Taxonomic class

Cactaceae

Common Trade Names

Multi-ingredient preparations: Cactus Grandiflorus, Cactus-Hawthorn

Compound, Cereus Grandiflorus, Night-Blooming Cereus

Common Forms

Available as liquid extract and tincture.

Source

Active components are derived from the stems and flowers of Selenicereus grandiflorus, which is native to tropical and subtropical America , including the West Indies .

Chemical Components

The plant contains a digitalis-like glycoside, either cactine or hordenine (N,N -dimethyl -4- hydroxy-beta - phenethylamine). Other reported components include betacyanin, isorhamnetin-3-glucoside, narcissin, rutin, cacticine, kaempferitrin, grandiflorine, hyperoside, isorhamnetin-3-beta­galactosyl- rutinoside, and isorhamnetin- 3-beta- xylosyl- rutinoside.

Actions

Night-blooming cereus is thought to elevate arteriolar tension by increasing the muscular energy of the heart and causing arteriolar contraction. This theory has not been confirmed by human data. Early research with commercial preparations of the active compound proved it to be physiologically inert. More recently, in studies with rats and dogs, hordenine showed a positive inotropic effect on the heart, with increased systolic and diastolic blood pressures and peripheral blood flow volume . Flavonoids and their derivatives (rutin, rutinoside, and kaempferitrin) are thought to improve capillary function by decreasing abnormal leakage .

Reported Uses

In Europe , the liquid plant extract has been used to treat angina pectoris, irritable bladder, kidney congestion, nervous headache, palpitations, and prostatic diseases. The herb has been used as an antirheumatic and a cardiotonic in Cuba . Other indications for its use include cystitis, dyspnea, edema, endocarditis, and myocarditis. Anecdotal reports claim that the herb is valuable as a cardiac stimulant and a partial substitute for digitalis in heart disorders related to anemia, dyspepsia, Graves’ disease, neurasthenia, and tobacco toxicity.

Dosage

Traditional uses suggest the following dosages:

Liquid extract: 0.7 ml (12 minims) P.O. every 4 hours.

Tincture: 1 to 1.8 ml (15 to 30 minims) P.O. every 4 hours.

Adverse Reactions

EENT: burning sensation in the mouth.

GI: diarrhea, nausea, vomiting.

Interactions

ACE inhibitors, antiarrhythmics, beta blockers, calcium channel blockers, cardiac glycosides: May increase effects of these drugs. Avoid administration with night-blooming cereus.

Contraindications and Precautions

Night-blooming cereus is contraindicated during the first trimester of pregnancy.

Special Considerations

Monitor the patient’s heart rate and blood pressure if the is also taking prescription cardiac drugs.

Encourage the patient with a CV disorder to be evaluated by a health care provider and, if necessary, receive prescribed cardiac drugs. Because the use of night-blooming cereus as a substitute for digitalis has not been confirmed by human clinical trials, it should not be used by itself for heart-related disorders.

Urge the patient to immediately report heart-related adverse effects (blood pressure changes, increased heart rate, and palpitations) to his health care provider.

Instruct women to report planned or suspected pregnancy.

Advise women to avoid using night-blooming cereus during pregnancy or when breast-feeding.

Commentary

Although night-blooming cereus contains a digitalis-like glycoside, its use as a substitute for digitalis preparations (digoxin or digitoxin) or for treating heart-related disorders has not been evaluated in humans. Patients with such conditions should strongly be encouraged to seek professional medical advice. Also, patients who are taking prescription digitalis or other cardiac drugs should avoid concurrent use of this herb.