Multiple concentrations of 10X, 30X, and 100X each: Arsenicum Alb , Baptisia , Bryonia , Causticum , Cinchona bark extract , Dulcamara , Eup Perf , Echinacea Purp , eucalyptus , Gelsemium sempervirens , Influenzium "06" Lachesis , Phytolacca , Rhus tox , Sarcolacticum Ac , Sulfur , Wyethia • Multiple concentrations of 35C, 50C, and 100C each: Anas Barb , Avaire . Other Ingredients: Saline Solution.
Brand name products often contain multiple ingredients. To read detailed information about each ingredient, click on the link for the individual ingredient shown above.
This is a homeopathic preparation. Homeopathy is a system of medicine established in the 19th century by a German physician named Samuel Hahnemann. Its basic principles are that "like treats like" and "potentiation through dilution." For example, in homeopathy, diarrhea would be treated with an extreme dilution of a substance that normally causes diarrhea when taken in high doses.
Practitioners of homeopathy believe that more dilute preparations are more potent. Many homeopathic preparations are so diluted that they contain little or no active ingredient. Therefore, most homeopathic products are not expected to have any pharmacological effects, drug interactions, or other harmful effects. Any beneficial effects are controversial and cannot be explained by current scientific methods.
Dilutions of 1 to 10 are designated by an "X." So a 1X dilution = 1:10, 3X=1:1000; 6X=1:1,000,000. Dilutions of 1 to 100 are designated by a "C." So a 1C dilution = 1:100; 3C = 1:1,000,000. Dilutions of 24X or 12C or more contain zero molecules of the original active ingredient.
Homeopathic products are permitted for sale in the US due to legislation passed in 1938 sponsored by a homeopathic physician who was also a Senator. The law still requires that the FDA allow the sale of products listed in the Homeopathic Pharmacopeia of the United States. However, homeopathic preparations are not held to the same safety and effectiveness standards as conventional medicines. For more information, see the Homeopathy monograph.
Below is general information about the effectiveness of the known ingredients contained in the product Total Flu Cld #1 Nasal Spray. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of bryonia.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of gelsemium.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product Total Flu Cld #1 Nasal Spray. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when organic arsenic is consumed in normal food amounts. Organic forms of arsenic normally found in foods have not been linked to toxicity (7135,16309). ...when arsenic trioxide is used intravenously and appropriately under the guidance of a healthcare provider. Arsenic trioxide (Trisenox) is an FDA-approved prescription drug (15).
LIKELY UNSAFE ...when inorganic arsenic is used orally, especially when used long-term or in high doses. Taking large doses acutely, or in small doses for prolonged periods of time, can cause serious side effects. Chronic intake of 10 mcg/kg daily has been associated with symptomatic arsenicism. Acute doses of 5 mg, or sometimes less, can cause gastrointestinal symptoms. Higher doses can cause severe poisoning and death (7135,16310,16312,16313,16316,102892). Prolonged exposure to inorganic arsenic in drinking water and other sources has been linked to an increased risk of cardiovascular disease, diabetes, cancer, hypertension, and mortality (99824,99827,99829,99830,99832,99834,99835,109108,109110). Inorganic arsenic is classified as a human carcinogen (16312,16316). The maximum permissible level of arsenic in drinking water is 10 mcg/L (16316).
CHILDREN: LIKELY SAFE
when organic arsenic is consumed in food amounts.
Organic forms of arsenic found in a normal diet have not been linked to toxicity (7135,16309).
CHILDREN: LIKELY UNSAFE
when inorganic arsenic is used orally, especially when used long-term or in high doses.
Large doses acutely, or in small doses for prolonged periods of time, can cause serious side effects. Prolonged exposure to inorganic arsenic in drinking water has been linked to reduced scores on intelligence tests, developmental delays, impaired verbal comprehension, decreased memory and attention, and higher blood pressure in children (16319,99826,99828,99836,102898).
PREGNANCY AND LACTATION: LIKELY SAFE
when organic arsenic is consumed in food amounts.
Organic forms of arsenic found in a normal diet have not been linked to toxicity (7135,16309).
PREGNANCY AND LACTATION: LIKELY UNSAFE
when inorganic arsenic is taken orally, especially when used long-term or in high doses.
While exposure to inorganic arsenic in drinking water does not seem to increase the risk of neural tube defects (102897), it has been associated with an increased risk for spontaneous abortion, stillbirth, and neonatal mortality (99833). Exposure to inorganic arsenic in drinking water and other sources while pregnant has also been linked to changes in birth weight, length, and head circumference (102895), with one study showing that higher maternal blood arsenic levels are associated with 44% greater odds of delivering a small for gestational age infant and 103% greater odds of delivering a large for gestational age infant (102895,102896). Avoid arsenic supplements and water contaminated with arsenic during pregnancy or lactation.
