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Nerium oleander L.

Synonyms

Nerion oleandrum St.-Lag., Nerium carneum Dum.Cours., Nerium flavescens Spin, Nerium floridum Salisb., Nerium grandiflorum Desf., Nerium indicum Mill., Nerium japonicum Gentil,  Nerium kotschyi Boiss., Nerium latifolium Mill., Nerium lauriforme Lam., Nerium mascatense A.DC.,  Nerium odoratissimum Wender., Nerium odoratum Lam., Nerium odorum Aiton, Nerium splendens Paxton, Nerium thyrsiflorum Paxton, Nerium verecundum Salisb., Oleander indica (Mill.) Medik., Oleander vulgaris Medik [2][56]

Vernacular Names

English Oleander, Rose-bay, Sweet-scented Oleander
China Jia Zhu Tao
India Ashwamarakah, Hayamarakah (Sanskrit); Karabi (Bengali); Kanher, Kagaer (Gujerati); Chandni, Kaber, Kaner, Karavira (Hindi); Kanagile. Kanagilu, Paddale (Kannada); Dhavekaneri (Konkani); Areli, Karaviram (Malayalam); Kanera, Kanher (Marathi); Kaner (Punjabi); Arali, Kanaviram, Karaviram, Kasturipattai, Kaviram, Sevvarali, Valikkoli (Tamil); Ganneru, Karaviramu, Kasturipatta (Telugu)
Sri Lanka Araliya
Arab Defla, Zaqqum
Turkey Zakum, Zakkum, Zakhum
France Laurier Rose, Laurel de Jardin, Laurel Sora, Flourier Rose, Olean. [1][2]

General Information

Description

Nerium oleander is a member of the Apocynaceae family. It is a perennial shrub which can grow up to 4m tall. It has erect stem with profuse branching. The leaves form whorls of three, each being 10cm long, evergreen, leathery, simple, entire, lanceolate lengthwise, pointed with median veins which is prominent underneath and a number of secondary veins. The flowers are strongly aromatic and grow in terminal corymbs. The calyx is shorter than the corolla. There are five multifid scales opposing the lobes. The stamens are enclosed and inserted in the middle of the corolla. The fruits are cylindrical and composed of two fused, linear follicles. There are many seeds in each fruit, each with a red-haired pappus. [1]

Plant Part Used

Roots and leaves. [1]

Chemical Constituents

16beta,17beta-epoxy-12beta-hydroxypregna-4,6-diene-3,20-dione; (20S,24R)-epoxydammarane-3beta,25-diol; (20S,24S)-epoxydammarane-3beta,25-diol; 20beta,28-epoxy-28alpha-methoxytaraxasteran-3beta-ol; 20beta,28-epoxytaraxaster-21-en-3beta-ol; 20R-hydroxypregna-4,6-diene-3,12-dione; 21-hydroxypregna-4,6-diene-3,12,20-trione; 28-nor-urs-12-en-3beta-ol; 28-nor-urs-12-ene-3beta,17beta-diol; 3beta,13beta-dihydroxyurs-11-en-28-oic acid; 3beta,27-dihydroxy-12-ursen-28-oic acid; 3beta,27-dihydroxy-12-oleanen-28-oic acid; 3beta,20alpha-dihydroxyurs-21-en-28-oic acid; 3beta,12alpha-dihydroxyoleanan-28,13beta-olide; 3beta-hydroxy-5alpha-carda-14; 3beta-hydroxyurs-12-en-28-aldehyde; adigoside; adynergine; alpha-neriursate; beta-anhydroepidigitoxigenin; beta-neriursate; betulin; betulinic acid; cardenolides B-1 and B-2; cardenolides N-1, N-2, N-3, N-4; corteneroside; glucose; isoneriucoumaric acids; kaempferol-5-O-[α-L-rhamnopyranosyl-(1→6)-β-D-glucopyranoside; kanerocin; neridienone A; neridienone B; neridiginoside; nerioside; neritaloside; neriucoumaric; neriumogenin-A-3beta-D-digitaloside; nerizoside; oleanderen; oleanderoic acid; oleanderocioic acid; oleandigoside; oleandrine; oleanolic acid; odorosides; odoroside-H; proceragenin; quercetin-5-O-[α-L-rhamnopyranosyl-(1→6)]-β-D-glucopyranoside; rosaginoside; tannins; urs-12-en-3beta-ol; urs-12-ene-3beta,28-diol; ursolic acid; vitamin C. [1][4-17]

