Thevetia peruviana (Pers.) K. Schum.

Synonyms

Thevetia neriifolia Juss. ex Steud., Cascabela thevetia (L.) Lippold. [1]

Vernacular Names

Malaysia Bunga Loceng Kuning
English Yellow Oleander, Lucky Nut Tree, Trumpet Flower, Milk Bush, Exile Tree, Be-still Tree
China Huang Hua Jia Zhu Tao
Indonesia Ginje, Ki Hujan (Sunda); Oleander (Java)
India Karavira, Viraka, Ashvamaarka, Hayamaara, Gauripushpa, Siddhapushpa, Rakta pushpa, Raktaprasava, Ravipriya (Ayurveda); Kaner, Diflaa, Samm-ul-maar, Khar-zaharah (Unani); Alari, Arabivayr (Siddha)
France Laurier Jaune des Indes, Laurier a Fleurs Juanes, Chapeau de Napoleon, Bois a Lait.
Germany Schellenbaum, Thevetie
Spain Adelfa Amarilla, Azuceno, Bellaquillo, Cabalonga
Portugal Loendro Amarelo, Chapeu de Napoleao
Africa Mbagi (Swahili). [1-4]

General Information

Description

Thevetia peruviana is a member of the Apocyanaceae family. It is a shrub or small tree which can reach up to 8m high. The branches are glabrous, with grey bark and white latex. The leaves are arranged in a spiral manner. They are simple, entire and almost sessile. The leaf blade is linear-lanceolate, 6-15cm x 0.5-1cm with decurrent base and long-acuminated apex. The inflorescence is terminal and sometimes axillary cyme with few flowers. The flowers are bisexual, regular, 5-merous, faintly fragrant. The corolla tube and lobes are yellow to peach pink. The fruit is in the shape of depressed-globose drupe 3-4cm in diameter, yellowish-green when young and turning black upon maturing., Each fruit contains 2-4 seeds within a stony endocarp. The seeds are ovoid, 2cm x 1.5cm, flattened. [1]

Plant Part Used

Barks, leaves, roots, seeds (whole plant). [1-4]

Chemical Constituents

3-[2""-sinapoylglucosyl](1 --> 4)[6"'-sinapoylglucosyl](1 --> 2)galactoside; 5-alpha-adynerin; alpha-amyrin; alpha-amyrin acetate; bernesitol; beta-sitosterol; cerebrin; cerebroside; digitoxigenin-alpha-L-oleandroside; eruvoside-e-monoactetate; gentiobiosyloleandrin; isolupenyl acetate; kaempferol; kaempferol 3-glucosyl(1 --> 4) [6"'-sinapoylglucosyl] (1 --> 2) galactoside; kaneroside; linoleic acid; linolenic acid; lupeol acetate; lupedienyl acetate; neriifolin; neriperside; neriumoside; odoroside A – H; oleandrin; oleic acid; palmatic acid; perubosidic acid; peruvianoside I – III, peruvianursenyl acetate A; peruvianursenyl glucoside; peruvianursenyl acetate B; peruvianursenyl acetate C; peruvoside; plumericin; quercetin 3-glucosyl(1 --> 2)galactoside; quercetin 3-[6"'-sinapoylglucosyl](1 --> 2)galactoside; ruvoside; stearic acid; thevebioside; thevefolin; thevelene; theveneriine; theveside; therviriside; thevitin A; vertiaflavone. [1] [3-7]

Traditional Uses

T. peruviana is considered acrid, bitter, hot and toxic. It is cardiotonic, diuretic, anti-inflammatory and anthelmintic. The plant being toxic must be used with great caution especially when taken orally. Users are reminded that the toxic dose is only a little higher than the therapeutic dose. [1] [2] 

Cardiovascular diseases

In Indonesia the plant is recognized as a cardiotonic and the leaves are used in the treatment of cardiac failure associated with palpitations. [2]

Gastrointestinal diseases

The bark or leaf decoction is a purgative and an emetic. The seeds is also used as a purgative. In Ghana, they used the decoction of the leaves to purge out intestinal worms and to treat jaundice. [1] [2]

Skin diseases

In India, the various parts of the plant are used in the treatment of skin problems. Charaka who is one of the founders of Ayurveda text recommended the use of the leaves of the white variety to treat obstinate and chronic skin diseases including leprosy. Sushruta who is the other pioneer also used the leaves to treat eczema, impetigo and other skin diseases. He also incorporates the plant in a paste for alopecia. The Indians also use seed oil for the same purpose. In Mali the latex is applied to soften corns and calluses. [1-4] 

Poison

The poison in the plant has been used for specific purposes. In Africa, the bark and seeds are used to poison rats. The seeds mashed with soap is used as insecticide. In Southern Africa and the Cameroon the seeds are used as an arrow or ordeal poison. The seeds, leaves and bark are also used to induce abortion in Africa. [1]