POSSIBLY SAFE ...when the stem is used orally or topically and appropriately (2,18).
LIKELY UNSAFE ...when the leaves or berries are used orally. The plant contains the toxic compounds solanine, solanidine, and dulcamarin (6).
CHILDREN: LIKELY UNSAFE
when used orally; unripe berries have caused poisonings.
A lethal dose is estimated to be 200 berries (18). There is insufficient reliable information available about the safety of bittersweet nightshade when used topically in children; avoid using.
PREGNANCY: LIKELY UNSAFE
when used orally.
The alkaloids of the plant, solasodine, soladulcine, and related compounds have been linked to birth defects in animals (6); avoid using. There is insufficient reliable information available about the safety of bittersweet nightshade when used topically during pregnancy; avoid using.
LACTATION: LIKELY UNSAFE
when orally; avoid using.
There is insufficient reliable information available about the safety of bittersweet nightshade when used topically; avoid using.
LIKELY UNSAFE ...when the root or berries are used orally (2,18). Consuming 40 berries might be fatal (18).
CHILDREN: LIKELY UNSAFE
when the root or berries are used orally (2,18).
Consuming as few as 15 berries can be fatal in children (18).
PREGNANCY: UNSAFE
when the root is used orally.
Bryonia root might have abortifacient effects (2). ...when the berries are used orally (2).
LACTATION: LIKELY UNSAFE
when the root or berries are used orally (2).
LIKELY SAFE ...when used orally as a flavoring in tonic water and alcoholic beverages. The US Code of Federal Regulations allows not more than 83 parts per million (ppm) of total cinchona alkaloids in finished beverages (93229).
POSSIBLY UNSAFE ...when used orally in medicinal amounts. Cinchona derivatives marketed as over-the-counter (OTC) medicines are required to carry the warning, "Caution - discontinue use if ringing in the ears, deafness, skin rash, or visual disturbances occur" (93231). Cinchona contains the alkaloid quinine that was previously available OTC in the US for treatment and prevention of nocturnal leg muscle cramps. In 1994 the US Food and Drug Administration (FDA) determined that quinine was not generally recognized as safe and effective for this indication, citing serious adverse reactions and its narrow therapeutic index (93232,93233). A final ban on marketing of OTC quinine products was implemented by the FDA in 2007, and a Risk Evaluation and Mitigation Strategy (REMS) to reduce off-label use of prescription quinine products for night-time leg cramps was introduced in 2010 (93232).
LIKELY UNSAFE ...when excessive amounts are used orally. Cinchona contains the alkaloids quinine and quinidine, which are used as prescription medicines and have been associated with significant adverse effects at doses of 2 grams per day or more (505). The amount of these constituents in cinchona products is variable (13).
PREGNANCY: LIKELY UNSAFE
when used orally.
Cinchona is reported to have uterine stimulant and abortifacient activity, and to be fetotoxic and teratogenic, causing visual and auditory defects (12,19). Avoid using.
LACTATION: POSSIBLY UNSAFE
when used orally.
The cinchona alkaloids quinine and quinidine are reported to be excreted in breast milk and may be toxic to infants (19).
LIKELY SAFE ...when used orally in amounts commonly found in foods. Eucalyptus has Generally Recognized As Safe status (GRAS) for use in foods as a flavoring in the US (4912).
POSSIBLY SAFE ...when eucalyptol, a constituent of eucalyptus oil, is used orally and appropriately. Eucalyptol appears to be safe for up to 12 weeks (13302).
POSSIBLY UNSAFE ...when the undiluted oil is used topically. Prolonged or widespread exposure has caused neurotoxicity (12869). There is insufficient reliable information available about the safety of diluted eucalyptus oil when used topically.
LIKELY UNSAFE ...when the undiluted oil is ingested orally. Ingesting 3.5 mL of undiluted oil can be fatal in adults (12867). There is insufficient reliable information available about the safety of eucalyptus oil when inhaled as aromatherapy or when eucalyptus leaf is used orally in medicinal amounts.
CHILDREN: LIKELY SAFE
when used orally in amounts commonly found in foods.
Eucalyptus has Generally Recognized As Safe (GRAS) status for use in foods in the US (4912).
CHILDREN: LIKELY UNSAFE
when eucalyptus oil is used orally (12867,49002,107493,107495).