Traditional Used:

Skin diseases

The plant is used to treat various skin problems for both Africans and Indian. For parasitic infestations like scabies and lice the macerated leaves are applied over the lesion. The crushed leaves are allied over non bleeding skin lesion like bruises, burns and tumours. Scaly skin and leprotic ulcers the oil from the root is applied locally. For ringworm, the paste made from the roots and leaves are recommended. For gangrene, the leaves of N. oleander are pounded with honey and apply it as a poultice. [3]

Respiratory diseases

The roots of the N. oleander as a fumigant are used to treat common colds. In India the Santhal tribe makes use of the plant to treat asthma, bronchitis and pulmonary tuberculosis. [1][3]

Eye and ear diseases

In ophthalmia with copious lachrymation the Indian makes use of the fresh juice of the leaves. For earache, ear infection with pus discharging the crushed root heated in gingelly oil is dropped into the ear while still bearably warm. [3]

Other uses

Dioscorides and Pliny recommend the use of oleander poison in combination with wine and rue as an antidote for snakebite. In India the juice expressed from the leaves is applied over the venomous bites including those of scorpions. The leaves are considered emmenagogue and are used to induce abortion and to treat menorrhagia. [1][3]

NB. There is 2 ½ times more poison in oleander leaves than in digitalis. [3]

Pre-Clinical Data

Pharmacology

Hepatoprotective activity

The methanol extract of the flower of N. oleander exhibited potent antioxidant activity and hepatoprotective activity against CCl4 induced hepatotoxicity in rats. This is evidenced by the normalization of the serum enzymatic level and also in histopathological findings. [18]

Antidiabetic activity

Nerium oleander extract improved insulin and glucose level in streptozotocin induced diabetic rats. However, this effect is not as good as glimepiride. On the other hand the N. oleander distillate showed an ability to reduce fasting blood glucose, HbA1c, insulin resistance, total cholesterol, low density lipoprotein, atherogenic index, triglyceride-HDl ratio, insulin and leptin levels. It also improved beta cell function and HDL concentration. At the same time the distillate enhanced mRNA expression of PPAR (peroxisome proliferator-activated-receptor)- alpha, beta, and gamma in adipose tissue and the PPAR-alpha-gamma in liver. [19][20]

Hypolipidaemic activity

It has already been mentioned above the N. oleander distillate exhibit significant antidyslipidaemic activity. Gayathri et al. tested the ethanol extract of the flowers to look for hypolipidaemic activity. In high-fat diet fed Sprague Dawley rats the extract was found to significantly lower the increased body weight gain, lipid and lipoprotein levels with concomitant increase in HDL in plasma and heart. The activities of lipolytic enzymes were also upheld by the extract. [21]

CNS Depressant Activity

The CNS depressant activity of the leaves of N. oleander were studies using the methanol extract and bioassay directed fractionation. Two purified fractions (B-1 and B-3) showed reduction in locomotor activity, roat rod performance and potentiation of hexabarbital sleeping time. Both showed protection against convulsion induced by picrotoxin and bicuculline. Three cardenolides were isolated from these fractions and they showed CNS depressant activities. They are 3 beta-O-(D-2-O-methyldigitalosyl)-14 beta-hydroxy-5 beta-carda-16,20(22)-dienolide; 3 beta-O-(D-digitalosyl)-14 beta-hydroxy-16 beta-acetoxy-5 beta-card-20(22)-enolide; and 3 beta-O-(D-digitalosyl)-14 beta-hydroxy-5 beta-card-20(22)-enolide. [22-24]

