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Oleander (Nerium oleander, Thevetia peruviana) Be aware that the U.S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain oleander. Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with their pharmacist or health care provider before starting.
Scientists have studied oleander for the following health problems: Congestive heart failure | Oleander is used in countries outside the United States for treating symptoms of congestive heart failure; it is similar to the drug digoxin. However, scientific studies in humans are lacking, and safe doses have not been established. | Cancer | There is evidence from laboratory experiments that oleander may have anti-tumor properties. However, there are no studies in humans evaluating this claim. Therefore, it is not clear what effect oleander has in treating or preventing cancers. |
Oleander has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care provider before taking oleander for any unproven use. Abnormally low weight
Abortion
Alcoholism
Anorexia
Antifertility
Anti-inflammatory
Asthma
Bacterial infections
Cardiac abnormalities
Cathartic
Corns
Diuretic
Emetic
Epilepsy
Eye diseases
Heart tonic
Hemorrhoids
Indigestion
Inflammation | Insecticide
Leprosy
Malaria
Menstrual cramps
Menstrual stimulant
Nerve disorders
Parasites
Psoriasis
Psychiatric disorders
Rat poison
Ringworm
Sinus problems
Skin diseases
Skin eruptions
Snakebites
Swelling
Venereal disease
Warts
Weight gain |
Allergies People with known allergy should avoid oleander. Signs of allergy may include rash, itching or shortness of breath. Skin irritation may occur from contact with freshly cut oleander leaves. Side Effects Oleander is generally considered unsafe for internal use. Extracts from oleander have been used as rat poison, insecticide and fish poison and are toxic to humans. Accidental deaths and suicides have occurred after taking oleander by mouth. The cause of death is probably related to oleander?s effects on the heart. Possible benefits must be weighed carefully with the risk of toxicity. When using oleander, some people may experience stomach discomfort, including pain, anorexia, diarrhea, vomiting or nausea. Liver and kidney damage has also been reported. Oleander may have significant adverse effects on the heart, resulting in complete heart block, extremely slow heart rhythms, irregular rhythms or rapid, pounding heartbeat. Potassium levels in the body may become dangerously high with oleander. Depression, difficulty breathing, vision abnormalities and ringing in the ears have also occurred. Other side effects may include nerve pain, weakness and fatigue, irritability, altered level of consciousness, dizziness, seizures, headaches, sweating and neck stiffness. Skin irritation may occur after contact with sap from freshly cut oleander leaves. These adverse effects may be the result of oleander allergies. It is possible that plants grown in the same soil as oleander plants or in soil exposed to oleander may contain trace amounts of oleander. Pregnancy And Breast-Feeding Oleander cannot be recommended during pregnancy and breast-feeding because of the risk of birth defects or spontaneous abortion.
Interactions with drugs, supplements and other herbs have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with your health care provider or pharmacist before using herbs or dietary supplements. Interactions With Drugs Oleander has similar cardiac glycoside properties to digoxin (Lanoxin), and the adverse effects of oleander on the heart are likely to be increased if it is taken with digoxin or digitoxin. Many drugs interact with digoxin, and because of the similarities between oleander and digoxin, these drugs may also increase the toxicity of oleander. Examples include erythromycin, tetracycline, quinine, laxatives, antiarrhythmic agents and diuretics. Oleander toxicity may also be increased if used with drugs that lower potassium levels, such as some diuretics or laxatives. Interactions With Herbs And Dietary Supplements Oleander may have an increased risk of toxic effects if used with other herbs that possess glycoside properties, such as foxglove. Additionally, these toxic effects may be increased if used with other supplements that affect the heart, such as calcium; those that cause potassium loss, such as licorice ( Glycyrrhiza glabra); or herbs with laxative properties, such as senna; or herbs with diuretic (urine-producing) properties, such as horsetail.
The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient and may not be effective. Appropriate dosing should be discussed with a health care provider before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas. There are no standard or well-studied doses of oleander, and many different doses are used traditionally. Adults (Aged 18 Or Older) Because of the risks of toxicity, no specific dose of oleander can be recommended. Studies have used 1.8 to 3.2 milligrams as an initial dose of oleander by mouth, followed by 0.6 milligrams daily by mouth. However, safety has not been established. Children (Younger Than 18) There are not enough scientific data to recommend oleander for use in children, and oleander is not recommended because of the risk of significant toxicity and death.
Oleander has been suggested as a treatment for many conditions and has been most studied as a treatment for symptoms of congestive heart failure. However, there is not enough scientific evidence to support the use of oleander for any medical condition. Oleander may be associated with significant toxicity, especially with harmful effects on the heart. It may interact with many drugs, herbs or supplements. It should be avoided in pregnant or breast-feeding women and in children. Consult your health care provider immediately if you have any side effects. The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.
- Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
- National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research
Selected Scientific Studies: Oleander Natural Standard reviewed more than 170 articles to prepare the professional monograph from which this version was created. Some of the more recent articles are listed below: - 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):1935-1938.
- 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):219-221.
- 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. Patterns and problems of deliberate self-poisoning in the developing world. QJM 2000;93(11):715-731.
- Eddleston M, Persson H. Acute plant poisoning and antitoxin antibodies. J Toxicol Clin Toxicol 2003;41(3):309-315.
- Eddleston M, Warrell DA. Management of acute yellow oleander poisoning. QJM 1999;92(9):483-485.
- 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):293-295.
- 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):523-524.
- Lim DC, Hegewald K, Dandamudi N. A suicide attempt with an oleander cocktail. Chest 1999;116(4):405S-406S.
- 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.
- 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):1686-1688.
Last updated June 20, 2005
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