...when eucalyptus oil is used topically in infants and young children. There are reports of neurotoxicity in infants and young children exposed to topical eucalyptus oil. In one of these cases, a 12-month-old child was bathed in water containing eucalyptus oil and other essential oils; in another case, a child had a dressing containing eucalyptus oil applied every 2-4 hours daily for 2 days (12868,12869). ...when eucalyptus solutions are inhaled using a vaporizer (49002).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods (4912).
There is insufficient reliable information available about the safety of medicinal amounts of eucalyptus oil; avoid using.
UNSAFE ...when the rhizome or root are used orally. All parts of the plant contain toxic alkaloids. The adult lethal dose is 2-3 grams or 4 mL of the fluid extract (18).
CHILDREN: UNSAFE
when used orally.
The lethal dose is 500 mg (18).
PREGNANCY AND LACTATION: UNSAFE
when used orally due to toxicity (6).
LIKELY UNSAFE ...when used orally or topically (6). Poison ivy is highly irritant and allergenic (68970).
PREGNANCY AND LACTATION: LIKELY UNSAFE
when used orally or topically (6); avoid using.
POSSIBLY SAFE ...when used topically and appropriately, short-term. Topical products containing sulfur in concentrations up to 10% have been used safely in clinical research for up to 8 weeks (27846,27847,88107,88112,88123,88124,98205,98207,100735). There is insufficient reliable information available about the safety of using sulfur orally.
CHILDREN: POSSIBLY SAFE
when used topically and appropriately, short-term.
Topical products containing sulfur in concentrations up to 6% have been used safely when applied nightly in children and adolescents for up to 6 nights (27846,27847). In infants, topical products containing sulfur in concentrations up to 2% have been safely applied for 3 hours daily for up to 6 days (27847).
PREGNANCY AND LACTATION: POSSIBLY SAFE
when applied topically and appropriately, short-term.
Topical products containing sulfur in concentrations up to 6% have been safely applied nightly for up to 6 nights (27846,27847). There is insufficient reliable information available about the safety of sulfur when used orally; avoid using.
LIKELY UNSAFE ...when used orally in large doses. Wild indigo is considered poisonous when consumed in doses of about 30 grams (12,19).
PREGNANCY AND LACTATION: LIKELY UNSAFE
when used orally or topically due to its toxic potential (12,19).
Below is general information about the interactions of the known ingredients contained in the product Total Flu Cld #1 Nasal Spray. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Arsenic trioxide can prolong the QT interval.
Details
Up to 40% of patients treated with prescription arsenic trioxide have a prolonged QT interval on their electrocardiogram (ECG) (15). Theoretically, non-prescription arsenic could have an additive effect when combined with drugs that prolong the QT interval.
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Theoretically, taking cinchona might decrease the effectiveness of antacids. Theoretically, taking antacids might also increase the risk of adverse effects from cinchona.
Details
Some research shows that taking cinchona lowers stomach acid pH (19). In addition, some research shows that taking antacids might increase urinary pH. Theoretically, this may increase the amount of quinidine, a constituent of cinchona, reabsorbed in the renal tubules and increase the risk of quinidine toxicity (3046).
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Theoretically, taking cinchona might increase the drug effects and risk of bleeding with anticoagulant and antiplatelet drugs.
Details
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Theoretically, taking cinchona might increase the adverse effects of carbamazepine.
Details
Clinical research shows that taking quinine, a constituent of cinchona, increases the peak plasma concentration and area under the curve of carbamazepine (11016).
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Theoretically, taking cinchona might inhibit cytochrome P450 2D6 (CYP2D6) and increase levels of drugs metabolized by this enzyme.
Details
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Theoretically, taking cinchona might increase serum levels of digoxin.
Details
Quinine and quinidine, which are constituents of cinchona, decrease clearance of digoxin and increase serum digoxin levels in humans (3046).
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Theoretically, taking cinchona might decrease the effectiveness of H2-blockers.
Details
Some research shows that taking cinchona lowers stomach acid pH (19).
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Theoretically, taking cinchona might increase the adverse effects of phenobarbital.
Details
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Theoretically, taking cinchona might decrease the effectiveness of PPIs.
Details
Some research shows that taking cinchona lowers stomach acid pH (19).
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Theoretically, taking cinchona with other QT interval-prolonging drugs might cause an additive effect and increase the risk of ventricular arrhythmias.
Details
Quinidine and quinine, which are constituents of cinchona, prolong the QT interval (3046).
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Theoretically, taking cinchona might increase plasma levels and adverse effects of quinidine.
Details
Cinchona contains quinidine (505).
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Theoretically, taking cinchona might increase plasma levels and adverse effects of quinine.
Details
Cinchona contains quinine (505).
