Taxonomic class

Liliaceae

Common Trade Names

None known.

Common Forms

Available as extracts.

Source

Active components are derived from leaves, roots, and flowers of Conval/aria majalis, a low-growing perennial herb that is native to Europe and naturalized throughout North America.

Chemical components

The entire plant contains cardiac glycosides (convallatoxol, convallotoxin, convallarin, convallamarin, locundjosid, and convallosid-which transforms into convallatoxin when dried), volatile oil, saponins, asparagin, resin, rutin, chelidonic acid, calcium oxalate, choline, carotene, and wax.

Actions

Tea made from this herb is claimed to have diuretic, emetic, pyrogenic, and sedative actions. Cardiac effects stem from plant glycosides thought to be less toxic than those offoxglove . The plant was also believed to exert hypoglycemic effects, but studies in diabetic mice have shown this to be false .

Reported Uses

The plant was traditionally used as an antidote to poison gas and as a cardiotonic agent for treating valvular heart disease. Russian herbalists have also reported its use as an antiepileptic. The roots have been used in an ointment to help heal burn wounds and prevent them from scarring. In Germany, the flowers are mixed with raisins and made into wille.

Dosage

No consensus exists.

Adverse Reactions

CNS: coma, dizziness, hallucinations, headache, paralysis.

CV: arrhythmias, heart failure.

EENT: burning pain in the mouth and throat, mydriasis, increased salivation.

GI: abdominal cramps and pain, diarrhea, nausea, vomiting.

GU: urinary urgencyMetabolic: hyperkalemia.

Skin: cold, clammy skin; dermatitis (contact with leaves) .

Other: death.

Interactions

Beta blockers, calcium channel blockers: Increased risk of heart block or bradycardia. Avoid administration with lily-of-the-valley.

Digoxin: May have additive effects. Avoid administration with lily-of­the- valley.

Contraindications and precautions

All parts of the plant are contraindicated.

Special considerations

Lily-of-the-valley has been used in folk medicine as a digitalis substitute. However, it should not be used for any cardiac condition because of its potential for toxicity and lack of accurate dosage information.

Alert The entire plant is toxic, causing digitalis-like symptoms. The water in which the cut flowers have been placed can also be toxic. Treatment includes emesis and gastric lavage followed by administration of activated charcoal and sorbitol cathartic as well as supportive care. Perform cardiac monitoring and restore normal sinus rhythm, if necessary, with atropine. Additional effects of plant ingestion may include other rhythm disturbances and hyperkalemia. Treatment is similar to that for digitalis toxicity.

Advise the patient to consult a health care provider before using herbal preparations because a treatment that has been clinically researched and proved effective may be available.

Keep lily-of-the-valley out of the reach of children and pets.

Points of Interest

The FDA considers lily-of-the-valley an unsafe and poisonous plant.

The essential oils of the highly aromatic flowers have been used in perfumes and cosmetics.

Commentary

Digoxin and digitalis preparations are available for treating heart failure and other cardiac conditions. There is little use for a highly toxic, insufficiently studied herbal product that might have a similar therapeutic action.