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Scilla Squill
Drimia maritima
Cardiac insufficiency in historical European medicine
How does Scilla squill work as a cardiac glycoside?
Scilla squill contains cardiac glycosides, primarily scillaren A and proscillaridin A, which work by inhibiting the sodium-potassium ATPase pump in cardiac cells. This inhibition increases intracellular calcium concentration, strengthening cardiac muscle contraction and improving cardiac output. Unlike digitalis, Scilla glycosides have a shorter half-life and are primarily eliminated through the liver rather than kidneys (Evidence Level B). This mechanism produces positive inotropic effects, making it historically useful for heart failure, though pharmaceutical preparations have largely replaced its medicinal use due to narrow therapeutic margins.
What drug interactions occur with Scilla squill?
Scilla squill carries significant drug interaction risks due to its cardiac glycoside content. Concurrent use with other cardiac glycosides (digoxin, digitoxin) increases toxicity risk. Potassium-depleting diuretics (furosemide, hydrochlorothiazide) enhance glycoside toxicity by causing hypokalemia. Quinidine, verapamil, and amiodarone can increase plasma glycoside levels. Calcium supplements may precipitate arrhythmias when combined with cardiac glycosides. Beta-blockers may potentiate bradycardia. Due to these serious interactions and narrow therapeutic index, Scilla squill should only be used under physician supervision with standardized pharmaceutical preparations (Evidence Level B).
What is the proper dosage of Scilla squill?
There is no safe home dosage for Scilla squill due to its extremely narrow therapeutic index and potential for fatal toxicity. The active compounds, particularly scillaren A and proscillaridin A, vary significantly in unstandardized preparations. Historically, pharmaceutical preparations were standardized and dosed by physicians based on individual patient response and cardiac status. Modern practice has largely abandoned Scilla squill in favor of safer, well-studied alternatives like digoxin. Self-medication with any unstandardized preparation is contraindicated (Evidence Level B).
Is Scilla squill safe during pregnancy and breastfeeding?
Scilla squill is unsafe during pregnancy and breastfeeding. The cardiac glycosides present in this herb, including scillaren A and proscillaridin A, can cross the placenta and may affect fetal cardiac development and rhythm. These compounds may also be excreted in breast milk, potentially causing toxicity in nursing infants. Historical use never included pregnancy applications, and modern assessment classifies it as contraindicated (Evidence Level B). Women who are pregnant, planning pregnancy, or breastfeeding should avoid all Scilla squill preparations.
What is Scilla squill used for in herbal medicine?
Scilla squill (Drimia maritima) has been used historically for cardiac insufficiency and as an expectorant for chronic coughs. Ancient Egyptian, Greek, and Roman physicians employed it for heart conditions and edema. The bulb contains cardiac glycosides that strengthen heart contractions, similar to digitalis but with a shorter duration of action. Red squill varieties have been used as rodenticides due to their toxicity. Modern herbal medicine rarely uses Scilla squill due to safety concerns, and it has largely been replaced by pharmaceutical cardiac glycosides (Evidence Level B, Traditional use).
What are the side effects and toxicity of Scilla squill?
Scilla squill has a narrow therapeutic window with potentially fatal toxicity. Common side effects include nausea, vomiting, abdominal pain, and diarrhea due to GI irritation. Cardiac toxicity manifests as arrhythmias, including bradycardia, atrioventricular block, and ventricular fibrillation. Neurological symptoms may include headache, fatigue, and visual disturbances. Unlike digitalis, Scilla glycosides cause more pronounced gastrointestinal symptoms before cardiac effects appear. The therapeutic dose is close to the toxic dose, making overdose a significant risk with unstandardized preparations (Evidence Level B).
PubMed-compiled information sheet
This sheet was compiled from PubMed (NIH) abstracts using AI assistance. Every factual claim is cited to a real PubMed article (see the source list). It has not yet been human-reviewed — confirm with a healthcare provider before use.
Compiled from 28 PubMed articles · model: gemma4:31b
Summary
Scilla Squill (Drimia maritima), also known as sea squill, is a medicinal plant containing cardiac glycosides and phenolic compounds used in traditional medicine for respiratory and inflammatory conditions [PMID:27998692, PMID:25027721].
Background
Drimia maritima (L.) Stearn, belonging to the Asparagaceae family, is a species widely spread across the Mediterranean region in two main varieties: white squill and red squill [PMID:30464515, PMID:37299060].
Traditional uses
In Traditional Iranian and Persian medicine, Squill has been used to treat asthma [PMID:27998692], alleviate phlegm dyspnea [PMID:35677368], and treat hair loss [PMID:31707498]. It has also been used globally for the treatment of various ailments, including cancer [PMID:30464515].
Active compounds
The plant contains cardiac glycosides (specifically bufadienolides such as scilliroside, scillarenin 3-O-beta-D-glucoside, and proscillaridin A), phenolic compounds (including dihydroquercetin derivatives, quercetin, and kaempferol), flavonoids, anthocyanins, and fructo-oligosaccharides like sinistrin [PMID:25027721, PMID:37299060, PMID:30981307, PMID:8324767, PMID:17236017].
Mechanism of action
Squill is reported to exert anti-inflammatory, anti-oxidant, anti-cholinergic, and mucus secretion modulating effects [PMID:27998692, PMID:35677368]. In breast cancer cells (MCF-7 and MDA-MB-468), it induces cytotoxicity via the mitochondrial apoptotic pathway, increasing ROS production, releasing cytochrome c, activating caspases, and increasing the Bax/Bcl-2 ratio and ER stress markers (CHOP, ATF-4, GADD34) [PMID:30464515].