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Theoretically, inhaling eucalyptol may reduce the effectiveness of amphetamines.
Details
Animal research suggests that inhaling eucalyptol may reduce the levels of amphetamines in the blood (48987).
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Theoretically, eucalyptus leaf might increase the risk of hypoglycemia.
Details
Animal research suggests that eucalyptus leaf might have hypoglycemic activity, and might have additive effects when used with antidiabetes drugs (12871).
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Theoretically, eucalyptus might increase the levels of CYP1A2 substrates.
Details
In vitro research suggests that eucalyptus oil might inhibit CYP1A2, although this has not been reported in humans (12479).
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Theoretically, eucalyptus might increase the levels of CYP2C19 substrates.
Details
In vitro research suggests that eucalyptus oil might inhibit CYP2C19, although this has not been reported in humans (12479).
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Theoretically, eucalyptus might increase the levels of CYP2C9 substrates.
Details
In vitro research suggests that eucalyptus oil might inhibit CYP2C9, although this has not been reported in humans (12479).
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Theoretically, eucalyptus might increase the levels of CYP3A4 substrates.
Details
In vitro research suggests that eucalyptus oil might inhibit CYP3A4, although this has not been reported in humans (12479).
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Theoretically, inhaling eucalyptol might reduce the effectiveness of pentobarbital.
Details
Animal research suggests that inhaling eucalyptol reduces the level of pentobarbital that reaches the brain (48987).
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Below is general information about the adverse effects of the known ingredients contained in the product Total Flu Cld #1 Nasal Spray. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General
...Orally, organic forms of arsenic found in the diet are well tolerated, with no clear links to adverse effects.
However, high doses or chronic intake of inorganic arsenic is associated with potentially serious adverse effects.
Serious Adverse Effects (Rare):
Orally: With the acute ingestion of inorganic arsenic, anemia, arrhythmias, bruising, gastrointestinal irritation or damage, hepatotoxicity, and peripheral neuropathy.
With chronic intake of inorganic arsenic, arsenicism can occur, including anorexia, cancer, skin hyperpigmentation and hyperkeratosis, and toxicity of the cardiovascular and neurological systems.
Cardiovascular
...Orally, doses of inorganic arsenic 1 mg/kg daily can cause hematopoietic depression including anemia, arrhythmias, and blood vessel damage leading to bruising (7135,16309,16312).
Acute ingestion of inorganic arsenic 10 mg/kg daily or more causes vasodilation and myocardial depression leading to myocardial injury, shock, and circulatory failure (17,7135,16313,16316,102892). Chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by cardiomyopathy and arrhythmias (17,7135,16309,16310,16316). Prolonged exposure to inorganic arsenic in drinking water at levels greater than or equal to 20 mcg/L has been linked, in a dose-dependent manner, to a 9% to 43% greater risk of cardiovascular disease, 11% to 55% greater risk of coronary heart disease, and 16% to 90% greater risk of cardiovascular-related death (99827). Also, each interquartile increase in urinary inorganic arsenic levels is associated with an increased risk of both cardiovascular and all-cause mortality in a specific area of the US (109110). A metabolite of arsenic, monomethylarsonic acid, has also been positively linked to stroke risk (99831). Increased exposure to inorganic arsenic has also been linked to the development of left ventricular hypertrophy (99835). The cardiovascular adverse effects of inorganic arsenic appear to be more profound in males with hypertension (99829).
The association between arsenic exposure and hypertension has also been investigated. A meta-analysis of observational research has found that the odds of having hypertension and risk of hypertension were increased by 14% and 30%, respectively, in those with the highest arsenic exposure when compared with the lowest. Exposure was determined based on intake of rice and rice products, as well as exposure in water, or levels in urine, hair, or toenails (109108). Additionally, increased exposure to inorganic arsenic in drinking water has been linked to higher blood pressure in children (102898).
Dermatologic ...Orally, chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by skin hyperpigmentation, hyperkeratosis, alopecia, and occlusive peripheral vascular disease leading to gangrene (17,7135,16309,16310,16316,102894). In one case, chronic intake of inorganic arsenic 30 ng daily has reportedly caused eczema of the hands, arms, and legs (102893).
Endocrine ...Orally, prolonged exposure to inorganic arsenic in drinking water has been associated with a 23% to 75% increase in the risk for diabetes (99830,99834). For every 100 mcg/L increase in inorganic arsenic levels in drinking water, the associated risk for diabetes increases by 13% (99834). A small meta-analysis has found that overall exposure to arsenic, including organic and inorganic arsenic, is associated with an increased risk of developing gestational diabetes (106539).
