Description
Medicinal Parts
The medicinal parts come from the bulbs of the white latex variety collected after flowering and the fresh, fleshy bulb scales of the white variety and of the red variety.
Flower and Fruit
The flowering stem is erect and 50 to 150 cm high. It is often a washed purple color and glabrous. The flowers, which often number 100, are arranged in richly flowered, dense racemes up to 60 cm long. The bracts are membranous and pointed. They are shorter than the pedicles and drop early. The pedicles are up to 3 cm long, thin, and smooth. The flowers are white, radial, and star-shaped. The ovary is ovate to oblong triangular. The capsule is ovate to oblong, 3-valved, obtuse, or almost pointed. Each chamber has 1 to 4 seeds, which are elongate, flattened, smooth, glossy, and winged.
Leaves, Stem, and Root
The plant is a perennial bulb plant. The bulbs are pear-shaped, about 15 to 30 cm in diameter. They are rarely sold whole commercially, as they tend to start growing. The fracture is short, tough and flexible.
Characteristics
The taste is bitter and acrid.
Habitat
Indigenous to the Mediterranean and is cultivated there too.
Production
Squill consists of the sliced, dried, fleshy middle scales of the onion of the white variety of Urginea maritima, harvested during the flowering season. It is collected mostly from uncultivated regions.
Other Names
Indian Squill, Maritime Squill, Sea Onion, Red Squill, Scilla, White Squill
Actions & Pharmacology
Compounds
Cardioactive steroid glycosides (bufadienolides, 1-3%): chief components glucoscillarene A, proscillaridin A, scillarene A; including among others, scillicyanoside, scilliglaucoside
Mucilage
Effects
The drug is inotropic on myocardial work capacity and negatively chronotropic. The overall effect is economy of heart action. There is a lowering of increased, left ventricular diastolic pressure and pathologically elevated venous pressure.
Indications & Usage
Approved by Commission E:
- Cardiac insufficiency NYHA I and II
- Arrhythmia
- Nervous heart complaints
Unproven Uses
Squill is used for reduced kidney capacity. In folk medicine it is used for catarrhal conditions of the upper respiratory tract, bronchitis, asthma, and whooping cough, also for wounds and fractures, back pain, and hemorrhoids, and for the disinfection of septic wounds.
Contraindications
The drug and pure glycosides, among others, should not be administered in the presence of second or third degree atrioventricular block, hypercalcemia, hypokalemia, hypertrophic cardiomyopathy, carotid sinus syndrome, ventricular tachycardia, thoracic aortic aneurysm, or WPW-syndrome.
Precautions & Adverse Reactions
General
No health hazards are known in conjunction with the proper administration of designated therapeutic dosages. Because of the narrow therapeutic range of cardioactive steroid glycosides, side effects could appear even with therapeutic dosages. Side effects include tonus elevation of the gastrointestinal area, loss of appetite, vomiting, diarrhea, headache, and irregular pulse.
Contact with the juice of the fresh bulb can lead to skin inflammation (squill dermatitis). The administration of pure glycoside is preferable due to the difficulties of standardizing the drug (proscillaridin A).
Drug Interactions
Major Risk
Digoxin
Concurrent use may result in increased risk of digoxin toxicity (nausea, vomiting, abnormal vision, cardiac arrhythmias, unexplained hyperkalemia). Clinical Management: A digoxin level may confim the diagnosis, but may not quantify the severity. Treatment with digoxin-specific Fab (dsFab) antibody fragments has been successful in toxic ingestion of other cardiac glycoside-containing plants.
Potential Interactions
Quinidine, Calcium, Saluretics, Laxatives, and Extended Therapy with Glucocorticoids
Concurrent use may result in increased effectiveness and side effects of these substances.
Arrhythmogenic Substances (sympathomimetics, methylxanthines, phosphodiesterase inhibitors, and quinidine)
Concurrent use may result in an increased risk of cardiac arrhythmias.
Overdosage
Besides the above-mentioned symptoms, overdosage can lead to cardiac rhythm disorders, life-threatening ventricular tachycardia, atrial tachycardia with atrioventricular block, stupor, vision disorders, depression, confused states, hallucinations, and psychosis. Fatal dosages lead to cardiac arrest or asphyxiation.
Treatment of poisoning includes gastric lavage and instillation of activated charcoal. All other measures are to be carried out according to the symptoms. In case of potassium loss, replenish carefully; for ectopic impulse formation in the ventricle, administer phenytoin as an antiarrhythmic drug; use lidocaine for ventricular extrasystole; for pronounced bradycardia, use atropine or orciprenaline. The prophylactic use of a pacemaker is recommended. Hemoperfusion for eliminating the glycosides or the administration of cholestyramine for interrupting the enterohepatic circulation are possible.
Dosage
Mode of Administration
Comminuted drug and other galenic preparations for internal use.
Preparation
Stabilized powder is standardized according to content, there are no more exact specifications in the literature, standardization according to DAB10.
Squill Extract — Evaporated extract 1:4; drug: diluted spirit of wine (EB6)
Acetum Scillae — drug: spirit of wine 1:1 (EB6)
Oxymel Scillae — 5 parts Acetum Scillae: 10 parts purified honey evaporated in a water bath to 10 parts
Daily Dosage
Single dose: 60 to 200 mg; Daily dose: 180 to 200 mg; Average daily dosage: 0.1 to 0.5 g of standardized sea onion powder.
Squill Extract: 1.0 g; Liquid extract: 0.03 to 2.0 mL; Tincture: 0.3 to 2.0 mL; Acetum Scillae: 1.0 g; Acetic acid maceration: 0.6 to 2.0 mL
Oxymel Scillae: 2.5 g
Storage
Squill should be protected from light and moisture at temperatures below 25ºC.
