- Rose laurel
For Patients & Caregivers
How It Works
Oleandrin may inhibit the growth of some cancer cells in the lab, but it has not yet been shown to be an effective cancer treatment.
Oleandrin is an extract from the plant, Nerium oleander. This shrub is native to northern Africa, the eastern Mediterranean basin, and Southeast Asia and although it looks appealing, is considered toxic. It contains substances that are similar to the active chemical found in the heart medication, digoxin. In the laboratory, Anvirzel™, a brand of oleandrin, is able to suppress growth and cause cell death in certain cancer cell lines. It has also increased sensitivity of prostate cancer cell lines to radiation therapy. However, it is unclear whether these effects can occur in the human body.
- To treat cancer Laboratory studies show some anticancer activity in cancer cell lines, but clinical trials have not evaluated the anticancer activities of oleandrin in humans. There is no scientific evidence to support the following claims:
- To treat congestive heart failure
- To treat hepatitis C
- To treat AIDS
- The raw plant from which Anvirzel™ is extracted, Nerium oleander, is highly toxic. Consumption of only one Nerium oleander leaf may be fatal.
- Onset of toxicity occurs several hours after consumption and includes vomiting, abdominal pain, bluish skin discoloration, low blood pressure, low body temperature, dizziness, respiratory paralysis, and death.
Do Not Take If
Anvirzel™ is not an approved treatment in the United States and should not be used outside of clinical trials.
- You are taking digoxin: Anvirzel™ contains cardiac glycosides, the same active chemical in digoxin, so the two medications may have additive effects, causing toxicity.
- You are taking P-glycoprotein (P-gp) substrates drugs: Oleander leaf extract may increase the blood levels of these drugs.
- You have high blood levels of calcium
- You have low blood levels of potassium
- You have abnormally slow heart rate
- You have abnormally fast ventricular heart rate
- You have heart failure Anvirzel™ contains the cardiac glycosides, the same active chemical in digoxin, and is therefore contraindicated in people with these conditions.
- Nausea and vomiting
- Pain at injection site
- Tumor pain
- Breast pain
- Abnormally high white blood cell counts
- Abnormally fast and irregular heart rate
- Death of an adult diabetic man: Due to consumption of oleander leaves.
- Death suspected from daily intramuscular injections: In a 43-year-old cancer patient, who used intramuscular injections of Nerium oleander extract for 2 months.
- Accidental poisoning: In a woman who attempted to self-medicate for thyroid disease.
For Healthcare Professionals
Nerium oleander is an ornamental shrub native to northern Africa, the eastern Mediterranean basin, and Southeast Asia. It is used in traditional medicine to treat hemorrhoids, ulcers, leprosy, and as an abortifacient. The leaf is poisonous because of oleandrin, a cardiac glycoside with structure and actions similar to those of digoxin, and both exert their effects by inhibiting membrane enzyme Na+, K+ -ATPase (1).
Most studies have focused on the anticancer activities of oleandrin because of its apoptotic effects in various cancer cell lines (2) (3) (4) (5) (6) (7) (8). It also increases sensitivity of PC-3 human prostate cells to radiotherapy (9) and reduces gentamycin toxicity (10). A study in glioma models suggest potential activity (27). In other studies, oleandrin demonstrated neuroprotective activity (11) and reduced infectivity of the HIV virus (24).
A hot water extract of the plant, known as Anvirzel™, has been developed as a potential treatment for cancer, AIDS, and congestive heart failure. It consists of a mixture of oleandrin and the glycone oleandrigenin. Experiments suggest that a combination of Anvirzel and cisplatin may be more effective than cisplatin monotherapy (28). In an earlier study, Anvirzel appeared safe in humans when injected intramuscularly, although adverse effects such as injection site pain, fatigue, and other GI symptoms were reported (12).
Anvirzel™ is not an approved cancer treatment in the United States. Until more data regarding its efficacy and toxicity are available, this product should not be used outside of clinical trials.
Mechanism of Action
Oleandrin may slow tumor growth by inhibiting the membrane enzyme Na+, K+ -ATPase (1), especially in cells that have higher ratio of alpha 3 to alpha 1 isoform expression (13). It improves cellular export of fibroblast growth factor-2 (FGF-2) (4). Oleandrin also induces apoptosis through NF-kB suppression (2) (15). It was shown to selectively sensitize lung cancer cells to apoptosis-inducing ligand Apo2L/TRAIL. This was accompanied by upregulation of death receptors 4 (DR4) and 5 (DR5) at both the RNA and protein levels (16).
Other proposed mechanisms include the formation of superoxide radicals that cause tumor cell injury via mitochondrial disruption (7), inhibition of interleukin-8 that mediates tumorigenesis (17), activation of caspase-3 (9), induction of tumor cell autophagy (6), and inhibition of Pgp (8).
In a recent study, PBI-05204, an extract of Nerium Oleander, inhibited proliferation of the Panc-1 tumor cells in part, via downregulation of PI3k/Akt and mTOR pathways (26).
- Common (Raw botanical) Consumption of even one Nerium oleander leaf can be fatal (25). Onset of toxicity occurs several hours following consumption. Symptoms include vomiting, abdominal pain, cyanosis, hypotension, hypothermia, vertigo, respiratory paralysis and death. These symptoms can occur at a serum oleandrin levels between 1.0 and 2.0 ng/mL (19).
- With Anvirzel™, pain at injection site, fatigue, transient erythema, nausea, vomiting and diarrhea.
- Death of an adult diabetic man: Due to consumption of oleander leaves. Oleandrin levels in the blood were roughly 10 ng/mL (20).
- Death suspected from daily intramuscular injections: In a 43-year-old patient with metastatic synovial sarcoma of the knee who used daily intramuscular injections of Nerium oleander extract for 2 months. Symptoms included nausea, vomiting, severe stomach pain and bloating followed by a gradual reduction in liver enzymes and cardiopulmonary arrest (21).
- Accidental poisoning: In a woman who attempted to self-medicate for thyroid disease (14).
- Digoxin: Theoretically, cardiac glycosides in Nerium oleander may have an additive effect with digoxin, causing toxicity.
- P-glycoprotein (P-gp) substrates: Oleander leaf extract inhibits P-gp and may increase the blood levels of substrate drugs. (8)