White Hellebore

Scientific Name(s): Veratrum album L., Veratrum californicum Dur., Veratrum fimbriatum A. Gray., Veratrum frigidum Schltdl. and Cham., Veratrum nigrum L., Veratrum viride Ait.
Common Name(s): Black false hellebore, California false hellebore, False hellebore, Fringed false hellebore, Green hellebore, Indian poke, Itchweed, Langwort, Western hellebore, White hellebore

Medically reviewed by Drugs.com. Last updated on Oct 22, 2021.

Clinical Overview

Use

Historically, false hellebore was evaluated for use in hypertension; however, toxicity precludes its widespread use. Research reveals no clinical trials regarding the use of veratrum for any condition.

Dosing

White hellebore is toxic; however, doses of 0.02 to 0.1 g of the powdered root have been traditionally used.

Contraindications

No longer considered safe for use.

Pregnancy/Lactation

Avoid use. Documented adverse effects.

Interactions

None well documented.

Adverse Reactions

GI irritation, hypersalivation, vomiting, headache, visual disturbances, paresthesia, dizziness, bradycardia, atrioventricular block, hypotension, and syncope have been reported.

Toxicology

Numerous nonfatal poisonings have been reported.

Scientific Family

• Liliaceae (lily)

Botany

The genus Veratrum comprises multiple recognized false hellebore species, including the archetypical V. album or white false hellebore. Veratrum should not be confused with the genus Helleborus (buttercup family). False hellebore is a perennial that is widely distributed throughout Europe, northern Asia, and North America. The plant grows 1.5 to 2.5 m in height and is characterized by a hairy stem and large, oval, yellow-green leaves that alternate around the stem and have a slightly hairy undersurface, with the plant's lower leaves reaching up to 0.3 m in length. Its greenish flowers bloom in June and July, producing a capsule-like fruit. The rhizome has an acrid taste and onion-like odor.Chevallier 2001, USDA 2016

History

The term "veratrum" is derived from the Latin words "vere" meaning "truly" and "ater" meaning "black." Historical use of V. album centers on its toxic potential. In Roman times, V. album was used as a poison and an extract of the plant was used as an arrow tip poison; there is some thought that poisoning with V. album extract was the cause of death for Alexander the Great.Schep 2014 Small doses were used to treat symptoms of cholera, often with less than desirable effects. White hellebore was used in place of Colchicum for the treatment of gout, to aid in the treatment of hypertension, and to treat herpetic lesions externally, but use has been limited by its toxicity. White hellebore was listed in the French pharmacopeia as a treatment for hypertension, toxemia of pregnancy, and cardiac failure until 1982; however, current use in herbal medicines is rare, except in homeopathy.Chevallier 2001, Quatrehomme 1993, Van Wassenhoven 2004

Chemistry

Reviews of the alkaloidal content of false hellebore species have been published, especially concerning that of veratrum extracts for use in the management of hypertension prior to being superseded by safer, more effective medications.Heretsch 2015, Li 2006, Schep 2006

More than 200 alkaloids have been described, including the toxicologically relevant cevadine and veratridine, as well as a mixture of alkaloids collectively referred to as "veratrine."Duke 1992,