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Castor

Scientific Name(s): Ricinus communis L.
Common Name(s): African coffee tree, Bofareira, Castor, Mexico weed, Ogiri-igbo, Palma christi, Tangantangan oil plant, Wonder tree

Clinical Overview

Use

Castor oil is commonly used as a laxative and for the induction of labor. However, there are no clinical trials to support these uses.

Dosing

Dosages of castor seed oil vary, ranging from 5 mL as a purgative to 120 mL for the induction of labor.

Contraindications

Contraindicated in pregnant women with previous cesarean delivery or uterine surgery.

Pregnancy/Lactation

Documented adverse reactions when used to induce labor. Avoid use.

Interactions

None well documented.

Adverse Reactions

Allergic reactions and contact dermatitis have been reported. Anaphylaxis has resulted from the use of intravenous (IV) preparations in which the vehicle is a castor oil derivative.

Toxicology

Deaths from castor plant/bean ingestion are rare. Ricin, a toxic protein of the castor bean, has been used as a biological weapon.

Botany

Castor, a common annual ornamental native to the West Indies, grows to heights of 12 m and bears broad, deeply-lobed leaves on broad stalks. The flowers develop into spiny capsules, each containing 3 seeds. As the capsules dry, they explode, scattering the glossy, speckled oval beans.Doan 2004, Krenzelok 2009, Ogunniyi 2006, USDA 2006 The castor plant has been naturalized to temperate regions of the continental United States and Hawaii.Bradberry 2003, Spivak 2005

History

The name Ricinus is derived from the Latin word for insect because the seeds resemble beetles in shape and markings. Castor beans are used as art objects and ornaments. The Egyptians used castor oil as a lamp oil and an unguent, also ingesting the oil with beer as a purgative. The roots, leaves, and seeds have a place in traditional folk remedies throughout the world. Other recorded medicinal uses include induction of labor, as a cathartic, as a contraceptive cream, and as a skin emollient.Audi 2005, Bradberry 2003, Doan 2004, Duke 1985, Ogunniyi 2006, Spivak 2005 The fast-drying, nonyellowing oil has been used in the manufacture of high-grade lubricants for industrial machinery and aircraft engines and in dyes, inks, paint, and varnishes.Audi 2005, Doan 2004, Ogunniyi 2006 The castor cake or pulpy residue that remains after oil extraction has been used as animal feed and as fertilizer despite its unsuitability due to traces of toxins.Ogunniyi 2006

Ricin was developed as a biological warfare agent in the 1920s and was considered for use during World Wars I and II. Arrests for terrorism activity have been made since the 1990s for the possession of ricin or castor beans.Bradberry 2003, Doan 2004, Spivak 2005

Initially hailed as a potential antitumor agent, ricin underwent phase 1 and 2 clinical trials for tumor-specific antibody action. However, the dose-limiting adverse reactions hypoalbuminema and edema, as well as the lack of specificity and intrinsic immunogenicity precluded approval.Spivak 2005

Chemistry

Cold expression of the kernels yields about 33% medicinal quality castor oil.Burdock 2006 The pulpy residue left after expression of the oil is known as the castor pomace.Marin 2006 An additional 13% to 20% of lesser quality fixed oil can be obtained by further extraction.Burdock 2006, Marin 2006 Castor oil is a mixture of triglycerides, of which 75% to 90% is ricinoleic acid.Leung 1980, Ogunniyi 2006 Lesser amounts (1% to 4%) of linoleic, oleic, palmitic, and stearic acids are also found.Ogunniyi 2006 Further refinement by steam, filtration, and bleaching removes some of the toxins (such as ricin and ricinine) and the allergen CB-1A.Burdock 2006, Doan 2004

Ricin, a 65 Kda glycoprotein phytotoxin, consists of a neutral A chain and an acidic B chain connected by disulfide bonds. The A chain inhibits protein synthesis (causing cell death), while the B chain serves as a carrier that binds the protein to cell surfaces and facilitates internalization, similar to other type II ribosome inactivating proteins such as the bacterial toxins from diphtheria, cholera, and anthrax.Doan 2004

Ricin can be separated into the highly toxic ricin D, acidic ricin, and basic ricin. The alkaloid ricinine found in the seeds is also present in the leaves.Doan 2004, Spivak 2005

Uses and Pharmacology

Cancer

A review suggests a potential application of ricin as a chemotherapeutic agent considering its ribosome-inactivating properties. Clinical studies are, however, lacking.Tyagi 2015

Chemical warfare

Ricin has been developed as a biological warfare agent.Bradberry 2003, Doan 2004, Spivak 2005 The immunogenicity that precluded the use of ricin as an antitumor agent is now being used in the development of an antiricin vaccine as a defensive biological agent. Animal studies have investigated active immunization and passive prophylaxis with limited success. A genetically engineered form of a ricin subunit elicited antibodies in animals and may protect against larger doses of ricin.Bradberry 2003, Doan 2004, Spivak 2005