Gastrointestinal ...Orally, acute ingestion of inorganic arsenic 5 mg, or sometimes less, can cause vomiting, diarrhea, stomach cramps, and flatulence (16316,102893). These effects usually resolve in about 12 hours without treatment (16316). Doses of inorganic arsenic 1 mg/kg daily can cause gastrointestinal irritation (7135,16309,16312). Acute ingestion of inorganic arsenic 10 mg/kg daily or more causes severe gastrointestinal symptoms including bloody rice-water diarrhea (17,7135,16313,16316,102892). Chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by anorexia and gastrointestinal disturbances (17,7135,16309,16310,16316).
Genitourinary ...Orally, chronic intake of inorganic arsenic 30 ng daily has reportedly caused irregular menstruation (102893). A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from genitourinary diseases (106541).
Hematologic ...Orally, chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by anemia, leukopenia, and occlusive peripheral vascular disease (17,7135,16309,16310,16316).
Hepatic
...Orally, doses of inorganic arsenic 1 mg/kg daily can cause hepatotoxicity (7135,16309,16312).
The homeopathic remedy, arsenicum album, has been associated with three cases of acute liver injury. In one case, a 70-year-old male with pre-existing non-alcoholic steatohepatitis (NASH) cirrhosis died following the acute liver injury associated with use of this compound for about 12 weeks. High levels of arsenic were found in his hair and nail samples. Symptoms in the two other individuals resolved upon discontinuation of homeopathic arsenic and use of corticosteroids (109114).
Musculoskeletal ...Orally, chronic intake of inorganic arsenic 30 ng daily has reportedly caused leg cramps in one patient (102893).
Neurologic/CNS
...Orally, doses of inorganic arsenic 1 mg/kg daily can cause peripheral neuropathy and encephalopathy (7135,16309,16312).
In one case, chronic intake of inorganic arsenic 30 ng daily has reportedly caused headache, dizziness, and difficulty concentrating (102893). Acute ingestion of inorganic arsenic 10 mg/kg daily or more can cause cerebral edema, leading to encephalopathy, convulsions, coma, and death (17,7135,16313,16316). Chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by sensory disturbances, peripheral neuropathy, encephalopathy, confusion, and memory loss (17,7135,16309,16310,16316). A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from nervous system diseases (106541).
In children, prolonged exposure to inorganic arsenic in drinking water has been linked to reduced scores on intelligence tests, developmental delays, impaired verbal comprehension, and decreased memory and attention (16319,99826,99828,99836).
Ocular/Otic ...Orally, chronic intake of inorganic arsenic 30 ng daily has reportedly caused conjunctivitis in one patient (102893). A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from traffic accidents. This is suggested to be related to a higher prevalence of visual field narrowing due to macular degeneration, as well as motor or sensory dysfunction, in those exposed to arsenic during infancy (106541).
Oncologic ...Inorganic arsenic is classified as a human carcinogen (16312,16316). Orally, chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, which can result in cancers of the skin, lungs, liver, kidneys, and bladder (17,7135,16309,16310,16316). Chronic ingestion of lower doses of inorganic arsenic, as a contaminant in well water, has also been linked to cancers of the skin, bladder, kidneys, and lungs (7135,99824,99832,106540). More specifically, levels of inorganic arsenic greater than 200 mcg/L in drinking water have been linked to lung cancer (99824). Levels of inorganic arsenic greater than 10 mcg/L in drinking water are also dose-dependently linked to an increased risk for bladder and kidney cancers (99832). A meta-analysis of observational research has found that arsenic exposure, especially from water and soil, is associated with prostate cancer risk (109109). A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from liver cancer (106541).
Psychiatric ...Orally, chronic intake of inorganic arsenic 30 ng daily has reportedly caused insomnia and anxiety in one patient (102893).
Pulmonary/Respiratory ...A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from respiratory diseases (106541).
Other
...Orally, high doses of inorganic arsenic can cause death.
In one case, a 24-year-old female receiving a combination of arsenic trioxide, realgar, and mung bean flour from an illegal medical provider died within days of taking the compounded preparation. Laboratory analysis revealed the amount of arsenic consumed to be around 1.1 grams on day 1 and 0.9 grams on day 4. Researchers concluded that arsenic as the source of poisoning was clear based on the amount of arsenic ingested and the patient's clinical presentation prior to death, which included vomiting, diarrhea, reduced urine output, liver and kidney abnormalities, and myocardial injury (102892).
A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased all-cause mortality (106541).
General
...When used orally, the leaves and berries of bittersweet nightshade may be unsafe.
