Foxglove
OTHER NAME(S): Dé de Bergère, Dead Man's Bells, Digitale, Digitale Laineuse, Digitale Pourpre, Digitale Pourprée, Doigtier, Fairy Cap, Fairy Finger, Gant-de-Bergère, Gant-de-Notre-Dame, Gantelée, Gantière, Grande Digitale, Lady's Thimble, Lion's Mouth, Purple Foxglove, Scotch Mercury, Throatwort, Witch's Bells, Woolly Foxglove, Digitalis purpurea, Digitalis lanata, Dedalera, Digitale pourpre
Overview
Foxglove (Digitalis purpurea, Digitalis lanata) is a plant. It is the source of the modern drug, digoxin. All parts of the plant are poisonous.
The chemicals in foxglove can increase the strength of heart muscle contractions, change heart rate, and increase heart blood output. Chemicals taken from foxglove are used to make the prescription drug digoxin. Digitalis lanata is the major source of digoxin in the US.
People use foxglove for irregular heartbeat and heart failure. It is also used for many other conditions, but there is no good scientific evidence to support these uses.
All parts of the foxglove plant are toxic. Any use requires monitoring by a medical professional.
Uses
Possibly Effective for
- Irregular heartbeat (atrial fibrillation). Taking foxglove by mouth may improve irregular heartbeat such as atrial fibrillation or flutter. But it can also be severely poisonous.
- Heart failure and fluid build up in the body (congestive heart failure or CHF). Taking foxglove by mouth may improve CHF and CHF-related swelling. But it can also be severely poisonous.
There is interest in using foxglove for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.
Side Effects
When taken by mouth: Foxglove is unsafe. Any use requires monitoring by a healthcare professional. All plant parts are toxic and can lead to serious side effects and death. Deaths have occurred when foxglove was mistaken for comfrey.
Precautions
When taken by mouth: Foxglove is unsafe. Any use requires monitoring by a healthcare professional. All plant parts are toxic and can lead to serious side effects and death. Deaths have occurred when foxglove was mistaken for comfrey.
Pregnancy and breast-feeding: Foxglove is unsafe when taken by mouth while pregnant or breast-feeding. Avoid use.
Children: Taking foxglove by mouth is likely unsafe for children.
Kidney disease: People with kidney problems may not clear foxglove from their system very well. This can increase the chance of foxglove build-up and poisoning.
Interactions
Moderate Interaction
Be cautious with this combination
- Antibiotics (Tetracycline antibiotics) interacts with FoxgloveTaking some antibiotics called tetracyclines with foxglove might increase the chance of side effects from foxglove.
- Digoxin (Lanoxin) interacts with FoxgloveDigoxin helps the heart beat more strongly. Foxglove also seems to affect the heart. Taking foxglove along with digoxin can increase the effects of digoxin and increase the risk of side effects. Do not take foxglove if you are taking digoxin.
- Quinine interacts with FoxgloveFoxglove can affect the heart. Quinine can also affect the heart. Taking quinine along with foxglove might cause serious heart problems.
- Stimulant laxatives interacts with FoxgloveFoxglove might affect the heart. Stimulant laxatives can cause diarrhea and decrease potassium levels. Low potassium levels can also affect the heart. Taking these products together can increase the risk of side effects.
- Water pills (Diuretic drugs) interacts with FoxgloveFoxglove might affect the heart. "Water pills" can decrease potassium levels. Low potassium levels can also affect the heart. Taking these products together can increase the risk of side effects.
- Antibiotics (Macrolide antibiotics) interacts with FoxgloveFoxglove can affect the heart. Some antibiotics might increase how much foxglove the body absorbs. Increasing how much foxglove the body absorbs might increase the effects and side effects of foxglove.
Dosing
There isn't enough reliable information to know what an appropriate dose of foxglove might be. Foxglove is also unsafe. Speak with a healthcare provider before use.
References
- Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Johnson JA, Lalonde RL. Congestive Heart Failure. Eds. DiPiro JT, et al. Pharmacotherapy, third ed. Stamford: Appleton and Lange, 1997.
- Gossel TA, Bricker JD. Principles of Clinical Toxicology. New York, NY:Raven Press, 1994.
- De Smet PAGM, Keller K, Hansel R, Chandler RF, Eds. Adverse Effects of Herbal Drugs 1. Verlag, Berlin: Springer, 1992.
- Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.
