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Oleander - White Oleander

Scientific Name(S): Nerium oleander L. Synonymous with N. indicum Mill. Family: Apocyanaceae

Common Name(S): Oleander, adelfa, laurier rose, rosa laurel, rose bay, rosa francesa. Should not be confused with yellow oleand0er (Thevetia neriifolia), also a toxic plant.

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.

Botany: The oleander is a shrub that grows to about 20 feet in height. It has long narrow leaves that attain almost a foot in length, and these are typically grouped in threes around the stem. The red, pink or white fluffy flowers form in small clusters. Cultivated plants rarely produce fruits. Although native to the Mediterranean, the oleander is widely cultivated throughout warm climates.

History: Despite its well recognized toxic potential, the oleander has been used in traditional medicine for centuries. Its uses included the management of such diverse ailments as cardiac illnesses, asthma, corns, cancer and epilepsy.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. 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.

Abnormal menstruation, alcoholism, anorexia, anti-fertility, anti-inflammatory, anti-parasitic, asthma, bacterial infections, cachexia (weight loss/wasting from some diseases), cardiac abnormalities, cathartic, corns, diuretic (increase urine flow), epilepsy (seizure), eye diseases, heart disease, hemorrhoids, indigestion, inflammation, insecticide, leprosy, malaria, menstrual stimulant, neurologic disorders, pregnancy termination, psoriasis, psychiatric disorders, rat poison, ringworm, sinus problems, snake bites, skin diseases, skin eruptions, swelling, venereal disease, vomiting, warts, weight gain.

Side Effects of Oleander

Oleander toxicity signs include pain in the oral cavity, nausea, emesis, abdominal pain, cramping, and diarrhea. Extreme toxicity precludes its use in any form.

Oleander is toxic and should be avoided by pregnant or breastfeeding women.

Toxicology: The entire oleander plant is toxic. Smoke from the plant and water in which the plant has been immersed also can be toxic.

In birds, as little as 0.12 to 0.7 g of the plant has been found to cause death. A horse can be killed by as few as 15 to 20 g of fresh leaves and a sheep by 1 to 5 g.

Deaths have been reported in children who ingested a handful of flowers and in adults who used the fresh twigs as meat skewers; the nectar makes honey toxic.

Symptoms of oleander toxicity include pain in the oral cavity, nausea, emesis, abdominal pain, cramping and diarrhea. Special attention must be given to cardiac function. The cardioactive glycosides may induce conduction defects such as sinus bradycardia, and systemic hyperkalemia induced by the plant may worsen cardiac function.

Oleander toxicity should be managed aggressively. Gastric lavage or induced emesis should be done, and activated charcoal may be administered orally. Saline cathartics have been reported to be of use. ECG monitoring for cardiac impairment and monitoring of serum potassium levels should be done frequently, and the conduction defects managed with atropine, phenytoin, transvenous pacing or other appropriate antiarrhythmic treatment, depending on the characteristics of the impairment.

Assays for serum digoxin levels were reported to have been conducted in a patient who ingested oleander; the levels of the glycoside were high (4.4 ng/ml) and were associated with bradyarrhythmias and tachyarrhythmias, which decreased as the serum concentration of the toxin decreased. Another patient who ingested seven oleander leaves in a suicide attempt demonstrated digoxin serum levels of 5.69 nmol/L using a digoxin radioimmunoassay. This assay confirmed the toxicity, but did not predict the severity of the toxicity.

In dogs given a tincture of oleander IV, the administration of large doses of a digoxin-specific Fab resulted in the survival of all five treated dogs (3 of 5 untreated dogs died) with a conversion to normal sinus rhythm within 8 minutes of Fab infusion. These antibodies have been used successfully to treat human oleander toxicity.

Summary: The oleander is an extremely toxic plant that is grown widely as an ornamental. Although it has been used in traditional medicine, its extreme toxicity precludes its use in any form.