- What other names is Oleander known by?
- What is Oleander?
- How does Oleander work?
- Are there safety concerns?
- Are there any interactions with medications?
- Dosing considerations for Oleander.
Adelfa, Baladre, Cascabela thevetia, Cerbera thevetia, Common Oleander, Exile Tree, Huang Hua Jia, Jia Zhu Tao, Kaner, Karvir, Karvira, Laurel Rosa, Laurier-Rose, Laurier Rose, Laurose, Nérier à Feuilles de Laurier, Nérion, Nerium indicum, Nerium Oleander, Nerium odorum, Oleanderblatter, Oléandre, Oleandri Folium, Rose Bay, Rose Laurel, Sweet Scented Oleander, Thevetia neriifolia, Thevetia peruviana, Yellow Oleander.
Oleander is a plant. Its use as a poison is well known. In fact, oleander is reportedly a favorite suicide agent in Sri Lanka, where oleander poisonings exceed 150 per 100,000 each year. That's a high number. Approximately 10% of these ingestions are fatal.
Despite the danger, oleander seeds and leaves are used to make medicine. Oleander is used for heart conditions, asthma, epilepsy, cancer, painful menstrual periods, leprosy, malaria, ringworm, indigestion, and venereal disease; and to cause abortions.
A fixed combination of oleander leaf powdered extract, pheasant's eye fluid extract, lily-of-the-valley fluid extract, and squill powdered extract has been used for treating mild heart failure.
Oleander is sometimes applied to the skin to treat skin problems and warts.
Insufficient Evidence to Rate Effectiveness for...
Oleander contains chemicals called glycosides, which can affect the heart. These chemicals can slow the heart rate down.
Injecting a specific oleander product (Anvirzel) into the muscle is POSSIBLY SAFE when administered by a healthcare professional.
Oleander is LIKELY UNSAFE for anyone to take by mouth. It can cause a burning sensation in the mouth, nausea, vomiting, diarrhea, weakness, headache, stomach pain, serious heart problems, and many other side effects. Taking the oleander leaf, oleander leaf tea, or oleander seeds has led to deadly poisonings.
There isn't enough information to know whether or not it is safe to apply oleander to the skin. It's best not to do this.
Special Precautions & Warnings:It's LIKELY UNSAFE for anyone to take oleander by mouth. But oleander is especially dangerous for people with the following conditions:
Children: Oleander is LIKELY UNSAFE when taken by mouth in children. Taking the oleander leaf, oleander leaf tea, or oleander seeds has led to deadly poisonings.
Pregnancy and breast-feeding: Taking oleander by mouth is LIKELY UNSAFE as it might cause an abortion or cause birth defects. There isn't enough information to know whether or not it is safe for pregnant or breast-feeding women to apply oleander to the skin. Stay on the safe side and avoid use.
Too little potassium or too much calcium (electrolyte imbalance): Oleander affects the heart. An electrolyte imbalance also affects the heart. It's especially dangerous to use oleander if you have an electrolyte imbalance.
Antibiotics (Macrolide antibiotics)Interaction Rating: Major Do not take this combination.
Oleander can affect the heart. Some antibiotics might increase how much oleander the body absorbs. Increasing how much oleander the body absorbs might increase the effects and side effects of oleander.
Antibiotics (Tetracycline antibiotics)Interaction Rating: Major Do not take this combination.
Taking some antibiotics called tetracycline antibiotics along with oleander might increase the chance of side effects from oleander.
Digoxin (Lanoxin)Interaction Rating: Major Do not take this combination.
Digoxin (Lanoxin) helps the heart beat more strongly. Oleander also seems to affect the heart. Taking oleander along with digoxin can increase the effects of digoxin and increase the risk of side effects. Do not take oleander if you are taking digoxin (Lanoxin) without talking to your health care professional.
QuinineInteraction Rating: Major Do not take this combination.