Pre-Clinical Data

Pharmacology

Antispermatogenesis activity

The methanol extract of the stem bark of T. peruviana was found to inhibit spermatogenesis in male rats. When administered orally at the dose of 100mg/rat/day to male rats, the following were observed:

  1. Significant reduction in body weight and weight of reproductive organs
  2. Significant fall in total protein and sialic acid content of testis, epididymides, seminal vesicle and ventral prostate
  3. Fall in glycogen in testes and increased in cholesterol
  4. Decline in spermatogenic elements i.e. preleptoteneand pachytene spermatocytes, secondary spermatocytes, round spermatids and mature Leydig cells.
  5. Reduction in Leydig cell nuclear diameter, seminiferous tubular diameter and Sertoli area
  6. Reduction in sperm density and motility. [8]

Emetic activity

Peruvoside, a glycoside obtained from T. peruviana was found to induce vomiting in cats. This action was inhibited by catecholamine depleting drugs (reserpine, tetrabenaxine or syrosingopine, chloropromazine hydrochloride, mepyramine maleate), phenoxybenzamine, and haloperidol. This indicates that catecholamines may play a role in the mechanism of vomiting induced by peruvoside. [9]

Cardiotonic activity

The frequent occurrences of poisoning by ingestion of seeds of T. peruviana provided researchers opportunities to study the cardiotonic effects of the cardiac glycosides present in the seeds. In one review of patients who ingested the seeds, it was found that palpitation occurs in 12% of cases; 46% showed varying types of arrhythmias including sinus bradycardia (49%); 39% showed ischaemic changes. All 14 fatal cases showed subendocardial and perivascular haemorrhage with focal myocardial oedema in the heart. Another observation showed that most symptomatic patients had conduction defects affecting the sinus node , the atrioventricular node or both with very few developing the atrial or ventricular tachyarrhythmias or ventricular ectopic beats seen in digoxin toxicity. These patients had higher mean serum cardiac glycoside and potassium levels, but not magnesium. Administration of peruvoside to patients with congestive heart failure showed immediate and powerful positive inotropic and negative chronotropic effects. [10] [11] [12]

Toxicities

Most parts of the plant including the latex, are highly toxic; the seeds most highly so. The active principles are cardiac glucosides of the cardenolide type. The poison mainly affects the cardiovascular system causing various types of arrhythmias, and the gastrointestinal tract. Vomiting is a common symptom of poisoning in about 30% cases, ischaemic changes occur in about 40% and palpitations in about 10%. The most serious and immediate cause leading to death is a peripheral vascular failure.[1] 

The cardiac glycosides of T. peruviana are triosides thevitin as the major component of the seeds in a mixture of cerebroside (thevetin B) and thevitin A in a 2:1 ratio or monosides neriifolin, cerebrin, peruvoside, ruvoside and perubosidic acid. [1]

Apart from the cardiac toxicity, animal studies showed that the plant also has marked neurotoxicity producing hind limb paralysis, rolling of the body on the long axis, circular flailing of the tail, muscular twitch, tetanic convulsions, tremors, collapse and death. [13-15]

Teratogenic effects

No documentation

Clinical Data

Clinical Trials

No documentation

Adverse Effects in Human:

No documentation

Used in Certain Conditions

Pregnancy / Breastfeeding

No documentation

Age Limitations

Neonates / Adolescents

No documentation

Geriatrics

No documentation

Chronic Disease Conditions

No documentation

Interactions

Interactions with drugs

Those taking cardiotonic drugs should not take this herb together with them.

Interactions with Other Herbs / Herbal Constituents

No documentation

Contraindications

Contraindications

No documentation

Case Reports

Poisoning by T. peruviana seeds is a common cause of self-inflicted poisoning in India and Sri Lanka. The references are reports and reviews of cases of poisoning occurring especially in Sri Lanka and India. [16-25]