There is limited information available about the adverse effects of the stem of bittersweet nightshade when used in medicinal amounts.
Serious Adverse Effects (Rare):
Orally: The leaves and berries can cause toxicity, including circulatory and respiratory depression, convulsions, cyanosis, diarrhea, dilated pupils, gastrointestinal bleeding, headache, scratchy throat, speech difficulties, subnormal temperature, vertigo, vomiting, and even death.
Cardiovascular ...Orally, bittersweet nightshade leaf and berry can cause circulatory depression (6).
Gastrointestinal ...Orally, bittersweet nightshade leaf and berry can cause diarrhea, gastrointestinal bleeding, scratchy throat, vomiting and (6).
Neurologic/CNS ...Orally, bittersweet nightshade leaf and berry can cause convulsions, headache, speech difficulties, subnormal temperature, and vertigo (6).
Ocular/Otic ...Orally, bittersweet nightshade leaf and berry can cause dilated pupils (6).
Pulmonary/Respiratory ...Orally, bittersweet nightshade leaf and berry can cause cyanosis and respiratory depression (6).
General
...Orally, bryonia root can cause dizziness, vomiting, convulsions, colic, bloody diarrhea, abortion, nervous excitement, and kidney damage.
Large doses of bryonia can cause anuria, collapse, paralysis, and death (2). Bryonia berries can be fatal when taken orally; 40 berries can be fatal in adults, and 15 berries can be fatal in children (18).
Topically, skin contact with fresh bryonia may cause irritation (19).
Dermatologic ...Topically, skin contact with fresh bryonia may cause irritation (19).
Gastrointestinal ...Orally, bryonia root can cause vomiting, colic, and bloody diarrhea (2).
Genitourinary ...Orally, bryonia root can cause abortion (2). Large doses of bryonia can cause anuria and death (2).
Musculoskeletal ...Orally, large doses of bryonia can cause paralysis and death (2).
Neurologic/CNS ...Orally, bryonia root can cause dizziness, convulsions, and nervous excitement (2). Large doses of bryonia can cause paralysis and death (2).
Renal ...Orally, bryonia root can cause kidney damage (2). Large doses of bryonia can cause anuria and death (2).
Other ...Orally, bryonia berries can be fatal. Consuming 40 berries can be fatal in adults and as few as 15 berries can be fatal in children (18).
General
...Information on the adverse effects of cinchona is limited.
Orally, prolonged use of high doses of cinchona can cause severe adverse effects. Topically, a thorough evaluation of safety outcomes has not been conducted.
Most Common Adverse Effects:
Orally: Diarrhea, nausea, ringing ears, vomiting.
Topically: Contact dermatitis, urticaria.
Serious Adverse Effects (Rare):
Orally: Arrhythmias, cinchonism syndrome, hemolytic uremic syndrome, QT prolongation, thrombotic thrombocytopenic purpura.
Cardiovascular ...Cinchona contains the alkaloids quinidine and quinine that can prolong the QT interval on the electrocardiogram, and cause potentially fatal cardiac arrhythmias such as torsades de pointes (3046,93232)
Dermatologic ...Topical use of cinchona bark extracts and occupational exposure to cinchona bark dust can cause contact dermatitis and other urticarial reactions (11,93234). A 31-year old man developed itching, erythema, and edema of the face and upper chest after occupational exposure to dust from cinchona bark. Skin testing produced reactions to ethanol and ether extracts of the bark, but not to the individual alkaloids quinine and quinidine (93234).
Gastrointestinal ...Cinchona stimulates secretion of stomach acid and has been associated with nausea, vomiting, and diarrhea (6,19).
Hematologic ...Quinine, which is present in cinchona, has been associated with serious, sometimes fatal, hematological disorders including thrombocytopenia, thrombotic thrombocytopenic purpura (TTP), and hemolytic uremic syndrome (hemolytic anemia, acute renal failure, and thrombocytopenia) (93232,93233). Initial symptoms may include bleeding from the gums, nose or gastrointestinal tract, easy bruising, and petechiae (93233). Bone marrow depression and thrombocytopenia have also been associated with quinidine (505).
Immunologic ...Oral use of quinine, an alkaloid present in cinchona, has been associated with severe allergic skin reactions, as well as anaphylaxis (19,93232).
Ocular/Otic ...Cinchona contains quinine that can cause dose-related adverse effects on hearing and vision, including tinnitus, deafness, vision changes, and blindness (6,8,12,93232).