Oleander can affect the heart. Quinine can also affect the heart. Taking quinine along with oleander might cause serious heart problems.
Stimulant laxativesInteraction Rating: Major Do not take this combination.
Oleander can affect the heart. The heart uses potassium. Laxatives called stimulant laxatives can decrease potassium levels in the body. Low potassium levels can increase the chance of side effects from taking oleander.
Water pills (Diuretic drugs)Interaction Rating: Major Do not take this combination.
Oleander might affect the heart. "Water pills" can decrease potassium in the body. Low potassium levels can also affect the heart and increase the risk of side effects from oleander.
Calcium supplementsInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Oleander can stimulate the heartbeat. Calcium might also affect the heart. Taking oleander along with calcium might cause the heart to be too stimulated. Do not take oleander along with calcium supplements.
The appropriate dose of oleander depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for oleander. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
Health Solutions From Our Sponsors
Ada, S. E., Al Yahya, M. A., and Al Farhan, A. H. Acute toxicity of various oral doses of dried Nerium oleander leaves in sheep. Am J Chin Med 2001;29(3-4):525-532. View abstract.
Ahlawat, S. K., Agarwal, A. K., and Wadhwa, S. Rare poisoning with cerebra thevetia (yellow oleander): a report of three cases. Trop.Doct. 1994;24(1):37-38. View abstract.
Al Yahya, M. A., Al Farhan, A. H., and Adam, S. E. Preliminary toxicity study on the individual and combined effects of Citrullus colocynthis and Nerium oleander in rats. Fitoterapia 2000;71(4):385-391. View abstract.
Ansford, A. J. and Morris, H. Fatal oleander poisoning. Med J Aust. 4-4-1981;1(7):360-361. View abstract.
Apted, J. Oleander dermatitis. Contact Dermatitis 1983;9(4):321. View abstract.
Arnold HL, Middleton WS, and Chen KK. The action of thevetin, a cardiac glucoside, and its clinical application. Amer Heart J 1935;189:193-206.
Arriola, Martinez P., Montero, Aparicio E., Martinez, Odriozola P., and Miguel, de la, V. [Toxicity due to oleander (Nerium oleander) ingestion]. Med Clin (Barc.) 11-18-2006;127(19):759. View abstract.
Bhatia, M. L., Manchanda, S. C., and Roy, S. B. Haemodynamic studies with peruvoside in human congestive heart failure. Br Med J 9-26-1970;3(725):740-743. View abstract.
Bhatia, M. L., Manchanda, S. S., Gupta, S. P., and Roy, S. B. Clinical and haemodynamic studies with peruvoside (Cd. 421) in congestive heart failure. Indian Heart J 1971;23(2):159-163. View abstract.
Blum, L. M. and Rieders, F. Oleandrin distribution in a fatality from rectal and oral Nerium oleander extract administration. J Anal.Toxicol. 1987;11(5):219-221. View abstract.
Bose, T. K., Basu, R. K., Biswas, B., De, J. N., Majumdar, B. C., and Datta, S. Cardiovascular effects of yellow oleander ingestion. J Indian Med Assoc. 1999;97(10):407-410. View abstract.
Bourgeois, B., Incagnoli, P., Hanna, J., and Tirard, V. [Nerium oleander self poisoning treated with digoxin-specific antibodies]. Ann.Fr.Anesth.Reanim. 2005;24(6):640-642. View abstract.
Brewster, D. Herbal poisoning: a case report of a fatal yellow oleander poisoning from the Solomon Islands. Ann.Trop.Paediatr. 1986;6(4):289-291. View abstract.
Burton, L. E., Picchioni, A. L., and Chin, L. Dipotassium edetate as an antidote in poisoning from oleander and its chief glycoside, oleandrin. Arch Int Pharmacodyn.Ther. 1965;158(1):202-211. View abstract.