Cardiogenic activity

Nerium oleander posses a number of cardiotonic steroid compounds formed from cardenolides and bufadienolides within its substance. The crude ethanol extract of the dried leaves could increase the force of contraction, heart rate and cardiac flow in isolated guinea pig heart. The fresh leaf extract showed changes in adult rat cardiomyocytes and cultured neonatal cardiomyocytes comparable to verapamil and ouabain. These changes include (1) increased intracellular calcium levels in a dose dependent manner; (2) reduced calcium transient heights and eventual cessation of beating; and (3) increased sparking intensity led to subsequent beating and eventual calcium overload. This is probably due to the presence of oleandrine which inhibit ryanodine receptor calcium release channesl, calcium uptake via Na+, K+ - ATPase inhibition and/or dysfunction of sarcolemmal calcium release channels. [25-27]

Antimicrobial activity

Several extracts of dried leaves of N. oleander containing alkaloid, terpenoids, cardiac glycosides, saponins, tannins and carbohydrates, showed antibacterial activities against Staphylococcus aureus, Pseudomonas aeruginosa and Salmonella typhimurium. Oleandrin from the aqueous extract was found to significantly reduce the expression of the envelope protein gp120, the sole determinant of virus activity, of HIV. [28][29]

Cytotoxic activity

Oleandrin is a cardiac glycoside that is present in aqueous extract of the leaves of N. oleander and is the active component of a proprietary drug Anvirzel. This compound was found to have anticancer activities. It blocked TNF-induced activation of NF-kappaB in a concentration and time-dependent manner. This effect seems to be species specific. Amongst the human cancers that were found to be inhibited by Anvirzel and oleandrin include human prostatic cancer PC3 and DU145, human pancreatic cancer, and human melanoma BRO. [30-39]

Toxicities

The plant is classified as highly poisonous with the toxic component being its content of cardiac glycosides. There have been reports of death from consumption of the plant parts either in fresh form or processed form. There was even a case report of a couple developing symptoms and signs of toxicity by consuming escargot stew. Analysis of the snail showed significant levels of cardiac glycosides derived from N. oleander namely oleandrin. [40-55]

Teratogenic effects

No documentation

Clinical Data

Clinical Trials

No documentation

Adverse Effects in Human:

Unsupervised intake of herbal preparation containing N.oleander leaves had resulted in victims developing digitalis-like intoxication symptoms.

Used in Certain Conditions

Pregnancy / Breastfeeding

Preparations containing N. oleander should not be taken by pregnant and lactating women. This plant had been used to induce abortion. [3]

Age Limitations

Neonates / Adolescents

Being considered a toxic plant, preparations containing N. oleander should not be given to children for whatever purpose. [3]

Geriatrics

No documentation

Chronic Disease Conditions

No documentation

Interactions

Interactions with drugs

The presence of cardiac glycosides in the substance of the plant present a potential interaction of summative effects when taken with digitalis. There had been reports of death in patients on digoxin ingesting herbal tea containing N. oleander. It has been proven that the plant can potentiate the effects of barbiturates. Its antidiabetic activity can potentiate hypoglycaemia in patients on anti-diabetic therapy. [19][20][22-25]

Interactions with Other Herbs / Herbal Constituents

No documentation

Contraindications

Contraindications

No documentation

Case Reports

From 1985 to 2012 there had been 15 case reports of poisoning due to ingestion of N. oleander leaves either accidentally or intentionally. Of these 5 cases were reported fatal. The non-fatal cases usually presented with gastrointestinal symptoms which were nausea, vomiting and diarrhoea. Detectable cardiac symptoms included bradycardia, tachycardia, first and second degree of atrioventricular nodal block and digitalis-like toxicity changes in ECG i.e. ST-T wave changes. [38-53]

