DRUGS AND SUPPLEMENTS

Nux vomica(Strychnos nux-vomica)

March 22, 2017

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Nux vomica(Strychnos nux-vomica)

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Arabinose, Brechnuss, Brechnusssamen, brucine, brucine N-oxide, galactan, galactomannan, galactose, Loganiaceae (family), loganic acid, ma qian zi, noce vomica, noix vomique, nuez vomica, poison nut, Quaker buttons, rhamnose, shudha kupilu, slang nut, strychni semen, strychnine, Strychnos nux-vomica, strychnos seed, vishamushti.

Background

  • Nux vomica is the dried, ripe seed of Strychnos nux-vomica L., a native tree of Burma, China, eastern India, Thailand, and northern Australia. There are reports of toxic effects with traditional use of the seeds or fruit of Strychnos nux-vomica L.

  • In homeopathy, nux vomica is used for allergies, back pain, colds, constipation, digestive problems, emotional stress, flu, hangovers, headaches, hemorrhoids, and menstrual problems. Nux vomica is also a polycrest, or a homeopathic remedy used to treat many ailments. As a polycrest, nux vomica's primary indication is for disorders related to abuse of narcotic drugs, alcohol, coffee, or tobacco, overindulgence of rich food and beverages, and mental strain from excessive work.

  • Athough nux vomica appeared as a treatment in 19th Century medical publications, there is very little documentation on its therapeutic effectiveness in today's standard medical journals. However, because nux vomica is a common homeopathic medicine, research continues on it, albeit in laboratory and animal studies. This remedy is in the category of unapproved herbs according to the German Commission E.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

No available studies qualify for inclusion in the evidence table.

*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

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.

  • Abscesses, aging, alcohol abuse, allergies, analgesic (pain reliever), anemia (secondary), anthelminthic (expels worms), anti-bacterial, anti-inflammatory, anti-oxidant, anxiety, appetite stimulant, back pain, bubonic plague, cancer, cardiovascular disorders, colds, constipation, depression, drug abuse, eating disorders, encephalopathy (glycine), expectorant, eye diseases, neuralgia (facial nerve pain), gastrointestinal disorders, gout, hangovers, headaches, hemorrhoids, hysteria, impotence, indigestion, influenza, insomnia, irritable bowel syndrome, liver cancer, menstrual problems, menopausal symptoms, migraine, muscle spasm, myasthenia gravis, nerve disorders (paresthesia), rabies, Raynaud's disease, Reiter's syndrome, respiratory ailments, rheumatism, stress (emotional), substance abuse (coffee), substance abuse (tobacco), tonic.

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 nux vomica. As pills or powders, 0.3-0.9g per day has traditionally been used.

  • Homeopathic preparations are the most commonly used form, and nux vomica comes in several strengths, including 6X, 12X, 30X, and 30C. Traditionally, sublingual doses are taken one-half hour before or after eating, brushing teeth, or drinking anything but water.

Children (younger than 18 years):

  • There is no proven safe or effective dose for nux vomica, and use in children is not recommended due to potential toxicity. In children, as little as 50mg of seed may cause intoxication or death.

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 Strychnos nux-vomica.

Side Effects and Warnings

  • In general, nux vomica has predominantly neurological effects, and may cause painful seizures, spasms, difficulty breathing, dizziness and confusion. Other adverse effects include muscle cramps, pain and tenderness.

  • Chest discomfort, tonic contractions of all limb muscles, carpopedal spasm, muscle pain, numbness, hyperventilation, confusion, hyperreflexia, nystagmus (rapid movement of the eyes), knee-jerks, tiredness and seizure have been reported after taking a multi-herb concoction containing nux vomica. Seizures can occur within 15 minutes of ingestion (or five minutes of inhalation) and may result in hyperthermia, metabolic and respiratory acidosis, rhabdomyolysis, and myoglobinuric renal (kidney) failure. Strychonos nux-vomica fruit may also cause crampy abdominal and leg pain and tense thigh muscles with tenderness to touch.

  • Avoid taking nux vomica seeds by mouth, as the seeds may contain toxic amounts of strychnine. Use cautiously in other forms due to potential toxicity from strychnine in nux vomica. Also use cautiously in patients with seizure disorders, as nux vomica has induced seizures.

