Mistletoe

(BAN, USAN, rINN)

💊 Chemical information

European Mistletoe; Gui; Mistelkraut; Muérdago; Tallo de Muérdago; Visci Caulis; Visci herba; Viscum; Viscum Album.

Pharmacopoeias.

In Ger.

💊 Profile

Mistletoe is the dried, evergreen, dioecious semi-parasite, Viscum album (Loranthaceae), which grows on the branches of deciduous trees, chiefly apple, poplar, and plum. It occurs as a mixture of broken stems and leaves and occasional fruits. Mistletoe has a vasodilator action and has been used in herbal preparations for hypertension and cardiovascular disorders although its activity when taken orally is questionable. It has also been used in nervous disorders. Mistletoe contains lectins with cytotoxic and immunomodulatory actions in vitro and preparations have been given by injection in a number of neoplastic diseases. Ingestion of the berries and other parts has been reported to cause nausea, vomiting, diarrhoea, and bradycardia.

Homoeopathy.

Mistletoe has been used in homoeopathic medicines under the following names: Viscum album; Vis. alb. There are about 1300 species of mistletoe representing 36 genera of the Loranthaceae, and what is called the "common mistletoe" varies from country to country: in Europe the term describes Viscum album while in the USA it describes Phoradendron flavescens. The toxicity of aqueous extracts of mistletoe has been found to depend upon the nature of the host plant. Three classes of cytotoxic compounds are present in the leaves and stems of V. album although the berries are generally considered to be the most toxic part of the plant. These are alkaloids, viscotoxins, and lectins. The viscotoxins have been shown to cause hypotension, bradycardia, arterial vasoconstriction, and a negative inotropic effect, and may act as acetylcholine agonists. The lectins show toxic effects in animals similar to those seen with ricin.
1. Anderson LA, Phillipson JD. Mistletoe—the magic herb. Pharm J 1982; 229: 437–9.

Adverse effects.

There have been reports of hepatitis after the ingestion of herbal remedies containing mistletoe.1,2 Severe delayed hypersensitivity has been reported3 in a patient given intravenous chemotherapy for breast cancer concurrently with subcutaneous injections of a mistletoe extract. It was thought that mistletoe had stimulated the reaction to methotrexate and gemcitabine.
1. Harvey J, Colin-Jones DG. Mistletoe hepatitis. BMJ 1981; 282: 186–7.
2. Weeks GR, Proper JS. Herbal medicines—gaps in our knowledge. Aust J Hosp Pharm 1989; 19: 155–7
3. Shaw HS, et al. Delayed-type hypersensitivity reaction with Iscador M given in combination with cytotoxic chemotherapy. J Clin Oncol 2004; 22: 4432–4.

Malignant neoplasms.

Reviews1-3 of the use of mistletoe for the treatment of malignant neoplasms revealed that studies have been of variable quality, and have produced conflicting results; it has been suggested that the more rigorous studies do not show benefit.3 A systematic review4 of 21 randomised controlled studies found major methodological flaws in most of the studies and concluded that there was insufficient evidence to provide guidelines for the use of mistletoe extracts in oncology.
1. Mansky PJ. Mistletoe and cancer: controversies and perspectives. Semin Oncol 2002; 29: 589–94
2. Kienle GS, et al. Mistletoe in cancer—a systematic review on controlled clinical trials. Eur J Med Res 2003; 8: 109–19
3. Ernst E, et al. Mistletoe for cancer? A systematic review of randomised clinical trials. Int J Cancer 2003; 107: 262–7
4. Horneber MA, et al. Mistletoe therapy in oncology. Available in The Cochrane Database of Systematic Reviews; Issu
2. Chichester: John Wiley; 2008 (accessed 03/06/08).

💊 Preparations

Proprietary Preparations

Austria: Eurixor; Helixor; Iscador; Isorel; Cz.: Nat Jmeli; Ger.: Abnobaviscum; Cefalektin; Eurixor; Helixor; Iscador; Lektinol; Mistel Curarina; MistelKrautertabletten; Mistelol-Kapseln†; Misteltropfen Hofmanns; Misteltropfen†; Salus Mistel-Tropfen; Viscysat; Switz.: Iscador. Multi-ingredient: Austral.: Calmo; Pacifenity†; Austria: Rutiviscal; Wechseltee St Severin; Cz.: Alvisan Neo; Hypotonicka; Fr.: Mediflor Tisane Circulation du Sang No 12; Ger.: Antihypertonicum S; Asgoviscum N†; Heusin†; Hypercircin; Ilja Rogoff; Presselin Arterien K 5 P†; Syviman N†; Viscophyll†; Pol.: Cravisol; Venoforton; Rus.: Herbion Drops for the Heart (Гербион Сердечные Капли).
Published May 08, 2019.