affect the heart. Taking oleander in combination with digoxin could increase the effect of digoxin and the risk of side effects. For this reason, oleander should only be used after prior consultation with your doctor if you are taking digoxin.

Quinine

Oleander can affect the heart. Quinine can also affect the heart. Taking quinine in combination with oleander could cause serious heart problems.

Stimulant laxatives

Oleander can affect the heart. Laxatives, known as stimulant laxatives, can lower potassium levels in the body. Low potassium levels can increase the risk of side effects from oleander.

Diuretics

Oleander could affect the heart. Diuretics can lower potassium levels in the body. Low potassium levels can increase the risk of side effects from oleander.

Care should be taken when combining oleander with the following medications:

Calcium supplements

Oleander can stimulate the heartbeat. Calcium could also affect the heart. Taking oleander in combination with calcium can stimulate the heart too much. For this reason, oleander should not be taken in combination with calcium supplements.

Dosage

An appropriate dosage of oleander depends on various factors such as age, state of health and others. At the present time there is

there is insufficient scientific data to make a statement about appropriate dosage ranges for oleander. For this reason, you should follow the dosage instructions on the label and/or consult a doctor or pharmacist before use.

References

  1. Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.
  2. Eddleston M, Rajapakse S, Rajakanthan K, et al. Anti-digoxin Fab fragments in cardiotoxicity induced by ingestion of yellow oleander: a randomized controlled trial. Lancet 2000;355:967-72.
  3. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp, 1999.
  4. Foster S, Tyler VE. Tyler's Honest Herbal, 4th ed, Binghamton, NY: Haworth Herbal Press, 1999.
  5. Furbee B, Wermuth M. Life-threatening plant poisoning. Crit Care Clin 1997;13:849-88.
  6. Haynes BE, Bessen HA, Wightman WD. Oleander tea: herbal draught of death. Ann Emerg Med 1985;14:350-3.
  7. Langford SD, Boor PJ. Oleander toxicity: an examination of human and animal toxic exposures. Toxicology 1996;109:1-13.