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Poinsettia

Scientific Name(s): Euphorbia pulcherrima Willd. ex Klotzsch
Common Name(s): Christmas flower, Christmas star, Easter flower, Lobster flower plant, Mexican flame leaf, Noch Buena, Papagallo, Poinsettia, Star of Bethlehem

Medically reviewed by Drugs.com. Last updated on Apr 1, 2019.

Clinical Overview

Use

Poinsettias are used primarily as Christmas ornamentation but have been used traditionally to treat skin conditions, warts, and toothaches; however, clinical studies are lacking to support these uses.

Dosing

No recent clinical evidence exists to support specific dosing of poinsettia in a therapeutic context.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Allergy and contact dermatitis have been reported. Minor GI irritation following ingestion is possible requiring only supportive therapy.

Toxicology

Although many published reports have warned of the plant's toxicity, there is little clinical evidence to support this claim.

Scientific Family

  • Euphorbiaceae (spurge)

Botany

Poinsettia belongs to the Euphorbiaceae (spurge) family, which includes more than 1,000 herbs, shrubs, and trees. Many members of this family, including poinsettia, are characterized by the presence of a milky latex emulsion found in the lactiferous vessels. When damaged, the plants secrete this latex. Poinsettia is a perennial ornamental found throughout warmer climates in the United States and Mexico. The plant has small yellow flowers and red leaves (bracts), which are prized for their decorative effect. The plant has also been referred to as Euphorbia poinsettia Buist and Poinsettia pulcherrima Graham.Trejo 2012, USDA 2015

History

The poinsettia plant was brought from Mexico to the United States by Joel Robert Poinsett, a physician, botanist, and US diplomat, in the early 1800s.Trejo 2012 E. pulcherrima sap has been used as a depilatory agent, and extracts of the plant were used traditionally as an antipyretic and to stimulate lactation.Duke 1992, Winek 1978 Poinsettia has also been used as a natural remedy for warts and toothaches, although the plant is now primarily used for decorative purposes.Duke 1992, Trejo 2012

Chemistry

The stems and leaves may contain small amounts of alkaloids; however, there are conflicting data regarding the presence of these compounds. The latex or milky sap contains aminobutyric acids, cycloartenol, and pseudotaraxasterol.Duke 1992 Although saponic glycosides and diterpene esters from the sap are often believed to be toxic, there is little evidence of the plant's toxicity.Cortinovis 2013, Petersen 2011 Compounds found in the leaves and stems include germanicol, beta-amyrin, pulcherol, octaeicosanol, beta-sitosterol, rubber, caffeic acid, and anthocyanin.Duke 1992 Chemical constituents of the flowers and fruit have also been described.Duke 1992, Gupta 1983

Uses and Pharmacology

Animal data

Crude E. pulcherrima extract exhibited some antiviral activity; however, further fractionation resulted in loss of this effect.Forero 2008

Molluscicidal activity against fresh water snails has been demonstrated with aqueous poinsettia latex extract.Singh 2005

Effects of dried poinsettia latex on the CNS, including antinociception, anticonvulsant, motor coordination, sedative-hypnotic potentiation, and antianxiety effects, were evaluated in rodents; only anticonvulsant effects were observed.Singh 2012

Clinical data

Research reveals no clinical data regarding the use of poinsettia.

Dosing

Clinical evidence does not support specific dosing of poinsettia in a therapeutic context.

Pregnancy / Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking. Traditional use as a galactogenic agent has not been clinically supported.Winek 1978

Interactions

None well documented.

Adverse Reactions

Reports of contact dermatitisD'Arcy 1974, Massmanian 1998 and allergy with rhinitis and asthma have been reported,Ibáñez 2004 especially in atopic individuals.Aydin 2014, Evens 2012

Toxicology

Although many published reports have warned of the plant's toxicity, there is little clinical evidence to support this claim.Evens 2012, Winek 1978 The apparent source of these reports is a single, poorly documented 1919 case in which a 2-year-old child in Hawaii died after ingesting the plant leaves.Evens 2012, Krenzelok 1996, Winek 1978 Due to the bright color of the foliage, ingestion by children is common; however, there are very few poison center reports of adverse effects.Evens 2012, Krenzelok 1996 Supportive therapy is recommended; lavage or induction of vomiting is not necessary.Krenzelok 1996