Induction of labor

Castor oil was widely used to induce labor by US midwives in the past, but use has declined.Sicuranza 2003, Tenore 2003 Reviews of trials and case reports find no evidence supporting this use.Kelly 2003, Tenore 2003 Doses cited range from 5 to 120 mL; however, no clinical data are available to support these doses.Sicuranza 2003 One proposed mechanism of action is stimulation of endogenous prostaglandin E synthesis by ricinoleic acid.Sicuranza 2003

No morbidity or mortality data are available in these studies for either mother or newborn. Nausea was commonly reported. Complications included amniotic fluid embolism after a single 30 mL dose and uterine rupture after a 5 mL dose in a woman with a previous cesarean delivery.Sicuranza 2003

Laxative/purgative

The oil has long been used as a laxative and purgative following treatment for intestinal parasites. The components of castor oil are known to exert a cathartic effect.Bradberry 2003, Duke 1985, Rajshekhar 2004

Ophthalmic

A small randomized clinical trial evaluating the efficacy of castor oil eye drops in treating meibomian gland dysfunction resulted in an increase in tear stability and a lubricating effect.Goto 2002

Vehicle/solubilizer

Castor oil is used for its water-insoluble lipid and surfactant properties in certain oral and injectable drugs and vitamin preparations, including cyclosporin A, phytonadione, tacrolimus, and carbamazepine.Andrade 2014, Riegert-Johnson 2002, Strickley 2004, Tayrouz 2003

Wound management

Castor oil is found in topical wound care preparations, often combined with Peru balsam and trypsin.Glenn 2006, Gray 2004

Dosing

Dosages of castor seed oil vary considerably, with 5 to 120 mL reported as a single dose in the literature. The lower dose has been used as a purgative, and the higher dose has been used to induce labor.Doan 2004, Spivak 2005

Pregnancy / Lactation

Avoid use. Particularly contraindicated in pregnant women with previous cesarean delivery or uterine surgery.Kelly 2013, Sicuranza 2003

Interactions

The kinetics of digoxin were affected by coadministration of the castor oil derivative polyoxyl 35 castor oil. Oral cremophor delayed and enhanced absorption of an oral dose of digoxin 0.5 mg in healthy adults. The increase in plasma digoxin concentrations did not result in clinical effects.Tayrouz 2003 Experimental interactions with IV doxorubicin and doxorubicinol and oral saquinavir also have been observed, with proposed action via interference with the efflux pump P-glycoprotein membrane transporter. Interactions with other drugs with relatively low bioavailability, such as amiodarone and phenytoin, are theoretically possible.Tayrouz 2003

Adverse Reactions

Immunoglobulin E-mediated allergy to castor bean dust was common among castor oil factory workers, presenting as an increased incidence of asthma.Marin 2006

Case reports of allergic reactions to the castor oil component in topical preparations exist, including reactions to vaginal lubricating gels.Di Berardino 2003

A review of anaphylactic reactions to IV phytonadione suggested that the vehicle polyoxylated castor oil was responsible. No previous exposure or sensitization was documented for the reaction.Riegert-Johnson 2002

Toxicology

R. communis is a commonly cultivated plant, and ornamental use of the beans makes them attractive to small children. The leaves and seeds of the plant contain the toxic protein ricin and the alkaloid ricinine.Di Berardino 2003, Kinamore 1980 Nonetheless, deaths from castor plant or bean are rare. Between 1983 and 2002, no deaths were recorded by the American Association of Poison Control CentersDoan 2004, O'Connell 2005, Spivak 2005 and more recent analyses of case reports suggest that toxicity from castor poisoning is usually not severe.Doan 2004, Spivak 2005, Thornton 2014

Toxicity of ricin is dependent on both the dose and the route of administration. Intracellular uptake of ricin is relatively slow; however, a small number of molecules can cause cell death via irreversible inactivation of ribosomes leading to inhibition of protein synthesis.Bradberry 2003, Doan 2004, Spivak 2005 In a primate study, a dose-dependent latency to onset of symptoms of up to 24 hours was demonstrated following inhalation exposure, with death occurring within 36 to 48 hours.Spivak 2005

The mean lethal dose is lowest for the inhalational route and highest for the intragastric route. Inhalation of castor bean dust may lead to pulmonary and systemic effects in factory workers. Poor absorption results from ingestion of the bean as enzymatic degradation occurs. Contact dermatitis has been reported, but dermal absorption is poor.Spivak 2005 Experiments in rats and mice to determine the distribution of ricin found 50% to 68% of the IV dose in the liver, muscle, and spleen.Doan 2004, Spivak 2005 Parenteral doses of ricin up to 20 mcg/m 2 in clinical trials were well tolerated, with adverse reactions of flu-like symptoms and muscle pain reported.Bradberry 2003, Doan 2004, Spivak 2005

