|
Other common
name(s): oleander, dogbane, laurier rose, rosebay,
Anvirzel, Xenavex, SAOB-0401
Scientific/medical
name(s): Nerium
oleander, Oleandri polium, Thevetia peruviana
Description
Oleander is a poisonous evergreen shrub or small tree
identified by its fragrant white, red, pink, or purple flowers and long
slender, leathery leaves, which grow in pairs opposite each other or in
whorls of 3. It grows in mild climates or as an indoor plant. The
active ingredients are extracted from the leaves, but all parts of the
plant are poisonous.
Overview
Oleander extracts—in carefully controlled
doses—are in the early phases of testing to find out whether
they are effective in treating cancer. There have been numerous reports
of poisoning and death from ingestion of oleander, oleander leaf tea,
and its extracts. It has killed adults, children, pets, and livestock.
Even a small amount of oleander can cause death due to its effects on
the heart. Inhaling the smoke from burning oleander or eating honey
made from its nectar can produce poisonous effects. Since such tiny
amounts can cause death, oleander supplements and extracts from any
part of the oleander plant should not be used except under the careful
observation and controlled conditions of a clinical trial.
How is it promoted for use?
Even though oleander is poisonous, heavily diluted oleander
preparations have been promoted to treat a variety of conditions
including muscle cramps, asthma, corns, menstrual pain, epilepsy,
paralysis, skin diseases, heart problems, and cancer. It has also been
used in folk remedies as an insecticide and to kill rats.
What does it involve?
There is no established therapeutic dose of oleander extract.
The oleander leaf is on the Commission E (Germany's regulatory agency
for herbs) list of unapproved herbs. This means that it is not
recommended for use because it has not been proven to be safe or
effective. The plant parts are toxic, whether cooked, raw, or made into
tea.
An injectable oleander extract with the brand name of Anvirzel
was available at one time, but it has not been approved for marketing
by the U.S. Food and Drug Administration (FDA). In March 2000, the FDA
warned Anvirzel’s manufacturers to stop promoting the product
as safe and effective after it found misleading information on their
Web site. The FDA noted that claims were being made based on
preliminary and inconclusive data. A company cannot claim a drug is
safe and effective unless it has been fully tested and shown to be so.
What is the history behind it?
Although this plant is poisonous, products made from oleander
have been used for centuries as herbal medicine. Historical records
show that the Mesopotamians in the 15th century B.C. believed in the
healing properties of oleander. The Babylonians used a mixture of
oleander and licorice to treat hangovers. Pliny, the Elder of ancient
Greece, wrote about the appearance and properties of oleander. Arab
physicians first used oleander as a cancer treatment in the 8th century
A.D.
During the 1960s, Huseyin Z. Ozel, MD, a Turkish physician,
began his studies of oleander as an anti-cancer treatment. He developed
an oleander extract that he patented and trademarked in the United
States and Europe as Anvirzel. He began his study because of folk
traditions that suggested that an extract of oleander was effective
against leukemia.
What is the evidence?
The effectiveness of oleander has not been proven. In test
tube studies, oleandrin, one of the substances found in oleander
extracts, caused apoptosis (a specific type of cell death) of prostate
cancer cells. In other test tube studies, Anvirzel appeared to slow the
growth of human bladder cancer cells, but human studies are needed to
determine whether it will work in people. Very early studies of
carefully dosed Anvirzel in people with cancer have not yet shown that
it helps. Side effects included nausea and vomiting, aches, and redness
at the injection site, but the drug did not appear to affect the cancer
in these patients. One very early study of 18 patients with advanced
cancer was done primarily to determine the best dose of the drug. No
measurable responses were noted in patients’ cancer during
this small study. Although there are claims that Anvirzel improves
quality of life, reduces pain, increases energy, and causes cancer
regression and remission, available scientific evidence does not
support these claims.
Another company had planned to offer an oleander extract that
could be placed under the tongue, which they named Xenavex. Phase I and
Phase II clinical trials on Xenavex were announced in 2005 on people
with non–small-cell lung cancer. However, the clinical trials
were not done, and the announcements were later removed from the
federal clinical trials Web site. The company did not return calls or
e-mails about the product.
Before any form of oleander can be recommended for human use,
it must be thoroughly tested in people using the carefully controlled
dosing and observation procedures used in clinical trials.
Are there any possible problems or
complications?
This substance
may not have been thoroughly tested to find out how it interacts with
medicines, foods, herbs, or supplements. Even though some reports of
interactions and harmful effects may be published, full studies of
interactions and effects are not often available. Because of these
limitations, any information on ill effects and interactions below
should be considered incomplete.