References

  1. Centre for Mediterranean Cooperation, International Union for Conservation of Nature and Natural Resources. A Guide to Medicinal Plants in North Africa. Malaga, Spain: IUCN; 2005. p. 169-170.
  2. MobileReference. The Illustrated Encyclopedia of Trees and Shrubs. MobileReference; 2008. Availabe from http://books.google.com.my/books?id=mZEhZMOFLiQC&pg=PT1093&dq=Nerium+oleander&hl=en&sa=X&ei=SFDCUfLRCc3hrAfDt4CoDw&redir_esc=y. Accessed on 2nd May 2014
  3. Sairam TV. Home Remedie: Volume 3. New Delhi, India: Penguin Books; 2003. p.120-125.
  4. Siddiqui S, Siddiqui BS, Hafeez F, Begum S. Isolation and Structure of Neriucoumaric and Isoneriucoumaric Acids from the Leaves of Nerium oleander. Planta Med. 1987 Oct;53(5):424-7.
  5. Siddiqui S, Siddiqui BS, Hafeez F, Begum S. Oleanderoic Acid and Oleanderen from the Leaves of Nerium oleander. Planta Med. 1988 Jun;54(3):232-4.
  6. Siddiqui S, Siddiqui BS, Begum S, Hafeez F. Kanerocin: A New Triterpene from the Leaves of Nerium oleander. Planta Med. 1989 Jun;55(3):292-3.
  7. Müller BM, Rosskopf F, Paper DH, Kraus J, Franz G. Polysaccharides from Nerium oleander: structure and biological activity. Pharmazie. 1991 Sep;46(9):657-63.
  8. Begum S, Siddiqui BS, Sultana R, Zia A, Suria A. Bio-active cardenolides from the leaves of Nerium oleander. Phytochemistry. 1999 Feb;50(3):435-8.
  9. Huq MM, Jabbar A, Rashid MA, Hasan CM, Ito C, Furukawa H. Steroids from the roots of Nerium oleander. J Nat Prod. 1999 Jul;62(7):1065-7.
  10. Fu L, Zhang S, Li N, Wang J, Zhao M, Sakai J, Hasegawa T, Mitsui T, Kataoka T, Oka S, Kiuchi M, Hirose K, Ando M. Three new triterpenes from Nerium oleander and biological activity of the isolated compounds. J Nat Prod. 2005 Feb;68(2):198-206.
  11. Zhao M, Zhang S, Fu L, Li N, Bai J, Sakai J, Wang L, Tang W, Hasegawa T, Ogura H, Kataoka T, Oka S, Kiuch M, Hirose K, Ando M. Taraxasterane- and ursane-type triterpenes from Nerium oleander and their biological activities. J Nat Prod. 2006 Aug;69(8):1164-7.
  12. Bai L, Wang L, Zhao M, Toki A, Hasegawa T, Ogura H, Kataoka T, Hirose K, Sakai J, Bai J, Ando M. Bioactive pregnanes from Nerium oleander. J Nat Prod. 2007 Jan;70(1):14-8.
  13. Zhao M, Bai L, Wang L, Toki A, Hasegawa T, Kikuchi M, Abe M, Sakai J, Hasegawa R, Bai Y, Mitsui T, Ogura H, Kataoka T, Oka S, Tsushima H, Kiuchi M, Hirose K, Tomida A, Tsuruo T, Ando M. Bioactive cardenolides from the stems and twigs of Nerium oleander. J Nat Prod. 2007 Jul;70(7):1098-103. Epub 2007 Jun 27.
  14. Siddiqui BS, Khatoon N, Begum S, Durrani SA. Two new triterpenoid isomers from Nerium oleander leaves. Nat Prod Res. 2009;23(17):1603-8. doi: 10.1080/14786410802573958.
  15. Bai L, Zhao M, Toki A, Sakai J, Yang XY, Bai Y, Ando M, Hirose K, Ando M. Three new cardenolides from methanol extract of stems and twigs of Nerium oleander. Chem Pharm Bull (Tokyo). 2010 Aug;58(8):1088-92.
  16. Zhao M, Bai L, Toki A, Hasegawa R, Sakai J, Hasegawa T, Ogura H, Kataoka T, Bai Y, Ando M, Hirose K, Ando M. The structure of a new cardenolide diglycoside and the biological activities of eleven cardenolide diglycosides from Nerium oleander. Chem Pharm Bull (Tokyo). 2011;59(3):371-7.