Reports of toxicity (increased salivation, vomiting, and, rarely, diarrhea) in domestic cats, thought to be due to diterpenoid esters, have been published.Botha 2009, Cortinovis 2013 However, the diterpenes responsible for GI upset that are found in other members of the Euphorbia spp. are not found in E. pulcherrima.Evens 2012 Toxicity studies in rodents show no evidence of toxicity, even following instillation of the plant's latex into the eyes.Evens 2012, Runyon 1980, Stone 1971 Minor skin irritation has been observed after repeated exposure in rabbits.D'Arcy 1974, Evens 2012

Index Terms

  • Euphorbia poinsettia Buist
  • Poinsettia pulcherrima Graham

References

Aydin Ö, Erkekol FÖ, Misirloigil Z, Demirel YS, Mungan D. Allergic sensitization to ornamental plants in patients with allergic rhinitis and asthma. Allergy Asthma Proc. 2014;35(2):e9-e14.2471777910.2500/aap.2014.35.3733
Botha CJ, Penrith ML. Potential plant poisonings in dogs and cats in southern Africa. J S Afr Vet Assoc. 2009;80(2):63-74.19831265
Cortinovis C, Caloni F. Epidemiology of intoxication of domestic animals by plants in Europe. Vet J. 2013;197(2):163-168.2357077710.1016/j.tvjl.2013.03.007
D'Arcy WG. Letter: Severe contact dermatitis from poinsettia. Arch Dermatol. 1974;109(6):909-910.4830105
Duke J. Handbook of Biologically Active Phytochemicals and Their Activities. Boca Raton, FL: CRC Press; 1992.
Euphorbia pulcherrima. USDA, NRCS. 2015. The PLANTS Database (http://plants.usda.gov/java/, 2015). National Plant Data Center, Baton Rouge, LA 70874-4490 USA. 2015.
Evens ZN, Stellpflug SJ. Holiday plants with toxic misconceptions. West J Emerg Med. 2012;13(6):538-542.2335984010.5811/westjem.2012.8.12572
Forero JE, Avila L, Taborda N, et al. In vitro anti-influenza screening of several Euphorbiaceae species: structure of a bioactive Cyanoglucoside from Codiaeum variegatum. Phytochemistry. 2008;69(16):2815-2819.1885186210.1016/j.phytochem.2008.09.003
Gupta DR, Bhushan R, Ahmed B, Dhiman RP. Chemical Investigation of Fruits of Poinsettia pulcherrima. J Nat Prod. 1983;46(6):937-938.
Ibáñez MD, Fernández-Nieto M, Martínez J, et al. Asthma induced by latex from 'Christmas flower' (Euphorbia pulcherrima). Allergy. 2004;59(10):1127-1128.15355476
Krenzelok EP, Jacobsen TD, Aronis JM. Poinsettia exposures have good outcomes...just as we thought. Am J Emerg Med. 1996;14(7):671-674.8906768
Massmanian A. Contact dermatitis due to Euphorbia pulcherrima Willd, simulating a phototoxic reaction. Contact Dermatitis. 1998;38(2):113-114.9506231
Petersen DD. Common plant toxicology: a comparison of national and southwest Ohio data trends on plant poisonings in the 21st century. Toxicol Appl Pharmacol. 2011;254(2):148-153.2103475610.1016/j.taap.2010.10.022
Runyon R. Toxicity of fresh poinsettia (Euphorbia pulcherrima) to Sprague-Dawley rats. Clin Toxicol. 1980;16(2):167-173.7398206
Singh A, Singh SK. Molluscicidal evaluation of three common plants from India. Fitoterapia. 2005;76(7-8):747-751.16253436
Singh KK, Rauniar GP, Sangraula H. Experimental study of neuropharmacological profile of Euphorbia pulcherrima in mice and rats. J Neurosci Rural Pract. 2012;3(3):311-319.2318898410.4103/0976-3147.102612
Stone RP, Collins WJ. Euphorbia pulcherrima: toxicity to rats. Toxicon. 1971;9(3):301-302.5092399
Trejo L, Feria Arroyo TP, Olsen KM, et al. Poinsettia's wild ancestor in the Mexican dry tropics: Historical, genetic, and environmental evidence. Am J Bot. 2012;99(7):1146-1157.2276335410.3732/ajb.1200072
Winek CL, Butala J, Shanor SP, Fochtman FW. Toxicology of poinsettia. Clin Toxicol. 1978;13(1):27-45.737986

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