PDR for Herbal Medicines

HERBAL MONOGRAPHS LILY-OF-THE-VALLEY /475

Lilium martagon

See Martagon

Lily-of-the-Valley

Convallaria majalis

DESCRIPTION

Medicinal Parts: The medicinal parts are the dried flower

tips and the dried inflorescence, the Lily-of-the-Valley herb,

the dried root rhizome with the roots, the flowering aerial

parts and the whole, fresh, flowering plant.

Flower and Fruit: The flowers are in racemes nodding to

one side, usually with a triangular penduncle. The tips are

hemispheric, campanulate. 6-petalled with ovoid revolute

tips. The perigone is white or pink. The stamens are attached

to the base of the perigone. The fruit is a bright red, globular

berry with 2 blue seeds. The plant is autosterile.

Leaves, Stem and Root: The 15 to 20 cm high plant has 2 to

3 leaves at the tip of the runner-like, branched rhizome. The

leaves are elliptoid and acute. They taper to a long, sharp

petiole at the base, which is clasped by a membranous

sheath.

Characteristics: Fragrant but poisonous (all parts).

Habitat: The plant is native to Europe and has been

introduced into the U.S. and northern Asia.

Production: Lily-of-the-Valley herb consists of the dried,

above-ground parts of Convallaria majalis (or closely related

species^ottected during the flowering season. The harvest-

ed parts of the plant must be dried quickly at*ia maximum

temperature of 60°C.

Not to be Confused With: Lilly-of-the-Valley is easily

confused with Polygonatum odoratum.

Other Names: May Lily, May Bells, Convallaria, Our Lady's

Tears, Convall-Lily, Lily Constancy, Jacob's Ladder, Lad-

der-to-Heaven, Muguet

ACTIONS AND PHARMACOLOGY

COMPOUNDS

Cardioactive steroid glycosides (cardenolides): varying

according to geographical source, chief glycoside convalla-

toxin (western and northwestern Europe), convalloside

(northern and eastern Europe), or convallatoxin + convalla-

toxol (central Europe)

EFFECTS
Only older studies are available, which indicate the conval-
lara glycosides are qualitatively similar to digitoxin and

strophanthin. The studies show Lily-of-the-Valley to have

the following effects:

Cardiac: The power and speed of cardiac muscle contraction

is increased and there is a reduced relaxation time. The beat

frequency is slowed, stimulation transfer is delayed and the

ability of the chamber muscles to be stimulated is increased

(positively inotropic, negatively chronotropic, negatively

dromotropic and positively bathmotropic effect.)

Renal: In animal tests, the effect was natriuretic and diuretic.

Venous: In animal tests, Lily-of-the-Valley demonstrated a

dose-dependent, veno-constrictive effect.

INDICATIONS AND USAGE

Approved by Commission E:

• Arrhythmia


• Cardiac insufficiency NYHA I and II


• Nervous heart complaints

Unproven Uses: The drug is used for mild cardiac insuffi-

ciency (stage I-II NYHA), heart insufficiency due to old age

and chronic cor pulmonale. In folk medicine, Lily-of-the-

Valley was also used- for weak contractions in labor,

epilepsy, dropsy, strokes and ensuing paralysis, conjunctivi-

tis and leprosy. Use for these applications is no longer

common because of the drug's toxic effect.

PRECAUTIONS AND ADVERSE REACTIONS

General: Health risks following the proper administration of

designated therapeutic dosages are not recorded. Nausea,

vomiting, headache, stupor, disorders of color perception and

cardiac arrhythmias can occur as side effects, particularly

with an overdosage. - ,

Drug Interactions: The simultaneous administration of

quinidine, digoxin, calcium salts, saluretics, laxatives and

glucocorticoids enhances effects and side effects.

OVERDOSAGE

For symptoms of an acute poisoning and therapy, see

Digitalis folium. The dangers of poisoning are relatively low

with oral application, due to the poor absorbability of the

glycosides.

DOSAGE

Mode of Administration: Comminuted herb, as well as

galenic preparations for internal use; no longer considered

safe because of the levels of toxins.

How Supplied: All information is based on stabilized Lilly-

of-the-Valley powder as specified in the German pharmaco-

poeia. No other forms can be recommended. However,

commercial pharmaceutical preparations are available as

capsules, drops, solutions and tablets.