Pregnancy and Breastfeeding

  • Nux vomica should not be taken during pregnancy or breastfeeding due to risk of ingestion of toxic levels of strychnine. No safe internal dosage or maximum duration of homeopathic nux vomica during pregnancy or breastfeeding has been clinically established.

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

  • Anti-psychotics and phenothiazines are contraindicated in individuals with symptoms of poisoning, as they may compound the symptoms exhibited by the patient. Use is not recommended with nux vomica.

  • Strychnine in nux vomica can accumulate in the liver with extended administration, and especially in those with liver damage. Patients taking drugs that are potentially damaging to the liver should consult with a qualified healthcare professional, including a pharmacist.

Interactions with Herbs and Dietary Supplements

  • Strychnine in nux vomica can accumulate in the liver with extended administration, and especially in those with liver damage. Patients taking herbs and supplements that are potentially damaging to the liver, such as kava, should consult with a qualified healthcare professional, including a pharmacist.

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. Chan TY. Herbal medicine causing likely strychnine poisoning. Hum Exp Toxicol. 2002;21(8):467-468. View Abstract

  2. Choi YH, Sohn YM, Kim CY, et al. Analysis of strychnine from detoxified Strychnos nux-vomica [corrected] seeds using liquid chromatography-electrospray mass spectrometry. J Ethnopharmacol. 2004;93(1):109-112. View Abstract

  3. Deng X, Yin F, Lu X, et al. The apoptotic effect of brucine from the seed of Strychnos nux-vomica on human hepatoma cells is mediated via Bcl-2 and Ca2+ involved mitochondrial pathway. Toxicol.Sci 2006;91(1):59-69. View Abstract

  4. Gupta R, Manchanda RK. Reiter's disease treated with Nux vomica. Homeopathy. 2006;95(2):103-104. View Abstract

  5. Katz J, Prescott K, Woolf AD. Strychnine poisoning from a Cambodian traditional remedy. Am J Emerg.Med 1996;14(5):475-477. View Abstract

  6. Sukul A, Sarkar P, Sinhababu SP, Sukul NC. Altered solution structure of alcoholic medium of potentized Nux vomica underlies its antialcoholic effect. Br.Homeopath.J 2000;89(2):73-77. View Abstract

  7. Sukul A, Sinhabau SP, Sukul NC. Reduction of alcohol induced sleep time in albino mice by potentized Nux vomica prepared with 90% ethanol. Br.Homeopath.J 1999;88(2):58-61. View Abstract

  8. Sukul NC, De A, Dutta R, et al. Nux vomica 30 prepared with and without succession shows antialcoholic effect on toads and distinctive molecular association. Br.Homeopath.J 2001;90(2):79-85. View Abstract

  9. Sukul NC, De A, Sinhababu SP, Sukul A. Potentized Mercuric chloride and Nux vomica facilitate water permeability in erythrocytes of a fresh-water catfish Clarius batrachus under acute ethanol intoxication. J Altern.Complement Med 2003;9(5):719-725. View Abstract

  10. Sukul NC, Ghosh S, Sinhababu SP, Sukul A. Strychnos nux-vomica extract and its ultra-high dilution reduce voluntary ethanol intake in rats. J Altern Complement Med 2001;7(2):187-193. View Abstract

  11. Tripathi YB and Chaurasia S. Interaction of Strychnos nux-vomica-products and iron: with reference to lipid peroxidation. Phytomedicine 2000;7(6):523-528. View Abstract

  12. Umamaheswari M, Asokkumar K, Somasundaram A, et al. Xanthine oxidase inhibitory activity of some Indian medical plants. J Ethnopharmacol 2-12-2007;109(3):547-551. View Abstract

  13. Van Eenoo P, Deventer K, Roels K, Delbeke FT. Quantitative LC-MS determination of strychnine in urine after ingestion of a Strychnos nux-vomica preparation and its consequences in doping control. Forensic Sci Int 1-28-2006; View Abstract

  14. Yin W, Wang TS, Yin FZ, Cai BC. Analgesic and anti-inflammatory properties of brucine and brucine N-oxide extracted from seeds of Strychnos nux-vomica. J Ethnopharmacol. 2003;88(2-3):205-214. View Abstract

  15. Zhang X, Xu Q, Xiao H, Liang X. Iridoid glucosides from Strychnos nux-vomica. Phytochemistry 2003;64(8):1341-1344. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Updated:  

March 22, 2017