  17. Siddiqui BS, Khatoon N, Begum S, Farooq AD, Qamar K, Bhatti HA, Ali SK. Flavonoid and cardenolide glycosides and a pentacyclic triterpene from the leaves of Nerium oleander and evaluation of cytotoxicity. Phytochemistry. 2012 May;77:238-44. doi: 10.1016/j.phytochem.2012.01.001. Epub 2012 Jan 24.
  18. Singhal KG, Gupta GD. Hepatoprotective and antioxidant activity of methanolic extract of flowers of Nerium oleander against CCl4-induced liver injury in rats. Asian Pac J Trop Med. 2012 Sep;5(9):677-85. doi: 10.1016/S1995-7645(12)60106-0.
  19. Mwafy SN, Yassin MM. Antidiabetic activity evaluation of glimepiride and Nerium oleander extract on insulin, glucose levels and some liver enzymes activities in experimental diabetic rat model. Pak J Biol Sci. 2011 Nov 1;14(21):984-90.
  20. Bas AL, Demirci S, Yazihan N, Uney K, Ermis Kaya E. Nerium oleander Distillate Improves Fat and Glucose Metabolism in High-Fat Diet-Fed Streptozotocin-Induced Diabetic Rats. Int J Endocrinol. 2012;2012:947187. doi: 10.1155/2012/947187. Epub 2012 Dec 2.
  21. Gayathri V, Ananthi S, Chandronitha C, Sangeetha MK, Vasanthi HR. Hypolipidemic potential of flowers of Nerium oleander in high fat diet-fed Sprague Dawley rats. Nat Prod Res. 2011 Jul;25(11):1110-4. doi: 10.1080/14786419.2010.541883.
  22. Zia A, Siddiqui BS, Begum S, Siddiqui S, Suria A. Studies on the constituents of the leaves of Nerium oleander on behaviorin mice. J Ethnopharmacol. 1995 Nov 17;49(1):33-9.
  23. Siddiqui BS, Sultana R, Begum S, Zia A, Suria A. Cardenolides from the methanolic extract of Nerium oleander leaves possessing central nervous system depressant activity in mice. J Nat Prod. 1997 Jun;60(6):540-4.
  24. Dunn DE, He DN, Yang P, Johansen M, Newman RA, Lo DC. In vitro and in vivo neuroprotective activity of the cardiac glycoside oleandrin from Nerium oleander in brain slice-based stroke models. J Neurochem. 2011 Nov;119(4):805-14. doi: 10.1111/j.1471-4159.2011.07439.x. Epub 2011 Sep 26.
  25. Adome RO, Gachihi JW, Onegi B, Tamale J, Apio SO. The cardiotonic effect of the crude ethanolic extract of Nerium oleander in the isolated guinea pig hearts. Afr Health Sci. 2003 Aug;3(2):77-82.
  26. Poindexter BJ, Feng W, Dasgupta A, Bick RJ. Oleandrin produces changes in intracellular calcium levels in isolated cardiomyocytes: a real-time fluorescence imaging study comparing adult to neonatal cardiomyocytes. J Toxicol Environ Health A. 2007 Mar 15;70(6):568-74.
  27. Gayathri V, Ananthi S, Chandronitha C, Ramakrishnan G, Lakshmisundaram R, Vasanthi HR. Cardioprotective effect of Nerium oleander flower against isoproterenol-induced myocardial oxidative stress in experimental rats. J Cardiovasc Pharmacol Ther. 2011 Mar;16(1):96-104. doi: 10.1177/1074248410381759. Epub 2010 Dec 29.
  28. Bhuvaneshwari L, Arthy E, Anitha C, Dhanabalan K, Meena M. Phytochemical analysis & Antibacterial activity of Nerium oleander. Anc Sci Life. 2007 Apr;26(4):24-8.
  29. Singh S, Shenoy S, Nehete PN, Yang P, Nehete B, Fontenot D, Yang G, Newman RA, Sastry KJ. Nerium oleander derived cardiac glycoside oleandrin is a novel inhibitor of HIV infectivity. Fitoterapia. 2013 Jan;84:32-9. doi: 10.1016/j.fitote.2012.10.017. Epub 2012 Nov 2.
  30. Manna SK, Sah NK, Newman RA, Cisneros A, Aggarwal BB. Oleandrin suppresses activation of nuclear transcription factor-kappaB, activator protein-1, and c-Jun NH2-terminal kinase. Cancer Res. 2000 Jul 15;60(14):3838-47.
