Thevetia peruviana

Related Terms

Adelfa, adynerin, ahouai (Antilles), ahousin, Anvirzel?, Apocyanaceae (family), ashwahan, ashwamarak (Sanskrit), be-still nuts (Hawaiian), betulin, betulinic acid, boissaisi (Haitian), cardenolides, cardiac glycosides, cascaveleira (Brazilian), Cerebra thevetia (Indian), cerebrine, cerebrose, common oleander, corrigen, dehydroadynerigen, digitoxigenin, dogbane, exile, folinerin, horse poison, joro-joro (Dutch Guiana), karavira, karier, kohilphin, kokilpal (Indian), L-thevetose, laurier blane (Haitian), laurier bol, laurier desjundins, laurier rose, lorier bol, lucky seed (Jamaican), neriantin, neridiginoside, neridlenone A, neriifolin, neriine, nerin, nerioside, neritaloside, Nerium indicum, Nerium odorum, nerizoside, NOAG-II, odoroside H, oleanderblatter, Oleandri folium, oleandrigenin, oleandrin, oleandrinogen, oleandroside, oleanolic acid, olinerin, peruvoside, pila kaner (Indian), pink oleander, rosa francesa, rosagenin, rosebay, rose laurel, rosen lorbeer, ruvoside, soland, strospeside, Thevetia nerifolia, Thevetia neriifolia, thevetin A, thevetin B, thevetine, thevetoxin, triterpenes, white oleander, yee tho (Thai), yellow oleander.

Background

The term "oleander" refers to two plant species, Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander), which grow in temperate climates throughout the world. Both species contain chemicals called "cardiac glycosides" that have effects similar to the heart drug digoxin. Both species can be toxic when taken by mouth with many documented reports of deaths.

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 *


Laboratory studies of oleander suggest possible anti-cancer effects, although reliable research in humans is not currently available. There are reports that long-term use of oleander may have positive effects in patients with leiomyosarcoma, Ewing's sarcoma, prostate cancer, or breast cancer. More research is needed before a recommendation can be made.

C


Laboratory studies of oleander suggest possible anti-cancer effects, although reliable research in humans is not currently available. There are reports that long-term use of oleander may have positive effects in patients with leiomyosarcoma, Ewing's sarcoma, prostate cancer, or breast cancer. More research is needed before a recommendation can be made.

C


The term "oleander" refers to two plants: Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander). Both plants contain heart-active "cardiac glycoside" chemicals (similar to the prescription drug digoxin) and have been associated with serious side effects in humans, including death. The plants have been used to treat heart failure in China and Russia for decades, but scientific evidence supporting use is limited to small, poorly designed studies. Human research began in the 1930s, but was largely abandoned due to serious gastrointestinal and heart toxicity.

It should be noted that the drug digoxin may improve symptoms of congestive heart failure, but does not improve mortality (length of life).

 C


The term "oleander" refers to two plants: Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander). Both plants contain heart-active "cardiac glycoside" chemicals (similar to the prescription drug digoxin) and have been associated with serious side effects in humans, including death. The plants have been used to treat heart failure in China and Russia for decades, but scientific evidence supporting use is limited to small, poorly designed studies. Human research began in the 1930s, but was largely abandoned due to serious gastrointestinal and heart toxicity.

It should be noted that the drug digoxin may improve symptoms of congestive heart failure, but does not improve mortality (length of life).

 C
* 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)
Safety has not been established for any dose of oleander. Peruvoside, a heart-active substance in yellow oleander kernels (similar to the drug digoxin), has been studied at 1.8 to 3.2 milligrams by mouth, as an initial dose, followed by an average daily dose of 0.6 milligrams per day for congestive heart failure.

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
Based on animal and human studies, common oleander and yellow oleander contain cardiac glycoside heart-active substances similar to the drug digoxin. There may be an increased risk of unwanted side effects or damage to the heart if taken with other heart-active drugs, such as digoxin (Lanoxin?) or anti-arrhythmics.
Because oleander is similar to the drug digoxin, it may share some of the same interactions, although this has not been thoroughly studied.
Low potassium levels in the blood may increase the dangerous side effects of oleander. Therefore, oleander should be used cautiously with drugs that may lower potassium levels, such as laxatives or some diuretics (drugs that increase urine flow).
Oleander may interact with abortifacients, antibiotics, antidepressants, blood pressure-lowering drugs, antineoplastics, contraceptives, hormonal drugs, immunosuppressants, and neurologic drugs.

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

Arao T, Fuke C, Takaesu H, et al. Simultaneous determination of cardenolides by sonic spray ionization liquidchromatography-ion trap mass spectrometry--a fatal case of oleander poisoning. J Anal Toxicol 2002 May-Jun;26(4):222-7.
Bose TK, Basu RK, Biswas B, et al. Cardiovascular effects of yellow oleander ingestion. J Indian Med Assoc 1999;97(10):407-410.
de Silva HA, Fonseka MM, Pathmeswaran A, et al. Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial. Lancet 2003 Jun 7;361(9373):1935-8.
Downer J, Craigmill A, Holstege D. Toxic potential of oleander derived compost and vegetables grown with oleander soil amendments. Vet Hum Toxicol 2003 Aug;45(4):219-21.
Eddleston M, Ariaratnam CA, Sjostrom L, et al. Acute yellow oleander (Thevetia peruviana) poisoning: cardiac arrhythmias, electrolyte disturbances, and serum cardiac glycoside concentrations on presentation to hospital. Heart 2000;83(3):301-306.
Eddleston M, Warrell DA. Management of acute yellow oleander poisoning. QJM 1999;92(9):483-485.
Eddleston M, Persson H. Acute plant poisoning and antitoxin antibodies. J Toxicol Clin Toxicol 2003;41(3):309-15.
Fonseka MM, Seneviratne SL, de Silva CE, et al. Yellow oleander poisoning in Sri Lanka: outcome in a secondary care hospital. Hum Exp Toxicol 2002 Jun;21(6):293-5.
Juurlink DN, Sivilotti ML. Multidose activated charcoal for yellow oleander poisoning. Lancet 2003 Aug 16;362(9383):581; author reply 581.
Le Couteur DG, Fisher AA. Chronic and criminal administration of Nerium oleander. J Toxicol Clin Toxicol 2002;40(4):523-4.
Mekhail T, Kaur H, Ganapathi R, et al. Phase 1 trial of Anvirzel in patients with refractory solid tumors. Invest New Drugs 2006;24(5):423-427.
Monzani V, Rovellini A, Schinco G, et al. Acute oleander poisoning after a self-prepared tisane. J Toxicol Clin Toxicol 1997;35(6):667-668.
Ni D, Madden TL, Johansen M, Felix E, et al. Murine pharmacokinetics and metabolism of oleandrin, a cytotoxic component of Nerium oleander. J Exp Ther Oncol 2002 Sep-Oct;2(5):278-85.
Nishioka S, Resende ES. Transitory complete atrioventricular block associated to ingestion of Nerium oleander. Rev Assoc Med Bras 1995;41(1):60-62.
Wojtyna W, Enseleit F. A rare cause of complete heart block after transdermal botanical treatment for psoriasis. Pacing Clin Electrophysiol 2004 Dec;27(12):1686-8.