Ask the Expert: Oleandrin and COVID-19 - Today's Dietitian Magazine

January 2021 Issue

Ask the Expert: Oleandrin and COVID-19
By Toby Amidor, MS, RD, CDN, FAND
Today’s Dietitian
Vol. 23, No. 1, P. 9

Q: Some of my clients have asked about taking oleandrin to prevent or treat COVID-19. Is there research to support its use?

A: Nerium oleander and oleandrin have been touted in the media and by some political and business figures to treat numerous conditions including COVID-19, AIDS, congestive heart failure, hepatitis C, cancer, asthma, epilepsy, dysmenorrhea, leprosy, malaria, and sexually transmitted infections, and has been used as an abortifacient and topically for ulcers, skin eruptions, and warts.1 However, there’s no reliable research supporting its use for any of these purposes.

This article examines the limited research available for the use of oleandrin to treat COVID-19 and recommendations RDs can make to clients who may inquire about it.

Safety and Availability
Oleandrin (also known as oleander extract) comes from the oleander plant; common names for the oleander plant include rose laurel, adelfa, rosenlorbeer, and karavira. This flowering shrub is found mostly in temperate and subtropical climates such as North Africa, the eastern Mediterranean basin, and Southeast Asia. All parts of the plant contain toxic substances called cardiac glycosides; in parts of Asia, ingesting the plant is a common method of suicide. As such, the oleander plant never should be consumed orally as a dietary supplement or home remedy.

While some claim the compound oleandrin is safe because it’s a “purified” version of the toxic plant, research doesn’t support this. In fact, consuming oleandrin can result in a wide range of toxic effects such as vomiting, respiratory paralysis, serious heart problems, and even death. Furthermore, because of its toxic cardiac glycosides, which have effects similar to some heart medications, oleandrin can increase the risk of cardiac toxicity when used together with medications such as digoxin, diuretics, stimulant laxatives, and some antibiotics.

In August 2020, the American Botanical Council released a press release warning against the consumption of any form of the oleander plant, as well as capsules, tablets, teas, or extract preparations made from leaves or other parts of the plant, citing the potential of serious effects to the human heart, including death.2

At the time of that press release, the American Botanical Council wasn’t aware of any extracts or dietary supplement products sold in the United States that contain oleander. There are some homeopathic drugs made from oleander, but they’re highly diluted to the point where there are only minute amounts of molecules from oleander compounds left in the homeopathic dilution. While oleandrin isn’t available from traditional US retailers, consumers can access it—and other supplements barred in the United States—from nonmainstream online stores, and some consumers may try to make their own extracts from the oleander plant.

The company Phoenix Biotechnology, Inc, has attempted to bring a prescription drug and supplement containing oleandrin to market in the United States, claiming that peer-reviewed studies suggest that oleandrin is protective against congestive heart failure and has antiviral properties against Ebola, HIV, and SARS-CoV-2, the novel coronavirus that causes COVID-19.3 In August 2020, the FDA rejected Phoenix Biotechnology’s submission to market oleandrin as a supplement due to safety concerns, as well as the fact that oleandrin legally can’t be marketed as a supplement while being investigated as a prescription drug.4,5

COVID-19 Research
There’s a lack of scientific evidence to support the claim that oleandrin can treat COVID-19.6 One, as of yet non–peer-reviewed, study showed that in vitro treatment with oleandrin of cells pre and post exposure to SARS-CoV-2 reduced virus production 78-fold to 800-fold. Of note, the chief science officer of and a paid consultant for Phoenix Biotechnology were among the study’s authors, and in vitro results often don’t confer the same outcomes in humans. The study concluded that further research is needed in animals and humans to determine the efficacy of oleandrin on COVID-19.7

Recommendations for Clients
Nutrition professionals should explain to clients who inquire about oleandrin that there’s no evidence that it can treat or prevent COVID-19 and check for any potential medication interactions among patients who insist on taking supplements containing oleandrin. It’s important to stress that clients shouldn’t attempt to make their own treatment from any part of the oleander plant; taking even a small amount of a product containing oleander can be toxic.

— Toby Amidor, MS, RD, CDN, FAND, is the founder of Toby Amidor Nutrition (tobyamidornutrition.com) and a Wall Street Journal best-selling author. Her cookbooks include The Best Rotisserie Chicken Cookbook, The Create-Your-Plate Diabetes Cookbook, Smart Meal Prep for Beginners, The Easy 5-Ingredient Healthy Cookbook, The Healthy Meal Prep Cookbook, and The Greek Yogurt Kitchen. She’s a nutrition expert for FoodNetwork.com and a contributor to U.S. News Eat + Run and other national outlets.

References
1. Oleander. Natural Medicines website. https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=789#scientificName. Accessed October 30, 2020.

2. American Botanical Council warns consumers about high toxicity of oleander. American Botanical Council website. http://cms.herbalgram.org/press/2020/ABC-Warns-High-Toxicity-Oleander.html. Published August 18, 2020.

3. Oleandrin FAQ's. Phoenix Biotechnology, Inc website. http://www.phoenixbiotechnology.com/Oleandrin_FAQs.php

4. Submitted 75-day premarket notifications for new dietary ingredients. FDA website. https://www.fda.gov/food/new-dietary-ingredients-ndi-notification-process/submitted-75-day-premarket-notifications-new-dietary-ingredients. Updated November 6, 2020. Accessed October 30, 2020.

5. NDI 1157 - oleandrin from Phoenix Biotechnology, Inc. Regulations.gov website. https://beta.regulations.gov/document/FDA-2020-S-0023-0068. Published September 2, 2020. Accessed October 30, 2020.

6. COVID-19: warn patients about poisonous oleander extract. Natural Medicines website. https://naturalmedicines.therapeuticresearch.com/news/news-items/starnatural-medicines-and-covid-19star/covid-19-warn-patients-about-poisonous-oleander-extract.aspx. Published September 2020. Accessed October 30, 2020.

7. Plante KS, Plante JA, Fernandez D, et al. Prophylactic and therapeutic inhibition of in vitro SARS-CoV-2 replication by oleandrin [preprint published July 15, 2020]. bioRxiv. doi: 10.1101/2020.07.15.203489.