Convallaria majalis

Common Name: Lily of the valley

Family: Liliaceae (Lily family)

Parts used: Rhizome and leaf

Constituents: Cardioactive glycosides (convallotoxin), flavonoids

Taste/smell: Slightly acrid

Tendencies: Drying

Actions

• Cardiac Tonic

• Cardioactive Glycoside (positive inotropic, negative chronotropic)

• Vasoconstrictive

• Diuretic

• Ganglionic trophorestorative

Uses

Cardiac Tonic:

• Congestive heart failure (CHF)

• Angina

• Endocarditis

• Mitral insufficiency

• Heart palpitations

• Arrhythmias

• Cardiac decompensation

• Similar to Digitalis in its action but it is faster-acting, milder, and appears to be non-cumulative

Mental Picture and Specifics

• Lily of the valley is indicated for organic heart weakness with valvular insufficiency, edema, dyspnea, and venous stasis with a rapid and feeble pulse. The thoughts are dulled and the tongue is broad and thick with a heavy dirty coating that feels sore and scalded. The individual feels better in open air and worse in a warm room.

Contraindications

• Pregnancy and lactation

• Hypokalemia

• Hypo- or Hypercalcemia

• Hypomagnesemia

• Ventricular arrhythmias

• Kidney failure

• Severe carditis

Adverse Effects

• Generally no adverse effects are encountered at therapeutic doses

• Bradycardia and other arrhythmias

• Anorexia

• Fatigue

• Nausea and vomiting

• Yellow-green halo around objects

• Gynecomastia

• Loss of libido

Toxicity

• Much wider therapeutic window than Digitalis purpurea, although overdose can be lethal

• Toxicity can be antidoted with potassium

Interactions

• Toxicity potentiated by K+ and Mg2+-depleting drugs (i.e. diuretics, steroids)

• Ca2+ can promote arrhythmias

• Beta-blockers can cause heart block

• Can cause false positives on EKG

• Drugs that increase toxicity: alprazolam, antibiotics, anticholinergics, benzodiazepines, calcium channel blockers, ibuprofen, indomethacin, omeprazole, quinine, and quinidine

• Drugs that decrease toxicity: aminoglycosides, antacids, antihistamines, barbiturates, chemotherapy drugs, cholestyramine, dietary fiber, oral hypoglycemic, penicillamine, phenytoin, rifampin, sucralfate