Adonis herb + lily of the valley herb + sea onion + oleander leaves

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

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Last updated on: 10.04.2022

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Definition
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The fixed combination "Adonis herb + Lily of the Valley herb + Sea bulb + Oleander leaves" positively monographed by Commission E consists of:

  • Adonis herbliquid extract
  • Lily of the Valley dry extract
  • Sea onion dry extract
  • dry extract of oleander leaves.

The combination of medicines is used in case of impaired cardiac performance with accompanying circulatory instability.

Effects
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A fixed combination of Adonidis herba (adonis herb liquid extract), Convallariae herba (lily of the valley herb dry extract), Scillae bulbus (sea onion dry extract) and Oleandri folium (oleander leaf dry extract) has a negative influence on the excitation conduction of the heart and a positive influence on the stimulation threshold of the heart.

Field of application/use
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Fixed combinations of this composition are used in cases of limited cardiac output with associated circulatory instability.

Dosage
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In adults, the daily dose of solid and individually dosed dosage forms is between 270 and 540 MSE, and 3101 MSE for liquid dosage forms.
The extracts are mixed in a ratio of 25: 15: 25: 25.

This produces the following composition for solid dosage forms: liquid extract of adonis herbs 0.03 mg total glycosides (= 25 MSE), dry extract of lily of the valley herb 0.005 mg total glycosides (= 15 MSE), dry extract of sea onions 0.009 mg total glycosides (= 25 MSE) and dry extract of oleander leaves 0.004 mg total glycosides (= 25 MSE).

For liquid dosage forms, the following compositions are produced per 100 ml
: liquid extract of adonis herb 5.99 mg total glycosides (= 5,000 MSE), dry extract of lily of the valley herb 0.97 mg total glycosides (=3,125 MSE), dry extract of sea onion 1.73 mg total glycosides (=5,000 MSE) and dry extract of oleander leaves 0.86 mg total glycosides (=5,000 MSE).

Undesirable effects
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In rare cases, nausea, vomiting, diarrhoea, stomach problems, irregular pulse or cardiac arrhythmia may occur.

Contraindication
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Use should be withheld in existing NYHA stages III and IV heart failure, during therapy with digitalis glycosides, potassium deficiency, digitalis intoxication, bradycardia, or ventricular tachycardia.

Interactions
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If calcium, quinidine, saluretics, laxatives or long-term therapy with glucocorticoids are taken at the same time, the effects and side effects may be increased

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Heart failure;