  31. Pathak S, Multani AS, Narayan S, Kumar V, Newman RA. Anvirzel, an extract of Nerium oleander, induces cell death in human but not murine cancer cells. Anticancer Drugs. 2000 Jul;11(6):455-63.
  32. Smith JA, Madden T, Vijjeswarapu M, Newman RA. 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. Biochem Pharmacol. 2001 Aug 15;62(4):469-72.
  33. Ni D, Madden TL, Johansen M, Felix E, Ho DH, Newman RA. Murine pharmacokinetics and metabolism of oleandrin, a cytotoxic component of Nerium oleander. J Exp Ther Oncol. 2002 Sep-Oct;2(5):278-85
  34. Sreenivasan Y, Sarkar A, Manna SK. Oleandrin suppresses activation of nuclear transcription factor-kappa B and activator protein-1 and potentiates apoptosis induced by ceramide. Biochem Pharmacol. 2003 Dec 1;66(11):2223-39.
  35. Afaq F, Saleem M, Aziz MH, Mukhtar H. Inhibition of 12-O-tetradecanoylphorbol-13-acetate-induced tumor promotion markers in CD-1 mouse skin by oleandrin. Toxicol Appl Pharmacol. 2004 Mar 15;195(3):361-9.
  36. Mekhail T, Kaur H, Ganapathi R, Budd GT, Elson P, Bukowski RM. Phase 1 trial of Anvirzel in patients with refractory solid tumors. Invest New Drugs. 2006 Sep;24(5):423-7.
  37. Newman RA, Kondo Y, Yokoyama T, Dixon S, Cartwright C, Chan D, Johansen M, Yang P. Autophagic cell death of human pancreatic tumor cells mediated by oleandrin, a lipid-soluble cardiac glycoside. Integr Cancer Ther. 2007 Dec;6(4):354-64.
  38. Lin Y, Dubinsky WP, Ho DH, Felix E, Newman RA. Determinants of human and mouse melanoma cell sensitivities to oleandrin. J Exp Ther Oncol. 2008;7(3):195-205.
  39. Rashan LJ, Franke K, Khine MM, Kelter G, Fiebig HH, Neumann J, Wessjohann LA. Characterization of the anticancer properties of monoglycosidic cardenolides isolated from Nerium oleander and Streptocaulon tomentosum. J Ethnopharmacol. 2011 Apr 12;134(3):781-8. doi: 10.1016/j.jep.2011.01.038. Epub 2011 Feb 1.
  40. Haynes BE, Bessen HA, Wightman WD. Oleander tea: herbal draught of death. Ann Emerg Med. 1985 Apr;14(4):350-3.
  41. Blum LM, Rieders F. Oleandrin distribution in a fatality from rectal and oral Nerium oleander extract administration. J Anal Toxicol. 1987 Sep-Oct;11(5):219-21.
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  44. Nishioka Sde A, Resende ES. Transitory complete atrioventricular block associated to ingestion of Nerium oleander. Rev Assoc Med Bras. 1995 Jan-Feb;41(1):60-2.
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  53. Hugues T, Arnoult M, Beau N, Yaici K, Mélandri P, Saoudi N, Gibelin P. A non-fatal Nerium oleander self-poisoning: case report and discussion. Ann Cardiol Angeiol (Paris). 2012 Apr;61(2):128-31. doi: 10.1016/j.ancard.2011.07.003. Epub 2011 Aug 17.
  54. Papi L, Luciani AB, Forni D, Giusiani M. Unexpected double lethal oleander poisoning. Am J Forensic Med Pathol. 2012 Mar;33(1):93-7. doi: 10.1097/PAF.0b013e31822d33d4.
  55. Küçükdurmaz Z, Karapinar H, Gül I, Yilmaz A. Complete atrioventricular block after self-ingestion of Nerium oleander for relief of hemorrhoidal complaints. Turk Kardiyol Dern Ars. 2012 Mar;40(2):168-70. doi: 10.5543/tkda.2012.01703.
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