Dangerous oleander extract not a COVID-19 cure

An unusual and highly toxic compound made headlines after President Trump allegedly backed it up during a conversation in the Oval Office.

Axios Reports that Trump expressed his support for oleandrine, a botanical plant made from the poisonous oleander plant, at a meeting in July attended by MyPillow.com founder and CEO Mike Lindell and the Housing and Urban Development Secretary Ben Carson, MD.

Lindell, a longtime Trump supporter with an interest in the biotechnology that develops oleandrin – Phoenix Biotechnology – said Axios that Trump said “the FDA should approve it.”

FDA Commissioner Stephen Hahn, MD has resisted any effort around the compound, according to Axios, but Phoenix Biotechnology director Andrew Whitney said if he couldn’t market oleandrin as a medicine, he would do so as a dietary supplement.

The thought of another potentially dangerous compound touted as a “miracle cure” by the Trump administration, like hydroxychloroquine, drew medical experts on Twitter on Monday.

“Oleandrin? Yeah that would sure end up killing people,” tweeted David Juurlink, MD, PhD, from Sunnybrook Health Sciences Center in Toronto.

Juurlink said MedPage today that oleandrine is “similar to digoxin.” Too much can cause nausea, vomiting and diarrhea, but the main concern is arrhythmias, which can be fatal ”.

Jennifer Gunter, MD, tweeted that it is “easier to kill a person with oleandrine than COVID-19” and has highlighted a case report in which two people were poisoned after eating snails that nibbled on a bay plant- pink.

What makes oleander – the word usually covers the Nerium oleander, Nerium indicum, and odors of nerium; plants, and other common names are kaner, rosebay, and oleander – so deadly? All of its parts contain cardiac glycosides, the most potent of which are oleandrin and nerine, both of which are similar to digitalis’s main cardiac glycoside, digoxin.

According to a 2010 case report and review, oleandrine directly interferes with the heart’s sodium-potassium pump, potentially leading to arrhythmias. Ingestion also causes gastrointestinal effects, and both appear approximately four hours after ingestion.

The authors of an earlier case report calculated that 4 grams of oleander leaves would be fatal.

Juurlink has highlighted a case report in which a patient committed suicide using oleander leaves. This article estimates the toxic blood levels of oleandrin at 1 to 2 ng / ml and a lethal blood level of 9.8 to 10 ng / ml.

So far, there is no published evidence that oleandrin can help patients with COVID-19. A recent study tested the compound against SARS-CoV-2 in Vero cells, but no animal or human data are available for this indication. This study was a pre-print in bioRxiv and one of its authors, Robert Newman, is chairman of the science advisory board of Phoenix Biotechnology.

Oleandrin has also been studied in vitro as a possible cancer drug, but it is “unclear whether these effects can occur in the human body,” according to a Memorial Sloan Kettering Cancer Center information page on oleandrin.

“No one should take oleandrine to prevent COVID,” Juurlink said MedPage today. “Anyone who is gullible and stupid enough to take it despite this advice should get their own house in order beforehand.”

Last update August 18, 2020