Camphausen, C., Haas, N. A., and Mattke, A. C. Successful treatment of oleander intoxication (cardiac glycosides) with digoxin-specific Fab antibody fragments in a 7-year-old child: case report and review of literature. Z Kardiol. 2005;94(12):817-823. View abstract.
Carranza EM, Rodriguez JG, Marquez Moreno MD, and et al. [Digitalis poisoning by the leaves of Nerium oleander (common oleander)]. Revista Clin Espan 1995;195(7):516.
Cheung, K., Hinds, J. A., and Duffy, P. Detection of poisoning by plant-origin cardiac glycoside with the Abbott TDx analyzer. Clin Chem 1989;35(2):295-297. View abstract.
Clark, R. F., Selden, B. S., and Curry, S. C. Digoxin-specific Fab fragments in the treatment of oleander toxicity in a canine model. Ann Emerg.Med 1991;20(10):1073-1077. View abstract.
Dasgupta, A. and Hart, A. P. Rapid detection of oleander poisoning using fluorescence polarization immunoassay for digitoxin. Effect of treatment with digoxin-specific Fab antibody fragment (ovine). Am J Clin.Pathol. 1997;108(4):411-416. View abstract.
Dasgupta, A., Cao, S., and Wells, A. Activated charcoal is effective but equilibrium dialysis is ineffective in removing oleander leaf extract and oleandrin from human serum: monitoring the effect by measuring apparent digoxin concentration. Ther Drug Monit. 2003;25(3):323-330. View abstract.
Datta, P. and Dasgupta, A. Interference of oleandrin and oleandrigenin in digitoxin immunoassays: minimal cross reactivity with a new monoclonal chemiluminescent assay and high cross reactivity with the fluorescence polarization assay. Ther.Drug Monit. 1997;19(4):465-469. View abstract.
de Silva, H. A., Fonseka, M. M., Pathmeswaran, A., Alahakone, D. G., Ratnatilake, G. A., Gunatilake, S. B., Ranasinha, C. D., Lalloo, D. G., Aronson, J. K., and de Silva, H. J. Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial. Lancet 6-7-2003;361(9373):1935-1938. View abstract.
Dorsey CS. Plant dermatitis in California. Calif Med 1962;96(6):412-413.
Durakovic, Z., Durakovic, A., and Durakovic, S. Oleander poisoning treated by resin haemoperfusion. J Indian Med Assoc. 1996;94(4):149-150. View abstract.
Eddleston, M. and Warrell, D. A. Management of acute yellow oleander poisoning. QJM. 1999;92(9):483-485. View abstract.
Eddleston, M. Patterns and problems of deliberate self-poisoning in the developing world. QJM. 2000;93(11):715-731. View abstract.
Eliot RS and Blount SG. Calcium, chelates, and digitalis. A clinical study. Amer Heart J 1961;62(1):7-21.
Fu, L., Zhang, S., Li, N., Wang, J., Zhao, M., Sakai, J., Hasegawa, T., Mitsui, T., Kataoka, T., Oka, S., Kiuchi, M., Hirose, K., and Ando, M. Three new triterpenes from Nerium oleander and biological activity of the isolated compounds. J Nat Prod. 2005;68(2):198-206. View abstract.
Goerre, S. and Frohli, P. [A case from practice (261). Poisoning with digitoxin-like glycosides following eating of oleander leaves]. Schweiz.Rundsch.Med Prax. 1-26-1993;82(4):121-122. View abstract.
Gupta, A., Joshi, P., Jortani, S. A., Valdes, R., Jr., Thorkelsson, T., Verjee, Z., and Shemie, S. A case of nondigitalis cardiac glycoside toxicity. Ther.Drug Monit. 1997;19(6):711-714. View abstract.
Juurlink, D. N. and Sivilotti, M. L. Multidose activated charcoal for yellow oleander poisoning. Lancet 8-16-2003;362(9383):581. View abstract.