Clinical evidence
Evidence BModerate to severe persistent asthma
A pilot trial evaluated Squill Oxymel as an add-on treatment to routine corticosteroids and beta-2 agonists [PMID:27998692].
Evidence BModerate COPD
Patients receiving Squill-Oxymel showed a statistically significant increase in 6-minute walk test (6MWT) distance (P=0.011) [PMID:35677368].
Evidence BAlopecia areata
In a randomized double-blind trial, topical squill extract was compared to Clobetasol lotion; significant differences in regrowth scores (RGS4) were observed between groups after 2 and 3 months (P<0.05) [PMID:31707498].
Safety & adverse effects
Cardioactive steroids in red squill can cause toxicity similar to digoxin [PMID:29262029]. The plant has been utilized as a rodenticide due to its toxicity to rats and other animals [PMID:13115635, PMID:13115980, PMID:17647976, PMID:14907921, PMID:521820].
Evidence summary
Evidence consists of pilot randomized clinical trials for respiratory and dermatological conditions (Level B) and in vitro studies for anticancer activity (Level D).
PubMed sources
1.PMID: 29262029 (2026) — Phytochemical Analysis and Anticancer Properties of Drimia maritima Bulb Extracts on Colorectal Cancer Cells. · Molecules (Basel, Switzerland)
2.PMID: 27998692 (2017) — Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: A pilot, triple-blind, randomized clinical trial. · Journal of ethnopharmacology
3.PMID: 35677368 (2022) — An Add-On Treatment for Moderate COPD with Squill-Oxymel (a Traditional Formulation from Drimia maritima (L.) Stearn): A Pilot Randomized Triple-Blinded Placebo-Controlled Clinical Trial. · Evidence-based complementary and alternative medicine : eCAM
4.PMID: 25027721 (2014) — Simultaneous determination of bufadienolides and phenolic compounds in sea squill (Drimia maritima (L.) Stearn) by HPLC-DAD-MSn as a means to differentiate individual plant parts and developmental stages. · Analytical and bioanalytical chemistry
No direct government monograph is available for this herb. The content below is AI-generated and has not been verified against an authoritative government source. Use the search links to check official sources before relying on this information.
— Cytotoxic effect of Drimia maritima bulb extract and induction of mitochondrial apoptotic signaling in human breast cancer cells, MCF-7 and MDA-MB-468.
· OncoTargets and therapy
6.PMID: 13115635 (1953) — Rat poison from white squill. · British journal of pharmacology and chemotherapy
7.PMID: 37299060 (2023) — Comparative MS- and NMR-Based Metabolome Mapping of Egyptian Red and White Squill Bulbs F. Liliaceae and in Relation to Their Cytotoxic Effect. · Plants (Basel, Switzerland)
8.PMID: 25841205 (2015) — Metabolic fate of cardiac glycosides and flavonoids upon fermentation of aqueous sea squill (Drimia maritima L.) extracts. · Journal of pharmaceutical and biomedical analysis
9.PMID: 30981307 (2019) — Chemical characterization and acaricidal activity of Drimia maritima (L) bulbs and Dittrichia viscosa leaves against Dermanyssus gallinae. · Veterinary parasitology
10.PMID: 24938488 (2014) — Urgineaglyceride A: a new monoacylglycerol from the Egyptian Drimia maritima bulbs. · Natural product research
11.PMID: 42168276 (2026) — Plant‑mediated silver quantum dots from Drimia maritima: antioxidant modulation and ROS‑induced apoptosis in breast cancer cells. · Scientific reports
12.PMID: 26008751 (2016) — Laūq: A Sustained-Release Dosage Form for Respiratory Disorders in Traditional Persian Medicine. · Journal of evidence-based complementary & alternative medicine
13.PMID: 31707498 (2020) — The comparison of therapeutic effect of Clobetasol propionate lotion and squill extract in alopecia areata: a randomized, double-blind clinical trial. · Archives of dermatological research
14.PMID: 35270070 (2022) — Untargeted Phenolic Profiling and Functional Insights of the Aerial Parts and Bulbs of Drimia maritima (L.) Stearn. · Plants (Basel, Switzerland)
15.PMID: 17236017 (1994) — About the bufadienolide complex of "red" squill. · Planta medica
16.PMID: 13115980 (1953) — Rodenticides in bubonic-plague control. · Bulletin of the World Health Organization
17.PMID: 8324767 (1993) — Fructo-oligosaccharides from Urginea maritima. · Carbohydrate research
18.PMID: 17647976 (1943) — Toxicity of Red Squill for Swine and Rats. · Canadian journal of comparative medicine and veterinary science
19.PMID: 521820 (1979) — TLC-spectrophotometric assay of the main glycosides of red squill, a specific rodenticide. · Journal of natural products
20.PMID: 14907921 (1952) — The toxicity of red squill raticide to domesticated animals. · Journal of comparative pathology
21.PMID: 1473105 (1992) — The structure of the fructan sinistrin from Urginea maritima. · Carbohydrate research
22.PMID: 1238440 (1975) — Role of illness in producing learned taste aversions in rats: a comparison of several rodenticides. · Journal of comparative and physiological psychology