References

  1. Schmelzer GH., Fakim AG. Medicinal Plants 1, PROTA Foundation, Wageningen 2008 pg. 606 – 608
  2. Dalimartha S. Atlas Tumbuhan Obat Indonesia Jilid 5. Niaga Swadaya, Jakarta, 2008. pg. 38 – 40
  3. Khare CP., Indian Herbal Remedies: Rational Western Therapy, Ayurvedic, and Other Traditional Usage, Botany, Springer-Verlag, Berlin, 2004 pg. 328 – 330
  4. Jangkaru Z., Tanaman Obat Pelanchar Air Seni, Niaga Swadaya, Jakarta pg. 44
  5. Abe F, Iwase Y, Yamauchi T, Yahara S, Nohara T. Flavonol sinapoyl glycosides from leaves of Thevetia peruviana. Phytochemistry. 1995 Sep;40(2):577-81.
  6. Ali M, Ravinder E, Ramachandram R. New ursane-type triterpenic esters from the stem bark of Thevetia peruviana. Pharmazie. 2000 May;55(5):385-9.
  7. Tewtrakul S, Nakamura N, Hattori M, Fujiwara T, Supavita T. Flavanone and flavonol glycosides from the leaves of Thevetia peruviana and their HIV-1 reverse transcriptase and HIV-1 integrase inhibitory activities. Chem Pharm Bull (Tokyo). 2002 May;50(5):630-5.
  8. Gupta R, Kachhawa JB, Gupta RS, Sharma AK, Sharma MC, Dobhal MP. Phytochemical evaluation and antispermatogenic activity of Thevetia peruviana methanol extract in male albino rats. Hum Fertil (Camb). 2011 Mar;14(1):53-9. doi: 10.3109/14647273.2010.542230.
  9. Gaitondé BB, Joglekar SN. Role of catecholamines in the central mechanism of emetic response induced by peruvoside and ouabain in cats. Br J Pharmacol. 1975 Jun;54(2):157-62.
  10. Bose TK, Basu RK, Biswas B, De JN, Majumdar BC, Datta S. Cardiovascular effects of yellow oleander ingestion. J Indian Med Assoc. 1999 Oct;97(10):407-10.
  11. Eddleston M, Ariaratnam CA, Sjöström L, Jayalath S, Rajakanthan K, Rajapakse S, Colbert D, Meyer WP, Perera G, Attapattu S, Kularatne SA, Sheriff MR, Warrell DA. Acute yellow oleander (Thevetia peruviana) poisoning: cardiac arrhythmias, electrolyte disturbances, and serum cardiac glycoside concentrations on presentation to hospital. Heart. 2000 Mar;83(3):301-6
  12. Bhatia ML, Manchanda SC, Roy SB. Haemodynamic studies with peruvoside in human congestive heart failure. Br Med J. 1970 Sep 26;3(5725):740-3.
  13. Gaitondé BB, Joglekar SN. Mechanism of neurotoxicity of cardiotonic glycosides. Br J Pharmacol. 1977 Feb;59(2):223-9.
  14. Pahwa R, Chatterjee VC. The toxicity of yellow oleander (Thevetia neriifolia juss) seed kernels to rats. Vet Hum Toxicol. 1990 Dec;32(6):561-4.
  15. Oji O, Okafor QE. Toxicological studies on stem bark, leaf and seed kernel of yellow oleander (Thevetia peruviana). Phytother Res. 2000 Mar;14(2):133-5.
  16. Shaw D, Pearn J. Oleander poisoning. Med J Aust. 1979 Sep 8;2(5):267-9.
  17. Ansford AJ, Morris H. Fatal oleander poisoning. Med J Aust. 1981 Apr 4;1(7):360-1
  18. Saravanapavananthan N, Ganeshamoorthy J. Yellow oleander poisoning--a study of 170 cases. Forensic Sci Int. 1988 Feb;36(3-4):247-50.
  19. Samal KK, Sahu HK, Kar MK, Palit SK, Kar BC, Sahu CS. Yellow oleander (cerbera thevetia) poisoning with jaundice and renal failure. J Assoc Physicians India. 1989 Mar;37(3):232-3.
  20. Saraswat DK, Garg PK, Saraswat M. Rare poisoning with cerebra thevetia (yellow oleander). Review of 13 cases of suicidal attempt. J Assoc Physicians India. 1992 Sep;40(9):628-9.
  21. Langford SD, Boor PJ. Oleander toxicity: an examination of human and animal toxic exposures. Toxicology. 1996 May 3;109(1):1-13.
  22. Eddleston M, Ariaratnam CA, Meyer WP, Perera G, Kularatne AM, Attapattu S, Sheriff MH, Warrell DA. Epidemic of self-poisoning with seeds of the yellow oleander tree (Thevetia peruviana) in northern Sri Lanka. Trop Med Int Health. 1999 Apr;4(4):266-73.
  23. Maringhini G, Notaro L, Barberi O, Giubilato A, Butera R, Di Pasquale P. Cardiovascular glycoside-like intoxication following ingestion of Thevetia nereifolia/peruviana seeds: a case report. Ital Heart J. 2002 Feb;3(2):137-40.
  24. Fonseka MM, Seneviratne SL, de Silva CE, Gunatilake SB, de Silva HJ. Yellow oleander poisoning in Sri Lanka: outcome in a secondary care hospital. Hum Exp Toxicol. 2002 Jun;21(6):293-5.
  25. Dwivedi S, Rajpal S, Narang S. Cardiotoxic Manifestations of Yellow Oleander (Thevetia nerifolia) Poisoning and its Treatment: A Case Report. Indian Heart J. 2006 Nov-Dec;58(6):450-1.