Related Terms

• Basal tal-ghansar, bulbo de escila, Charybdis martima, Drimia maritime, European squill, ghansar, Indian squill, maritime squill, Mediterranean squill, Meerzwiebel, methylproscillaridin, pharmacist's squill, proscillaridine A, red squill, scilla, Scilla maritime, Scilla maritima (Linn.), Scillia urginea, scille, sea onion, sea squill, sea squill bulb, Urginea indica, Urginea maritima, Urginea maritima Baker, Urginea maritime, Urginea pancreatium, Urginea scilla, white sea onion, white squill.

Background

• About twenty-five species of squill have been described. Red squill and white squill varieties are distinguished by herbalists. No essential difference exists in the medicinal properties of the two kinds. The bulb has been used mainly as a stimulant, expectorant and diuretic. The fresh bulb is slightly more active medicinally than the dried bulb, but it also contains a sticky acrid juice that can cause skin inflammations.

• Squill seems to have cardiac effects similar to digoxin, although to a lesser degree, due to its poor absorption. Therefore, serious caution is indicated before its use.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Abortifacient (induces abortion), arrhythmia (abnormal heart rhythms), arthritis, asthma (with bronchitis), cancer, cardiotonic, catarrh (inflammation of the mucous membrane), chronic bronchitis, croup (laryngitis in infants), dandruff, diuretic, dropsy (swelling), dropsy (cardiac), edema (swelling), emetic (induces vomiting), expectorant, hair tonic, heart conditions, kidney disease, poisoning (rat), renal impairment, seborrhea, venous disorders, whooping cough.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older):

• There is no proven safe or effective dose for squill. Traditionally, extracts, syrups, tinctures, and vinegar preparations have been taken by mouth. Squill has also been studied for its cardiovascular effects using 1 milligram of an intravenous (injected) dose of methylproscillaridin (a cardiac glycoside of squill). Injections should only be given under the supervision of a qualified healthcare professional.

Children (younger than 18 years):

• There is no proven safe or effective dose for squill in children, and use is not recommended.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Avoid in individuals with a known allergy or hypersensitivity to squill (Urginea maritime).

Side Effects and Warnings

• Due to its cardiac glycoside constituents, squill has similar adverse effects as digitalis (a drug that regulates the rate and strength of the heartbeat), including arrhythmia (abnormal heart rate) and atrioventricular block. Other common adverse effects include abdominal pains, vomiting, blood in the vomit, nausea, and seizures. Death has been reported. When rubbed on the skin, irritation, including skin eruption, may occur.

• Recurrent fever, arthralgia (joint pain), myalgia (muscle pain), leukocytosis (high white blood cell count) and lymphopenia (loss of lymphocytes, a type of white blood cell), has occurred after ingestion of Venocuran®. Venocuran® was taken off of the market in 1975 and it is not clear whether it was the Urginea maritima or another constituent that caused the adverse effects.

• Avoid using squill in patients with heart, stomach, or intestine problems, including second or third degree atrioventricular block, hypertrophic cardiomyopathy (enlarged heart), carotid sinus syndrome, ventricular tachycardia, thoracic aortic aneurysm, or Wolff-Parkinson-White syndrome. Also avoid in patients with low potassium or high calcium levels.

Pregnancy and Breastfeeding

• Squill is not recommended for use in pregnant or breastfeeding women due to a lack of available scientific evidence. Squill may have abortifacient (abortion inducing) effects.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• Squill (Urginea maritime) has shown toxic effects similar to cardiac glycoside toxicity. In theory, squill may have additive toxic effects when used with cardiac glycosides, such as digoxin or digitoxin.

• Concomitant use with corticosteroids (steroids) may increase effects and adverse effects of long-term corticosteroid use. Caution is advised.

• When combined with quinidine (Quinidex®, Quinora®) or calcium, squill may increase the risk of cardiac toxicity and adverse effects. Laxatives and diuretics may deplete potassium and increase the risk of cardiac toxicity when taken with squill. Consult with a qualified healthcare professional, including a pharmacist, before combining therapies.

Interactions with Herbs and Dietary Supplements

• Squill (Urginea maritime) has shown toxic effects similar to cardiac glycoside toxicity. In theory, squill may have additive toxic effects when used with cardiac glycosides, such as foxglove.

• When combined with calcium, squill may increase the risk of cardiac toxicity and adverse effects. Laxatives, diuretics, and licorice all may deplete potassium and increase the risk of cardiac toxicity when taken with squill.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Court WE. Squill - energetic diuretic. Pharm J 1985;235:194-197.

2. Dallari A, Barbaresi F. [Clinical experimentation with a cardiokinetic extracted from squill: 3-beta-ramnoside-14-beta-hydroxy-delta-4,20,22-bufatrienolide (proscillaridine A)]. Clin Ter 1965;35(2):126-141. View Abstract

3. Stauch M, Grewe N, Belz GG. [Effect of proscillaridin-4'-methylether on pressure rise velocity in the left ventricle of patients with coronary heart disease (author's transl)]. Klin Wochenschr 1977;55(14):705-706. View Abstract

4. Tuncok Y, Kozan O, Cavdar C, et al. Urginea maritima (squill) toxicity. J Toxicol Clin Toxicol 1995;33(1):83-86. View Abstract

5. Walli F, Grob PJ, Muller-Schoop J. [Pseudo-(venocuran-)lupus--a minor episode in the history of medicine]. Schweiz Med Wochenschr 1981;111(38):1398-1405. View Abstract