Oleander poisoning
Rosebay poisoning; Yellow oleander poisoning; Thevetia peruviana poisoning
Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (Nerium oleander), or its relative, the yellow oleander (Cascabela thevetia).
This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Oleander (Nerium oleander) is a common ornamental evergreen shrub. It is used as a freeway median divider in warmer states, such as California. This plant is extremely toxic, and a single leaf may kill an adult. This photograph shows oleander not yet in bloom.
Poisonous Ingredient
Poisonous ingredients include:
- Digitoxigenin
- Neriin
- Oleandrin
- Oleondroside
Note: This list may not include all poisonous ingredients.
Where Found
The poisonous substances are found in all parts of the oleander plant:
- Flowers
- Leaves
- Stems
- Twigs
Symptoms
Oleander poisoning can affect many parts of the body.
HEART AND BLOOD
EYES, EARS, NOSE, MOUTH, AND THROAT
- Blurred vision
- Vision disturbances, including halos around objects
STOMACH AND INTESTINES
- Diarrhea
- Loss of appetite
- Nausea and vomiting
- Stomach pain
NERVOUS SYSTEM
SKIN
- Hives
- Rash
Note: Depression, loss of appetite, and halos are most often seen in chronic overdose cases.
Home Care
Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care provider.
Before Calling Emergency
Get the following information:
- Person's age, weight, and condition
- Name and part of the plant swallowed, if known
- Time it was swallowed
- Amount swallowed
Poison Control
Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive:
- Activated charcoal
- Blood and urine tests
- Breathing support, including oxygen through a tube through the mouth into the lungs, and a breathing machine (ventilator)
- Chest x-ray
- ECG (electrocardiogram, or heart tracing)
- Fluids through a vein (IV)
- Medicines to treat symptoms including an antidote to reverse the effects of the poison
- Tube through the mouth into the stomach to wash out the stomach (gastric lavage)
Outlook (Prognosis)
How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery.
Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely.
DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods.
References
Graeme KA. Toxic plant ingestions. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 65.
Mofenson HC, Caraccio TR, McGuigan M, Greensher J. Medical toxicology. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2023. Philadelphia, PA: Elsevier; 2023:1404-1457.
Version Info
Last reviewed on: 11/2/2023
Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