Other ...Orally, prolonged use of high doses of cinchona or its alkaloids, or a single dose of 3 grams or more of the alkaloid quinine are associated with a toxicity syndrome known as cinchonism. Symptoms include headache, dizziness, nausea and vomiting, diarrhea, hemolysis, hypotension, cardiac arrhythmias, tinnitus, deafness, vision changes, blindness, abdominal pain, delirium, convulsions, paralysis, and collapse (6,12,19,505,93232). Doses of 10-15 grams of quinine may be fatal (18).
General
...Orally, diluted eucalyptus oil is generally well tolerated, but the undiluted oil can cause toxicity.
Most Common Adverse Effects:
Orally: Diarrhea, nausea, vomiting.
Topically: Burning, itching, redness, stinging.
Serious Adverse Effects (Rare):
Orally: Signs of toxicity can occur with the undiluted oil at doses as low as 1 mL and include central nervous system depression, shallow respiration, rapid pulse, apnea, coma, and death.
Topically: Prolonged exposure or large amounts of eucalyptus oil can cause agitation, ataxia, drowsiness, muscle weakness, seizures, and slurred speech. The risk of toxicity may be greater in children.
Inhalation (as aromatherapy): Seizures.
Cardiovascular ...Orally, one case of premature ventricular contractions has been reported in a previously healthy 29-year-old male who ingested approximately one ounce of eucalyptus oil (48983).
Dermatologic ...Topically, eucalyptus pollen, leaves, oil, and the constituent eucalyptol can cause contact dermatitis in sensitive people (13303,48931,92856,92858,92859,98497). In some cases, symptoms respond to treatment with topical corticosteroids and tacrolimus (92856). In one case report, transient local redness, burning, and irritation was reported in a 4-year-old child who was bathed in water containing eucalyptus oil. The symptoms resolved within one hour of rinsing the skin with clear water (48983). In a clinical study, treatment with a combination of eucalyptus oil and lemon tea tree oil caused burning, redness, itching, or stinging in up to 20% of the patients. Stinging usually resolved within 10 minutes of application and redness within 30 minutes (19188,98492).
Gastrointestinal ...Orally, eucalyptus oil can cause nausea, vomiting, and diarrhea (48983,48993,48995). Abdominal pain has been reported in a trial of the eucalyptus constituent eucalyptol for inflammatory bowel disease (IBD) (48936).
Immunologic
...A case of IgE-mediated exacerbation of asthma and rhinitis symptoms has been reported in a patient who consumed eucalyptus.
Similar worsening of symptoms occurred when the patient inhaled eucalyptus pollen (48957).
Occupational exposure to eucalyptus may cause allergic dermatitis (98497).
Neurologic/CNS
...Orally, eucalyptus oil can cause central nervous system depression, coma, and status epilepticus (12867,48946,48983).
Topically, orally, and by inhalation, eucalyptus oil has been associated with seizures. A systematic review describes the characteristics of 49 children and 61 adults with seizures associated with various routes of administration. Patients with no seizure history were classified as a eucalyptus oil-induced seizure (EOIS), while patients with a history of seizure or susceptibility to seizure were defined as a eucalyptus oil-provoked seizure (EOPS). In EOIS cases, topical use was reported in 74%, inhalation in 22.5%, and ingestion in 3.5%; for EOPS cases, topical use was reported in 79%, inhalation in 16%, and ingestion in 5%. Generalized tonic-clonic seizures are the most prominent type of seizure in EOIS cases (96%). Among EOPS patients, 37% had focal onset motor seizures with impaired awareness, 24% had focal onset aware motor seizures, 13% had focal to bilateral tonic-clonic seizures, and 26% had generalized onset tonic-clonic seizures (107494). One prospective observational study that was included in this systematic review provided additional details on eucalyptus-induced seizures. This study included 18 reports of EOIS and 28 reports of EOPS in adults and children after topical or inhaled use of eucalyptus oil, either alone or in combination with camphor. The time to seizure onset was 0.5-48 hours after topical application, 2-30 minutes after inhalation, and 0.5-6 hours after ingestion. (105028).
One prospective observational study and one case series have described 20 case reports of seizures occurring in children after ingestion of eucalyptus oil. Most of these seizures are generalized tonic-clonic in nature, occur 15-30 minutes after exposure, and do not reoccur following the discontinuation of eucalyptus oil. Seizures have been reported with both overdoses and therapeutic doses (107493,107495) and include cases of both EOIS and EOPS (107495). Additionally, children appear more likely to require intensive care and mechanical ventilation when compared with adult cases (107494).
A case of fever and headache has been reported in a patient who routinely applied a teaspoon of gel containing eucalyptus extract in his throat or nose to treat sore throat or rhinitis (48946).
