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Thevetia peruviana contains potent cardiac glycosides, including thevetin A, thevetin B, peruvoside, and neriifolin. These compounds inhibit the sodium-potassium ATPase pump in cardiac cells, which increases intracellular calcium and strengthens cardiac muscle contractions. This mechanism is similar to digoxin but with a significantly narrower therapeutic window. Evidence Level C. The unpredictable potency of these glycosides makes the difference between a therapeutic and lethal dose extremely small, which is why internal use is considered highly dangerous and not recommended in modern practice.
What drugs interact with yellow oleander (Thevetia peruviana)?
Thevetia peruviana has dangerous interactions with cardiac medications. Concurrent use with digoxin or other cardiac glycosides can cause additive toxicity, leading to potentially fatal arrhythmias. Diuretics may worsen toxicity by causing electrolyte imbalances, particularly hypokalemia. Medications like quinidine, verapamil, and amiodarone can increase cardiac glycoside concentrations. Evidence Level C. Due to the extreme toxicity of Thevetia peruviana, internal use is contraindicated with any medications, as the plant itself poses life-threatening risks independent of drug interactions.
What is the safe dosage of Thevetia peruviana?
There is no established safe dosage for Thevetia peruviana. The plant contains cardiac glycosides with an extremely narrow therapeutic index, meaning the toxic dose is very close to any potentially therapeutic dose. The seeds are particularly dangerous, with ingestion of even small amounts capable of causing fatal cardiac arrhythmias. Evidence Level C. Medical literature documents numerous fatalities from accidental and intentional ingestion. Due to the high risk of death, no internal dosage is recommended. External applications in traditional medicine require professional guidance and are not standardized.
Is yellow oleander safe during pregnancy?
Thevetia peruviana is absolutely contraindicated during pregnancy and breastfeeding. The cardiac glycosides, including thevetin and peruvoside, can cross the placenta and cause fetal harm, including cardiac arrhythmias and potential fetal death. Evidence Level C. The plant's extreme toxicity poses life-threatening risks to both mother and developing fetus. No traditional or modern evidence supports any safe use during pregnancy. All parts of the plant, especially the seeds, should be strictly avoided throughout pregnancy, lactation, and in women who may become pregnant.
Is Thevetia peruviana poisonous to humans?
Yes, Thevetia peruviana (yellow oleander) is extremely poisonous to humans. All parts of the plant contain cardiac glycosides, with the seeds being most toxic. Ingestion can cause nausea, vomiting, abdominal pain, dizziness, and potentially fatal cardiac arrhythmias. Evidence Level C. The plant is responsible for numerous poisoning cases globally, particularly in tropical regions where it grows as an ornamental. Even small amounts require immediate emergency medical attention. Despite historical use in folk medicine, internal consumption is never recommended due to documented fatalities and the lack of a safe therapeutic window.
What are the traditional uses of Thevetia peruviana?
Historically, Thevetia peruviana has been used in folk medicine for treating heart conditions and, externally, for various skin ailments. The cardiac glycosides were researched as potential alternatives to digoxin, but development did not progress due to unacceptable toxicity risks. Evidence Level C. Some traditional systems apply the plant externally for skin conditions, though safety data for even topical use remains limited. Modern medical practice does not endorse internal use under any circumstances due to the documented risk of fatal cardiac toxicity and the availability of safer alternatives.
Fiche d'information compilée à partir de PubMed
Cette fiche a été compilée à partir de résumés PubMed (NIH) avec l'assistance d'une IA. Chaque affirmation factuelle est citée par un article PubMed réel (voir la liste des sources). Elle n'a pas encore été révisée par un humain — confirmez auprès d'un professionnel de santé avant utilisation.
Compilé à partir de 30 articles PubMed · modèle : gemma4:31b
Résumé
Thevetia peruviana, also known as yellow oleander, is a cardiotoxic evergreen shrub containing potent cardiac glycosides [PMID:40080906, PMID:20438743]. It is frequently associated with severe poisoning and mortality, particularly in cases of intentional self-harm in South Asia [PMID:19306191, PMID:30073854].
Contexte
Thevetia peruviana (syn. Cascabela thevetia) is an ornamental evergreen shrub native to Latin America and widely cultivated in tropical and subtropical regions globally [PMID:40080906, PMID:37082370].
