Aconite

(rINN)

💊 Chemical information

Acetylbenzoylaconine (aconitine); Aconit.; Aconit napel; Aconite Root; Aconiti Tuber; Acónito; Aconitum napellus; Monkshood Root; Radix Aconiti; Wolfsbane Root. 8-Acetoxy-3,11,18-trihydroxy-16-ethyl-1,6,19-trimethoxy-4-methoxymethylaconitan-10yl benzoate (aconitine).
Chemical formula: C34H47NO11 = 645.7 (aconitine).
CAS — 8063-12-5 (aconite); 302-27-2 (aconitine).

Description.

Aconite consists of the dried tuberous root of Aconitum napellus agg. (Ranunculaceae). It contains a number of alkaloids, the main pharmacologically active one being aconitine.

Pharmacopoeias.

In Chin.

💊 Adverse Effects and Treatment

Aconite has variable effects on the heart leading to heart failure. It also affects the CNS. Symptoms of aconite poisoning may appear within minutes or up to 2 hours after oral ingestion; in fatal poisoning death usually occurs within 12 hours, although with larger doses it may be instantaneous. Initial symptoms (and an important diagnostic feature) are tingling sensations of the tongue, mouth, fingers, and toes followed by generalised paraesthesia. Other symptoms include nausea, vomiting, diarrhoea, muscle weakness, skeletal muscle paralysis, and difficult respiration; also sweats, chills and a feeling of intense cold may occur. Respiratory paralysis, hypotension, and cardiac arrhythmias may develop in severe cases. Although the benefits of gastric decontamination are uncertain, gastric lavage may be tried in patients within one hour of lifethreatening oral poisoning; activated charcoal may also be considered. Patients should be observed and monitored, and corrective and supportive treatment given as necessary. Arrhythmias are relatively resistant to treatment, although atropine has been tried for bradycardia.

Poisoning.

Reports of poisoning with aconite.
1. Kelly SP. Aconite poisoning. Med J Aust 1990; 153: 499
2. Tai Y-T, et al. Cardiotoxicity after accidental herb-induced aconite poisoning. Lancet 1992; 340: 1254–6
3. Kolev ST, et al. Toxicity following accidental ingestion of Aconitum containing Chinese remedy. Hum Exp Toxicol 1996; 15: 839–42
4. Mak W, Lau CP. A woman with tetraparesis and missed beats. Hosp Med 2000; 61: 438
5. Imazio M, et al. Malignant ventricular arrhythmias due to Aconitum napellus seeds. Circulation 2000; 102: 2907–8
6. Chan TYK. Incidence of herb-induced aconitine poisoning in Hong Kong: impact of publicity measures to promote awareness among the herbalists and the public. Drug Safety 2002; 25: 823–8
7. Lowe L, et al. Herbal aconite tea and refractory ventricular tachycardia. N Engl J Med 2005; 353:1532.

💊 Uses and Administration

Aconite liniments have been used in the treatment of neuralgia, sciatica, and rheumatism. Sufficient aconitine may be absorbed through the skin to cause poisoning; liniments should never be applied to wounds or abraded surfaces. Aconite should not be used internally because of its low therapeutic index and variable potency; however it is reported to be a common ingredient in traditional Chinese remedies and is also an ingredient of some cough mixtures.

Homoeopathy.

Aconite has been used in homoeopathic medicines.

💊 Preparations

Proprietary Preparations

Multi-ingredient: Arg.: No-Tos Adultos; Austria: Rheuma; Belg.: Colimax†; Eucalyptine Pholcodine Le Brun†; Saintbois; Braz.: Agrimel†; Expectomel; Gotas Nican†; Limao Bravo†; Melagriao; Pectal†; Xarope de Caraguata†; Xarope Peitoral de Ameixa Composto†; Xarope Sao Joao†; Chile: Gotas Nican†; Cz.: Homeovox; Pleumolysin; Ital.: Lactocol; Port.: AntiGripe†; Calmarum†; Spain: Encialina†.
Published October 21, 2018.