Catharanthus roseus 長春花

POISONOUS PARTS

Whole plant.⁴

TOXICITY

• Toxic Constituents

  Vinblastine and vincristine.⁵

• Mechanism

  Vinblastine and vincristine bind tubulin and prevent assembly of microtubules, resulting in failure of mitosis. This leads to bone marrow suppression and gastrointestinal toxicity.⁶

• Poisoning Features

  Paraesthesia, stomatitis, paralytic ileus, myalgia, fever, bone marrow suppression and multi-organ failure.⁷

• Poisoning Events

  A 67-year-old woman with hepatitis related liver cirrhosis and hepatocellular carcinoma developed severe bone marrow suppression after taking a 5-day course of C. roseus as an alternative anti-cancer treatment.⁸

CLINICAL MANAGEMENT

Supportive treatment.⁷

IDENTIFICATION FEATURES

Subshrubs or perennial herbs, 30–50(–100) cm tall. Leaves 2.5–9 × 1–3.5 cm, apex minutely apiculate, lateral veins 7–11 on each side of midvein. Corolla purple or white; tubes 2.5–3 cm long, pilose inside, throat villous; lobes 1.2–2 cm long. Follicles 1.5–3 × 0.3 cm, longitudinally grooved. Seeds oblong-cylindrical, black.⁹

MEDICINAL USES

Whole plant used in TCM: remove toxin and anti-cancer, reduce blood pressure, clear heat and pacify the liver. Recommended dose: 5–10 g. In addition, vinblastine and vincristine are used as anti-neoplastic drugs in western medicine.^2,6,10

LABORATORY ANALYSIS

Vinblastine and vincristine can be detected by HPLC-DAD and LC-MS/MS.¹¹