General ...Orally, gelsemium can cause headache, drooping of the eyelid, double vision, difficulty swallowing, dizziness, muscle weakness or rigidity, seizures, dyspnea, and bradycardia. Death due to failure of respiratory muscles can occur (18).
Neurologic/CNS ...Orally, gelsemium can cause headache, drooping of the eyelid, double vision, difficulty swallowing, dizziness, muscle weakness or rigidity, seizures, dyspnea, and bradycardia. Death due to failure of respiratory muscles can occur (18).
General
...When used orally or topically, poison ivy may be unsafe.
Most Common Adverse Effects:
Orally: Diarrhea, dizziness, fever, intestinal colic, nausea, vomiting, severe mucous membrane irritation.
Topically: Contact dermatitis, herpes-like blisters, reddening, swelling.
Inhaled: Fever.
Serious Adverse Effects (Rare):
Orally: Fever, hematuria, nephritis, stupor, unconsciousness.
Topically: Erythema multiforme, black spot poison ivy dermatitis. Eye contact can cause severe conjunctivitis, corneal inflammations, or loss of sight.
Inhaled: Lung infection, respiratory distress syndrome, throat swelling.
Dermatologic ...Topically, poison ivy can cause contact dermatitis, reddening, swelling, and herpes-like blisters (18). These reactions occur at the area of contact, usually within a few hours, but are sometimes delayed for several days (68970). Sometimes papules and vesicles develop and can spread beyond the area of initial contact, but are generally self-limiting and eventually form crusts. (3839,68955,68960,68977,69007,69008,69038,69042). In a few cases, small white papules known as milia have developed on an area of poison ivy exposure after the typical skin reaction has subsided (94222). Occasionally, poison ivy causes more severe dermatologic reactions such as erythema multiforme (3839,68983,69032,112851). Black spot poison ivy dermatitis also occurs in rare cases, with black lacquer-like lesions on the skin that cannot be washed off, followed by the typical pruritic papules (112850). The black lesions are concentrated urushiol oleoresin that has darkened with exposure to oxygen and moisture (68960,68997,69027,69034). They eventually peel off and the skin heals normally (68960,112850).
Gastrointestinal ...Orally, poison ivy can cause severe mucous membrane irritation, nausea, vomiting, and diarrhea (18).
Genitourinary ...Orally, poison ivy can cause hematuria (18).
Immunologic ...Cross-allergenicity with poison ivy exists with cashew, mango, and ginkgo biloba (106574).
Neurologic/CNS ...Orally, poison ivy can cause dizziness, fever, stupor, and unconsciousness (18).
Ocular/Otic ...Topically, eye contact with urushiol from poison ivy can cause severe conjunctivitis, corneal inflammation, and potentially loss of sight (18).
Pulmonary/Respiratory ...Inhaled, urushiol in the smoke from burning of poison ivy can result in life-threatening throat swelling, fever, and secondary lung infections (6). Respiratory distress syndrome after smoke inhalation from burning poison ivy has also been reported (69036). Two fatal cases of acute respiratory distress and anaphylaxis after inhaling burned poison ivy are reported in patients with known allergies to poison ivy (112420).
Renal ...Orally, poison ivy can cause nephritis (18).
General ...Topically, sulfur is generally well tolerated when used in concentrations of up to 10%. Adverse effects include skin dryness, irritation, and pruritus (27846,88112,88120,88121,88126). Orally, sulfur has been reported to cause diarrhea and metabolic acidosis (27845).
Dermatologic ...Topically, application of sulfur preparations can cause dryness, leading to local irritation and pruritus in up to 28% of patients (27846,88112,88120,88121,88126).
Gastrointestinal ...Orally, sulfur is converted to sulfide in the gastrointestinal tract, causing intestinal irritation which can lead to diarrhea (27845).
Renal ...There is one case report of metabolic acidosis occurring in a 57-year-old woman who had consumed approximately 250 grams of flowers of sulfur, a form of sulfur prepared by sublimation, over a 6-day period (27845). Underlying conditions, including diabetes and renal failure, may have contributed to the acidosis. Sulfur is converted to sulfide by colonic bacteria and then to sulfate in various tissues, generating hydrogen ions which can lead to acidosis when clearance mechanisms are overwhelmed (27845).
General ...Orally, large doses of wild indigo are considered poisonous and can cause vomiting, diarrhea, gastrointestinal complaints, and spasms (12). Wild indigo has also been studied in combination with other herbal extracts.
Gastrointestinal ...Orally, large doses of wild indigo can cause vomiting, diarrhea, and gastrointestinal complaints (12).
Musculoskeletal ...Orally, large doses of wild indigo are considered poisonous and can cause spasms (12).