Oleander poisoning

Alternative Names: Rosebay poisoning; Yellow oleander poisoning; Thevetia peruviana poisoning

Oleander poisoning occurs when someone sucks nectar from the flowers or chews leaves from the oleander or yellow oleander plant. Poisoning can also happen if you eat honey made by bees that used the oleander plant for nectar.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Poisonous Ingredient

• Digitoxigenin
• Neriin
• Oleandrin
• Oleondroside

Note: This list may not include all poisonous ingredients.

Where Found

All parts of the oleander plant:

• Flowers
• Leaves
• Stems
• Twigs

Symptoms

• Eyes, ears, nose, mouth, and throat
  • Blurred vision
  • Vision disturbances, including halos
• Gastrointestinal
  • Diarrhea
  • Loss of appetite
  • Nausea
  • Stomach pain
  • Vomiting
• Heart and blood
  • Irregular or slow heartbeat
  • Low blood pressure
  • Weakness
• Nervous system
  • Confusion
  • Death
  • Depression
  • Disorientation
  • Dizziness
  • Drowsiness
  • Fainting
  • Headache
  • Lethargy
• Skin
  • Hives
  • Rash

Note: Depression, loss of appetite, and halos are usually only seen in chronic overdose cases.

Home Care

Seek immediate medical help. Do NOT make a person throw up unless told to do so by poison control or a health care professional.

Before Calling Emergency

Determine the following information:

• Patient's age, weight, and condition
• Name and part of the plant swallowed, if known
• Time it was swallowed
• Amount swallowed

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

See: Poison control center - emergency number

What to Expect at the Emergency Room

The health care provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. You may receive:

• Activated charcoal
• Breathing support
• Electrocardiogram (EKG)
• Fluids through a vein (IV)
• Medicine (antidote) to reverse the effect of the poison
• Tube through the mouth into the stomach to wash out the stomach (gastric lavage)

Prognosis (Outlook)

How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery.

Hostetler M, Schreiber S. Poisonous plants. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 205.

Graeme K. Toxic plant ingestions. In: Auerbach PS, ed. Wilderness Medicine. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 58.

Oleander (Nerium oleander)

Review Date: 10/13/2009
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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