Foxglove

Related Terms

1,8-dihyroxy-3,7-dimethlyoctene-1-?-glucopyranoside, 1-methoxy-2-hydroxy-3-methyl-anthraquinone, 1-methoxy-2-methyl-anthraquinone, 3-methoxy-alizarin, 3-methylpurpurin, 4-hydroxydigitolutein, 6,8-dihydroxymyricetin, 14?-digipronin, 16-acetylgitoxin, acetic acid, acetylcholine, apigenin, apigenin-glucosylapioside, benzoic acid, bloody fingers, caffeic acid, calceolarioside, Camelot rose hybrids, cardeonolides, cardiac glycosides, cerotic acid, chlorogenic acid, choline, chromium, citric acid, common foxglove, cyaniding-3,5-diglucoside, dead man's bells, dead men's bells, degalactotigogenin, desglucodigitonin, desrhamnosyl aceteoside, digacetenin, digalogenin, digalonin, digicitrin, digifolein, digifucocellobioside, diginin, digipronin, digiproside, digipurpurin, digipurpurogenin, digitalein, digitalin, digitalis, Digitalis amandiana Samp., Digitalis dubia Rodr., Digitalis ferruginea, Digitalis grandiflora, Digitalis heywoodii (P.Silva & M.Silva) P.Silva & M.Silva, Digitalis lanata, Digitalis mariana Boiss., Digitalis miniana Samp., Digitalis minor, Digitalis nevadensis Kunze, Digitalis purpurea f. albiflora, Digitalis purpurea subsp. dubia (Rodr.) Knoche, Digitalis purpurea subsp. heywoodii, Digitalis purpurea subsp. heywoodii P.Silva & M.Silva, Digitalis purpurea supsp. mariana, Digitalis purpurea L. subsp. mariana (Boiss.) Rivas Goday, Digitalis purpurea subsp. purpurea, Digitalis purpurea L. subsp. purpurea var. tomentosa (Hoffmanns. & Link) Brot., digitalonin, digitogenin, digitoleutin, digitonin, digitopurpon, digitoxigenin, digitoxigenin-bisdigitoxoside, digitoxigenin-glucomethyloside, digitoxin, digoxin, dinatin, evatromonoside, fairy cap, fairy finger, fairy thimbles, fairy's glove, fatty acids, ferulic acid, F-gitonin, figwort, fingerhut (German), folk's glove, foxglove extract, foxy hybrids foxgloves, gallic acid, gitalin, gitaloxigenin, gitaloxigenin-bisdigitoxoside, gitaloxin, gitogenin, gitonin, gitorin, gitoroside, gitostin, gitoxigenin, gitoxigenin-bisdigitoxoside, gitoxin, gitoxincellobioside, gitoxoside, gloves of our lady, glucodigifucoside, glucodigitoxigenin-bisdigitoxoside, glucodigitoxigenin-glucomethyloside, gluco-evatromonoside, glucogitaloxin, glucogitoroside, glucogitoxigenin-bisdigitoxoside, glucolanadoxin, glucoverodoxin, glycoside A, glycoside B, Grecian foxglove, gum, inositol, isochrysophanol, lactic acid, lady's glove, lady's thimble, lanadoxin, lanafolin, lanatoside A, lanatoside B, lanatoside C, lanatoside D, lanatoside E, lion's mouth, loliolide, luteolin, luteolin-5-xyloside-7-glucuronide, luteolin-7-D-glucoside, luteolin-7-xyloside-5-glucuronide, luteolin-diglucoside, luteolin-L-7-glucosyl-glucuronide, luteolin-L-7-glucuronide, melissyl alcohol, neodigitogenin, neodigitalogenin, neogitostin, odorobioside G, odorobioside H, orobanchoside, p-coumaric acid, pelargonidin-3,5-diglucoside, phomarin, phomarin-6-methyl-ether, Plantaginaceae (family), plantainoside D, purlanoside B, purple foxglove, purpnin, purprin, purpronin, purpureagitoside, purpureaglycoside A, purpureaglycoside B, purpureaside A, revbielde (Norwegian), rusty foxglove, saponins, scotch mercury, Scrophulariaceae (family), sitosterol, spirostanol-glycosides, stansioside, starch, strospeside, succinic acid, sugar, throatwort, tigogenin, tigonin, triacontane, verodoxin, virgin's glove, volatile oil, witches' glove, witches' gloves, witch's bells, wolly foxglove, wooly foxglove, yellow foxglove.