Usages traditionnels
It has been used traditionally to treat edema, cardiac disorders, and as a diuretic [PMID:41074812], as well as to treat ulcers, scabies, hemorrhoids, and to dissolve tumors [PMID:28464893].
Composés actifs
The plant contains cardiac glycosides, including thevetin A, thevetin B, neriifolin, peruvoside, and thevetin C [PMID:19306191, PMID:37496389, PMID:22196940]. Other identified phytochemicals include terpenes, phenolics (such as gallic acid and chlorogenic acid), and flavonoids [PMID:41074812, PMID:37082370].
Mécanisme d'action
The active cardenolides exert positive inotropic effects on the heart by inhibiting the plasmalemma Na+,K+ ATPase, a mechanism similar to that of digitalis glycosides and digoxin [PMID:8619248, PMID:38371160].
Preuves cliniques
Preuve DCancer (In vitro)
Methanolic extracts of fruits and isolated cardenolides exhibited cytotoxic, antiproliferative, and apoptotic activity against human breast, colorectal, prostate, and lung cancer cell lines [PMID:28464893, PMID:35983797].
Preuve DSperm motility (In vitro)
Aqua-methanolic extract of leaves demonstrated a dose-dependent spermicidal effect on human spermatozoa, with complete immobilization observed at 160 mg/ml within 5 minutes [PMID:34845741].
Sécurité et effets indésirables
All parts of the plant are toxic [PMID:20438743]. Ingestion causes a syndrome of combined gastrointestinal symptoms (nausea, vomiting, abdominal pain, diarrhea) and cardiac symptoms [PMID:92752, PMID:20438743]. Cardiac toxicity manifests as bradyarrhythmias, tachyarrhythmias, heart block, and ventricular arrhythmias, which can lead to sudden cardiac death [PMID:19306191, PMID:38371160, PMID:30073854].
Synthèse des preuves
The available evidence is primarily based on toxicological case reports, reviews, and in vitro studies. There is strong evidence regarding the plant's acute toxicity and cardiac glycoside mechanism, but clinical therapeutic evidence is limited to pre-clinical in vitro models.
Sources PubMed
1.PMID: 37496389 (2023) — Yellow oleander (Thevetia peruviana) toxicosis in 4 goats. · Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc
2.PMID: 92752 (1979) — Oleander poisoning. · The Medical journal of Australia
5.PMID: 34845741 (2022) — In vitro spermicidal effect of Thevetia Peruviana leaves on human spermatozoa. · Andrologia
6.
Sources gouvernementales
Aucune monographie gouvernementale directe n'est disponible pour cette plante. Le contenu ci-dessous est généré par IA et n'a pas été vérifié par rapport à une source gouvernementale faisant autorité. Utilisez les liens de recherche pour consulter les sources officielles avant de vous fier à ces informations.
PMID: 41074812 (2025) — Cascabela thevetia (L.) lippold.- a review on its phytochemistry, pharmacology and toxicity. · Natural product research
7.PMID: 30073854 (2019) — Cardiac arrhythmias, electrolyte abnormalities and serum cardiac glycoside concentrations in yellow oleander (Cascabela thevetia) poisoning - a prospective study. · Clinical toxicology (Philadelphia, Pa.)
8.PMID: 20438743 (2010) — A review of the natural history, toxinology, diagnosis and clinical management of Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander) poisoning. · Toxicon : official journal of the International Society on Toxinology
9.PMID: 28464893 (2017) — Anticancer potential of Thevetia peruviana fruit methanolic extract. · BMC complementary and alternative medicine
11.PMID: 37082370 (2023) — Thevetia peruviana leaves, HPLC profile, isolation, and in vitro cytotoxicity. · RSC advances
12.PMID: 8619248 (1996) — Oleander toxicity: an examination of human and animal toxic exposures. · Toxicology
13.PMID: 40080906 (2025) — Thevetia peruviana or Yellow Oleander (Apocynaceae) Poisoning with Myocardial Bridging: An Autopsy-Based Case Report. · Wilderness & environmental medicine
14.PMID: 35983797 (2024) — Three new cardenolides from the fruits of Cascabela thevetia (L.) Lippold and their cytotoxic activities. · Natural product research