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Oleander poisoning

Definition

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.

Alternative Names

Rosebay poisoning; Yellow oleander poisoning; Thevetia peruviana poisoning

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:

Gastrointestinal:

  • Diarrhea
  • Loss of appetite
  • Nausea
  • Stomach pain
  • Vomiting

Heart and blood:

Nervous system:

  • Confusion
  • Death
  • Depression
  • Disorientation
  • Dizziness
  • Drowsiness
  • Fainting
  • Headache
  • Lethargy

Skin:

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

Poison Control

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
  • Blood and urine tests
  • Breathing support
  • Chest x-ray
  • EKG (electrocardiogram, or heart tracing)
  • Fluids through a vein (IV)
  • Medication to treat symptoms including an antidote to reverse the effects of the poison
  • Tube through the mouth into the stomach to wash out the stomach (gastric lavage)

Outlook (Prognosis)

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.

Symptoms last for 1 - 3 days and may require a hospital stay. Death is unlikely.

Prevention

Do not touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods.

References

Graeme K. Toxic plant ingestions. In: Auerbach PS, ed. Wilderness Medicine. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2011:chap 64.

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.


Review Date: 10/21/2013
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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