Background

Foxglove is a common name for plants belonging to the Digitalis species, including Digitalis purpurea and Digitalis lanata. Traditional medicine has used foxglove to treat heart conditions, fevers, wounds, swelling or inflammation, sores, ulcers, cancer, edema, and infections.
Reports describe foxglove leaves as being similar to those of other species, such as Inula conyza (ploughman's spikenard), Inula helenium (elecampane), Symphytum officinale (comfrey), Verbascum thapsus (great mullein), and Primulaceae (primrose).
Foxglove is rarely used for modern medical purposes because of its toxic effects, including nausea, vomiting, green-yellow vision, and death. Still, foxglove and other Digitalis species contain cardiac glycosides, agents known to increase the strength and speed of heartbeats, making it seemingly useful for treating certain heart disorders. However, scientific studies on the safety and efficacy of the crude herb are lacking. However, the modern drug digoxin is extracted from Digitalis lanata and is used to treat certain heart conditions. However, digoxin, unlike crude samples of foxglove, is standardized in controlled laboratory settings.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
There is no proven safe or effective dose for digitalis in adults.
Digoxin (Lanoxin?) is a drug made from digitalis and may be taken by mouth or injected.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Note: Agents that may interact with digoxin may also interact with foxglove.
Foxglove may increase the risk of bleeding when taken with other drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin?) or heparin, antiplatelet drugs such as clopidogrel (Plavix?), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin?, Advil?) or naproxen (Naprosyn?, Aleve?).
Foxglove may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as Iorazepam (Ativan?) or diazepam (Valium?), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
Foxglove may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking insulin or drugs for diabetes by mouth should be monitored closely by qualified healthcare professionals, including a pharmacist. Medication adjustments may be necessary.
Foxglove may affect blood pressure. Caution is advised in people taking other medications that affect blood pressure.
Because foxglove contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
Many tinctures contain high levels of alcohol and may cause nausea or vomiting when taken with metronidazole (Flagyl?) or disulfiram (Antabuse?).
Foxglove may also interact with agents that affect the immune system, agents that affect the nervous system, allergy medicine, Alzheimer's agents, antacids, antidepressants, anticancer medications, antifungals, anti-inflammatory agents (sulfasalazine in particular), antivirals, arthritis medication (sulfasalazine in particular), asthma medications, beta-blockers, birth control agents, blood vessel-widening medicines, calcium channel blockers, calcium salts, cardiac glycosides, charcoal, cholesterol-lowering agents (cholestyramine in particular), diphenoxylate, diuretics, heart medication (including heart rate-regulating agents), laxatives, macrolide antibiotics, magnesium, medicines that mimic activities of the nervous system, medicines that speed up mental or physical processes, metoclopramide, neurologic agents, pain relievers, propantheline, rifampin, skeletal muscle relaxants, skin creams, stomach ulcer medications, succinylcholine, tetracycline antibiotics, and thyroid hormones.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Aikawa JK, Reardon JZ, Harms DR. Effects of digitoxin on exchangeable and tissue contents of magnesium. Proc.Soc.Exp.Biol.Med 1961;108:684-686.
Bessen HA. Therapeutic and toxic effects of digitalis: William Withering, 1785. J.Emerg.Med. 1986;4(3):243-248.
Brunton TL, Tunnicliffe FW. On the Cause of the Rise of Blood-pressure produced by Digitalis. J Physiol 10-19-1896;20(4-5):354-363.
dos Santos MD, Almeida MC, Lopes NP, de Souza GE. Evaluation of the anti-inflammatory, analgesic and antipyretic activities of the natural polyphenol chlorogenic acid. Biol.Pharm.Bull. 2006;29(11):2236-2240.
Harada T, Ohtaki E, Misu K, Sumiyoshi T, Hosoda S. Congestive heart failure caused by digitalis toxicity in an elderly man taking a licorice-containing chinese herbal laxative. Cardiology 2002;98(4):218.
Hobbs RE. Digoxin's effect on mortality and hospitalization in heart failure: implications of the DIG study. Digitalis Investigation Group. Cleve.Clin.J.Med. 1997;64(5):234-237.
Hollman A. Drugs for atrial fibrillation. Digoxin comes from Digitalis lanata. BMJ 4-6-1996;312(7035):912.
Kim YW, Andrews CE, Ruth WE. Serum magnesium and cardiac arrhythmias with special reference to digitalis intoxication. Am.J Med Sci 1961;242:87-92.
Nahum LH. Potassium and digitalis. Conn.Med 1965;29:331-332.
Oishi A, Miyamoto K, Kashii S, Yoshimura N. Photopsia as a manifestation of digitalis toxicity. Can.J Ophthalmol. 2006;41(5):603-604.
Packer M, Gheorghiade M, Young JB, Costantini PJ, Adams KF, Cody RJ, Smith LK, Van Voorhees L, Gourley LA, Jolly MK. Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting-enzyme inhibitors. RADIANCE Study. N.Engl.J Med 7-1-1993;329(1):1-7.
Poole-Wilson PA. Digitalis: dead or alive? Cardiology 1988;75 Suppl 1:103-109.
Simpkiss M, Holt D. Digitalis poisoning due to the accidental ingestion of foxglove leaves. Ther.Drug Monit. 1983;5(2):217.
Slifman NR, Obermeyer WR, Aloi BK, Musser SM, Correll WA Jr, Cichowicz SM, Betz JM, Love LA. Contamination of botanical dietary supplements by Digitalis lanata. N.Engl.J.Med. 9-17-1998;339(12):806-811.
Wade OL. Digoxin 1785-1985. I. Two hundred years of digitalis. J.Clin.Hosp.Pharm. 1986;11(1):3-9.