Management of castor or ricin poisoning is generally symptomatic.Doan 2004, O'Connell 2002 Administration of IV fluids and electrolytes is the standard response, but gastric lavage is appropriate if the beans or plant parts have been chewed. If the seeds have been swallowed whole, poisoning is unlikely to occur.Doan 2004, O'Connell 2002 Symptoms of poisoning include nausea, vomiting, abdominal cramps, diarrhea, dehydration, GI hemorrhage, anuria, fever, and hypotension, as well as signs of liver and renal toxicity.Doan 2004, Spivak 2005

References

Andrade IM, Andrade KM, Pisani MX, et al. Trial of an experimental castor oil solution for cleaning dentures. Braz Dent J. 2014;25(1):43-47.24789291
Audi J, Belson M, Patel M, Schier J, Osterloh J. Ricin poisoning: a comprehensive review. JAMA. 2005;294:2342-2351.16278363
Bradberry SM, Dickers KJ, Rice P, Griffiths GD, Vale JA. Ricin poisoning. Toxicol Rev. 2003;22:65-70.14579548
Burdock GA, Carabin IG, Griffiths JC. Toxicology and pharmacology of sodium ricinoleate. Food Chem Toxicol. 2006;44:1689-1698. Epub 2006 May 26.16831502
Di Berardino L, Della Torre F. Side effects to castor oil. Allergy. 2003;58:826.12859571
Doan 2004Doan LG. Ricin: mechanism of toxicity, clinical manifestations, and vaccine development. A review. J Toxicol Clin Toxicol. 2004;42:201-208.15214627
Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press; 1985.
Glenn J. Managing a traumatic wound in a geriatric patient. Ostomy Wound Manage. 2006;52:94-98.16636366
Goto E, Shimazaki J, Monden Y, et al. Low-concentration homogenized castor oil eye drops for noninflamed obstructive meibomian gland dysfunction. Ophthalmology. 2002;109:2030-2035.12414410
Gray M, Jones DP. The effect of different formulations of equivalent active ingredients on the performance of two topical wound treatment products. Ostomy Wound Manage. 2004;50:34-38, 40, 42-44.
Kelly AJ, Kavanagh J, Thomas J. Castor oil, bath and/or enema for cervical priming and induction of labour. Cochrane Database Syst Rev. 2013;(7):CD003099.23881775
Kinamore PA, Jaeger RW, de Castro FJ. Abrus and ricinus ingestion: management of three cases. Clin Toxicol. 1980;17:401-405.6108823
Krenzelok EP. The castor "bean" plant: much maligned, but beautiful! Clin Toxicol (Phila). 2009;47(9):904.19821636
Leung AY. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. New York, NY: Wiley; 1980.
Marin V, Saraga J, Ariano R, et al. Allergic memory of patients sensitized to castor bean after a long stimulation-free period. J Asthma. 2006;43:193-198.16754520
O'Connell KP, Menuey BC, Foster D. Issues in preparedness for biologic terrorism: a perspective for critical care nursing. AACN Clin Issues. 2002;13:452-469.12151997
Ogunniyi DS. Castor oil: a vital industrial raw material. Bioresour Technol. 2006;97:1086-1091.15919203
Rajshekhar V. Purging the worm: management of Taenia solium taeniasis. Lancet. 2004;363:912.15043955
Ricinus Communis L. Castorbean. USDA, NRCS. 2006. The PLANTS Database (http://plants.usda.gov, 11 October 2006). National Plant Data Center, Baton Rouge, LA 70874-4490 USA.
Riegert-Johnson DL, Volcheck GW. The incidence of anaphylaxis following intravenous phytonadione (vitamin K1): a 5-year retrospective review. Ann Allergy Asthma Immunol. 2002;89:400-406.12392385
Sicuranza GB, Figueroa R. Uterine rupture associated with castor oil ingestion. J Matern Fetal Neonatal Med. 2003;13:133-134.12735415
Spivak L, Hendrickson RG. Ricin. Crit Care Clin. 2005;21:815-824, viii.16168316
Strickley RG. Solubilizing excipients in oral and injectable formulations. Pharm Res. 2004;21:201-230.15032302
Tayrouz Y, Ding R, Burhenne J, et al. Pharmacokinetic and pharmaceutic interaction between digoxin and Cremophor RH40. Clin Pharmacol Ther. 2003;73:397-405.12732840
Tenore JL. Methods for cervical ripening and induction of labor. Am Fam Physician. 2003;67:2123-2128.12776961
Thornton SL, Darracq M, Lo J, Cantrell FL. Castor bean seed ingestions: a state-wide poison control system's experience. Clin Toxicol (Phila). 2014;52(4):265-288.24579983
Tyagi N, Tyagi M, Pachauri M, Ghosh PC. Potential therapeutic applications of plant toxin-ricin in cancer: challenges and advances. Tumour Biol. 2015;36(11):8239-46.26349746

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