- Brustbauer, R. and Wenisch, C. [Bradycardiac atrial fibrillation after consuming herbal tea]. Dtsch.Med Wochenschr. 7-25-1997;122(30):930-932.
- Lacassie, E., Marquet, P., Martin-Dupont, S., Gaulier, J. M., and Lachatre, G. A non-fatal case of intoxication with foxglove, documented by means of liquid chromatography-electrospray-mass spectrometry. J Forensic Sci 2000;45(5):1154-1158.
- Thierry, S., Blot, F., Lacherade, J. C., Lefort, Y., Franzon, P., and Brun-Buisson, C. Poisoning with foxglove extract: favorable evolution without Fab fragments. Intensive Care Med 2000;26(10):1586.
- Jowett, N. I. Foxglove poisoning. Hosp.Med 2002;63(12):758-759.
- Ramlakhan, S. L. and Fletcher, A. K. It could have happened to Van Gogh: a case of fatal purple foxglove poisoning and review of the literature. Eur.J Emerg.Med 2007;14(6):356-359.
- Fujii, Y., Ikeda, Y., and Yamazaki, M. High-performance liquid chromatographic determination of secondary cardiac glycosides in Digitalis purpurea leaves. J Chromatogr. 10-6-1989;479(2):319-325.
- Yaginuma, M., Orimo, S., Kurosawa, T., Arai, M., and Hiyamuta, E. [Muscle weakness of the upper arms in the last trimester of administering digitalis]. Rinsho Shinkeigaku 1988;28(3):338-341.
- Lugt, C. B. and Noordhoek-Ananias, L. Quantitative fluorimetric determination of the main cardiac glycosides in Digitalis purpurea leaves. Planta Med 1974;25(3):267-273.
- Friedman, P. L. and Smith, T. W. Foxglove and Fab: immunological approaches to digitalis intoxication. Int.J.Cardiol. 1983;3(2):237-240.
- Simpkiss, M. and Holt, D. Digitalis poisoning due to the accidental ingestion of foxglove leaves. Ther.Drug Monit. 1983;5(2):217.
- Omvik, P. [Foxglove poisoning]. Tidsskr.Nor Laegeforen. 5-30-1981;101(15):949-950.
- Dickstein, E. S. and Kunkel, F. W. Foxglove tea poisoning. Am.J Med 1980;69(1):167-169.
- Rich, S. A., Libera, J. M., and Locke, R. J. Treatment of foxglove extract poisoning with digoxin-specific Fab fragments. Ann.Emerg.Med 1993;22(12):1904-1907.
- Mitchell, G. Foxed by the foxglove. Aust.Fam.Physician 1993;22(6):997-999.
- Hollman, A. Drugs for atrial fibrillation. Digoxin comes from Digitalis lanata. BMJ 4-6-1996;312(7035):912.
- Janssen RM, Berg M, Ovakim DH. Two cases of cardiac glycoside poisoning from accidental foxglove ingestion. CMAJ. 2016;188(10):747-50.
- Lin CC, Yang CC, Phua DH, Deng JF, Lu LH. An outbreak of foxglove leaf poisoning. J Chin Med Assoc. 2010;73(2):97-100.
- Wu IL, Yu JH, Lin CC, Seak CJ, Olson KR, Chen HY. Fatal cardiac glycoside poisoning due to mistaking foxglove for comfrey. Clin Toxicol (Phila). 2017:1-4.
- Negroni MS, Marengo A, Caruso D, et al. A case report of accidental intoxication following ingestion of foxglove confused with borage: High digoxinemia without major complications. Case Rep Cardiol. 2019;2019:9707428.
- Maes KR, Depuydt P, Vermassen J, De Paepe P, Buylaert W, Lyphout C. Foxglove poisoning: diagnostic and therapeutic differences with medicinal digitalis glycosides overdose. Acta Clin Belg. 2020:1-7.
- Lehmann A, Späni S, Harings-Kaim A, Probst C, Christ A, Leuppi-Taegtmeyer AB. A case of intoxication with tea made from Digitalis purpurea. Glob Cardiol Sci Pract 2021;2021(1):e202102.
- Rouault E, Ghnassia C, Filippi-Codaccioni E, Maillard N. Dose and efficacy of repeated administrations of digoxin-specific antibody fragments: Case report of foxglove poisoning. Basic Clin Pharmacol Toxicol 2021;128(1):183-186.
- Digoxin tablet prescribing information. Amneal Pharmaceuticals: Bridgewater, NJ. June 2019.