Kakrani, A. L., Rajput, C. S., Khandare, S. K., and Redkar, V. E. Yellow oleander seed poisoning with cardiotoxicity. A case report. Indian Heart J 1981;33(1):31-33. View abstract.
Kaojarern, S., Sukhupunyarak, S., and Mokkhavesa, C. Oleander Yee tho poisoning. J Med Assoc.Thai. 1986;69(2):108-112. View abstract.
Lim DC, Hegewald K, and Dandamudi N. A suicide attempt with an oleander cocktail. Chest 1999;116(4):405S-406S.
Mallick, B. K. Cardiotoxicity in yellow oleander seed poisoning. J Indian Med Assoc. 1984;82(8):296-297. View abstract.
Manna, S. K., Sah, N. K., Newman, R. A., Cisneros, A., and Aggarwal, B. B. Oleandrin suppresses activation of nuclear transcription factor-kappaB, activator protein-1, and c-Jun NH2-terminal kinase. Cancer Res. 7-15-2000;60(14):3838-3847. View abstract.
McConkey, D. J., Lin, Y., Nutt, L. K., Ozel, H. Z., and Newman, R. A. Cardiac glycosides stimulate Ca2+ increases and apoptosis in androgen- independent, metastatic human prostate adenocarcinoma cells. Cancer Res. 7-15-2000;60(14):3807-3812. View abstract.
Mekhail, T., Kaur, H., Ganapathi, R., Budd, G. T., Elson, P., and Bukowski, R. M. Phase 1 trial of Anvirzel in patients with refractory solid tumors. Invest New Drugs 2006;24(5):423-427. View abstract.
Mesa, M. D., Anguita, M., Lopez-Granados, A., Vivancos, R., Suarez, de Lezo, Valles, F., and Bueno, G. [Digitalis poisoning from medicinal herbs. Two different mechanisms of production]. Rev.Esp.Cardiol. 1991;44(5):347-350. View abstract.
Middleton, WS and Chen, KK. Clinical results from oral administration of thevetin, a cardiac glycoside. Amer Heart J 1936;11:75-88.
Misra, A. Poisoning from Thevetia nerifolia (yellow oleander). Postgrad.Med J 1990;66(776):492. View abstract.
Nishioka, Sd and Resende, E. S. Transitory complete atrioventricular block associated to ingestion of Nerium oleander. Rev Assoc Med Bras 1995;41(1):60-62. View abstract.
Pathak, S., Multani, A. S., Narayan, S., Kumar, V., and Newman, R. A. Anvirzel, an extract of Nerium oleander, induces cell death in human but not murine cancer cells. Anticancer Drugs 2000;11(6):455-463. View abstract.
Pietsch, J., Oertel, R., Trautmann, S., Schulz, K., Kopp, B., and Dressler, J. A non-fatal oleander poisoning. Int J Legal Med 2005;119(4):236-240. View abstract.
Roberts, D. M. and Eddleston, M. Yellow oleander poisoning. 2005;189-200.
Roberts, D. M., Southcott, E., Potter, J. M., Roberts, M. S., Eddleston, M., and Buckley, N. A. Pharmacokinetics of digoxin cross-reacting substances in patients with acute yellow Oleander (Thevetia peruviana) poisoning, including the effect of activated charcoal. Ther Drug Monit. 2006;28(6):784-792. View abstract.
Safadi, R., Levy, I., Amitai, Y., and Caraco, Y. Beneficial effect of digoxin-specific Fab antibody fragments in oleander intoxication. Arch Intern.Med 10-23-1995;155(19):2121-2125. View abstract.
Samal, K. K. Yellow oleander poisoning with jaundice and renal failure. J Assoc Physicians India 1990;38(10):821-822. View abstract.
Samal, K. K., Sahu, H. K., Kar, M. K., Palit, S. K., Kar, B. C., and Sahu, C. S. Yellow oleander (cerbera thevetia) poisoning with jaundice and renal failure. J Assoc Physicians India 1989;37(3):232-233. View abstract.