The oleander plant is poisonous, and many people have died of
heart failure or respiratory paralysis after eating parts of the plant
or drinking tea made from it. Some of the symptoms and signs of
oleander toxicity are nausea, vomiting, colic, appetite loss,
dizziness, drowsiness, high potassium levels, dilated pupils, bloody
diarrhea, seizures, loss of consciousness, slow or irregular pulse, and
heart block—a blockage of the electrical impulses that
stimulate the heart to contract. There have been reports of death
occurring after oral and/or rectal administration of the extract from
the plant. The FDA has received reports of at least 2 deaths linked to
Anvirzel.
Skin irritation from contact with oleander has occurred and
allergies are possible. One report observed that, when oleander was
taken by a pregnant woman 12 hours before delivery, her baby was
affected with seizures and a slowed heart rate. No other cause for the
seizures and low heart rate was found. This herb should be avoided,
especially by children and by women who are pregnant or breast-feeding.
Relying on this type of treatment alone and avoiding or delaying
conventional medical care for cancer may have serious health
consequences.
Additional Resources
More information from your American Cancer
Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be found on
our Web site (www.cancer.org)
or ordered from our toll-free number (1-800-ACS-2345).
References
Blumenthal M, ed.
The Complete German Commission E Monographs: Therapeutic Guide to
Herbal Medicines. Austin, TX: American Botanical Council;
1998.
Clark RF, Selden BS, Curry SC. Digoxin-specific Fab fragments
in the treatment of oleander toxicity in a canine model. Ann Emerg Med.
1991;20:1073-1077.
Davies MK, Mayne AJ. Oleander poisoning. Arch Dis Child.
2001;84:9.
Fetrow CW, Avila JR. Professional's
Handbook of Complementary & Alternative Medicines.
Philadelphia, PA: Lippincott Williams & Wilkins; 2004.
Gruenwald J. PDR
for Herbal Medicines. 3rd ed. Montvale, NJ: Thomson PDR;
2004.
Lamm D, Ashish K, DeHaven J. Cytotoxic effect of nerium
oleander extract (Anvirzel) on bladder cancer cells. In: Program and
abstracts of the American Society of Clinical Oncology (ASCO) annual
meeting; May 15-19, 1999; Atlanta, Georgia. Abstract 1328.
Langford SD, Boor PJ. Oleander toxicity: examination of human
and animal toxic exposures. Toxicology.
1996;109:1-13.
McConkey DJ, Lin Y, Nutt LK, Ozel HZ, Newman RA. Cardiac
glycosides stimulate Ca2+ increases and apoptosis in
androgen-independent, metastatic human prostate adenocarcinoma cells. Cancer Res.
2000;60:3807-3812.
Mekhail T, Kaur H, Ganapathi R, Budd GT, Elson P, Bukowski RM.
Phase 1 trial of Anvirzel in patients with refractory solid tumors. Inves New Drugs.
2006;24:423-427.
Oleander (nerium oleander, thevetia peruviana). Aetna
InteliHealth Web site.
http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/31402/351437.html.
Updated June 20, 2005. Accessed June 6, 2008.
Thilagar S, Thirumalaikolundusubramanian P, Gopalakrishnan S,
Lakshmikandan R, Ayyappan A, Subramanian R. Possible yellow oleander
toxicity in a neonate. Indian
Pediatr. 1986;23:393.
Turan N, Akgün-Dar K, Kuruca SE,
Kiliçaslan-Ayna T, Seyhan VG, Atasever B, Meriçli
F, Carin M. Cytotoxic effects of leaf, stem and root extracts of Nerium
oleander on leukemia cell lines and role of the p-glycoprotein in this
effect. J Exp Ther Oncol.
2006;6:31-38.
US National Institutes of Health. Clinical trial announcement:
a phase I/II multicenter, off-label, dose escalation study of Xenavex
in patients with advanced (stage IIIB or IV) non-small cell lung
cancer; for whom previous therapy has failed. Clinical Trials Web site.
http://www.clinicaltrials.gov. Accessed October 18, 2005. Content no
longer available.
Note: This information may not cover
all possible claims, uses, actions, precautions, side effects or
interactions. It is not intended as medical advice, and should not be
relied upon as a substitute for consultation with your doctor, who is
familiar with your medical situation.
Last Medical Review: 11/01/2008
Last Revised: 11/01/2008
|