Saraswat, D. K., Garg, P. K., and Saraswat, M. Rare poisoning with cerebra thevetia (yellow oleander). Review of 13 cases of suicidal attempt. J Assoc Physicians India 1992;40(9):628-629. View abstract.
Saravanapavananthan, N. and Ganeshamoorthy, J. Yellow oleander poisoning--a study of 170 cases. Forensic Sci.Int 1988;36(3-4):247-250. View abstract.
Shaw, D. and Pearn, J. Oleander poisoning. Med J Aust. 9-8-1979;2(5):267-269. View abstract.
Siddiqui, B. S., Sultana, R., Begum, S., Zia, A., and Suria, A. Cardenolides from the methanolic extract of Nerium oleander leaves possessing central nervous system depressant activity in mice. J Nat.Prod. 1997;60(6):540-544. View abstract.
Smith, J. A., Madden, T., Vijjeswarapu, M., and Newman, R. A. Inhibition of export of fibroblast growth factor-2 (FGF-2) from the prostate cancer cell lines PC3 and DU145 by anvirzel and its cardiac glycoside component, oleandrin(1). Biochem Pharmacol. 8-15-2001;62(4):469-472. View abstract.
Storz, H. [On the effect of the oleander glycoside Corrigen (Oleandrin). Clinical studies]. Med Welt 7-15-1967;28:1650-1655. View abstract.
Thilagar, S., Thirumalaikolundusubramanian, P., Gopalakrishnan, S., Lakshmikandan, R., Ayyappan, A., and Subramanian, R. Possible yellow oleander toxicity in a neonate. Indian Pediatr 1986;23(5):393. View abstract.
Wang, X., Plomley, J. B., Newman, R. A., and Cisneros, A. LC/MS/MS analyses of an oleander extract for cancer treatment. Anal.Chem 8-1-2000;72(15):3547-3552. View abstract.
Wenger, T. L., Butler, V. P., Jr., Haber, E., and Smith, T. W. Treatment of 63 severely digitalis-toxic patients with digoxin-specific antibody fragments. J Am Coll Cardiol 1985;5(5 Suppl A):118A-123A. View abstract.
Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.
Chiesara E, Borghini R, Marabini. Dietary fibre and drug interactions. Eur J Clin Nutr 1995;49:S123-8.
Corrigan JJ Jr. Coagulation problems relating to vitamin E. Am J Pediatr Hematol Oncol 1979;1:169-73. View abstract.
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. View abstract.
Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
Foster S, Tyler VE. Tyler's Honest Herbal, 4th ed., Binghamton, NY: Haworth Herbal Press, 1999.
Franklyn AJ, Bettenridge J, Daykin J, et al. Long-term thyroxine treatment and bone mineral density. Lancet 1992;340:9-13. View abstract.
Furbee B, Wermuth M. Life-threatening plant poisoning. Crit Care Clin 1997;13:849-88. View abstract.
Haynes BE, Bessen HA, Wightman WD. Oleander tea: herbal draught of death. Ann Emerg Med 1985;14:350-3. View abstract.
Hibbard MK, Sandri-Goldin, RM. Arginine-rich regions succeeding the nuclear localization region of the herpes simplex virus type 1 regulatory protein ICP27 are required for efficient nuclear localization and late gene expression. J Virol 1995;69:4656-7. View abstract.
Langford SD, Boor PJ. Oleander toxicity: an examination of human and animal toxic exposures. Toxicology 1996;109:1-13. View abstract.
Price JF. Antioxidant vitamins in the prevention of cardiovascular disease. The epidemiological evidence. Eur Heart J 1997;18:719-27.
Srivastava Y, Venkatakrishna-Bhatt H, Verma Y, et al. Antidiabetic and adaptogenic properties of Momordica charantia extract: An experimental and clinical evaluation. Phytother Res 1993;7:285-9.