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Known interactions

No interactions found.

Using of White Squill

Scientific Name: White Squill

Who is this for?

Note: The use of squill for treating any medical condition is not recommended. Various types of squill contain chemicals that have powerful effects on the heart and on the gastrointestinal tract.

White squill was used in early medicine as a heart drug and a diuretic ("water pill"). It has been replaced by safer and more effective prescription medications.

Red squill contains a toxic chemical that produces vomiting in humans; usually before dangerous amounts of squill have accumulated in the body. Because rodents such as mice and rats do not have the ability to vomit, red squill was formerly used as rat poison, but it was not particularly effective. Its use has largely been replaced by chemicals that control rodents better with less chance of accidental ingestion by humans or pets.

When should I be careful taking it?

Neither taking squill by mouth nor applying it to the skin is recommended.Certain individuals, however, are especially at risk for complications associated with the use of squill. Therefore, the individuals in the following groups should be extremely careful to avoid its use:

  • Chemicals in squill have been proven both to increase the force and to slow down the rate of heartbeats. Either effect could worsen several kinds of heart conditions. Individuals with any type of heart disease should avoid taking squill due to this risk. Squill has been shown to cause miscarriages in pregnant women, therefore women who are pregnant or who think they may be pregnant should avoid using squill.
  • Squill can worsen the effects on the heart from too much calcium or too little potassium in the blood. Individuals who may have too much calcium include cancer patients. Individuals who may have too little potassium include individuals taking diuretics ("water pills") or laxatives and individuals with severe diarrhea. In any of these cases, taking squill could increase the risk of dangerous changes in heart rhythm.
  • When it is taken by mouth, squill has been shown to irritate the esophagus, stomach, and intestines, so individuals who have or who have had gastroesophageal reflux disease (GERD), ulcers, or any other gastrointestinal conditions should not take squill.

Precautions

Handling fresh squill has caused skin irritation for some individuals. Numerous reports of blistering and rashes have been attributed to touching any part of the squill plant, particularly the onion-like bulbs.

What side effects should I watch for?

Large oral doses of squill have resulted in:

  • Seizures
  • Dangerous changes in heart rhythm
  • Psychoses
  • Heart Stoppage
  • Death

Less Severe Side Effects

When taken by mouth, squill can also cause:

  • Confusion
  • Nausea
  • Restlessness
  • Vision disturbances
  • Vomiting

Even small amounts of squill taken by mouth have resulted in:

  • Diarrhea
  • Erratic Pulse
  • Headache
  • Loss Of Appetite
  • Upset stomach

Individuals who handle fresh squill bulbs may develop skin rashes and blisters.

What interactions should I watch for?

Prescription Drugs

Squill has an effect on the heart that is similar to the effect of digoxin, a drug used to increase the force and decrease the rate of heartbeats. If squill and digoxin are taken together, the heartbeat may become too forceful and/or too slow, possibly resulting in dangerous changes in heart rhythm.

Some drugs used for asthma, heart problems, or other reasons can affect heart rhythm. Because squill can change the force and rate of heart beats, it may increase the risk of side effects from drugs such as:

  • theophylline and related drugs for asthma
  • albuterol
  • clonidine (Catapres)
  • Viagra

If squill is taken during long-term corticosteroid therapy, the effects and side effects of the corticosteroid may be increased. Long-term side effects of corticosteroids include increased cholesterol, reduced immune function, and weight gain. Corticosteroids are used for a wide range of inflammatory conditions including arthritis, asthma, cancer, eye conditions, and skin infections. Commonly prescribed corticosteroids include:

  • dexamethasone (Decadron)
  • hydrocortisone
  • methylprednisolone (Medrol)
  • prednisolone
  • prednisone (Deltasone, Orasone)

Diuretics ("water pills"), such as furosemide and hydrochlorothiazide, may promote the loss of potassium from the body. Since squill may also lead to potassium loss, the levels of potassium in the blood may become too low if squill is taken at the same time as a water pill. Low blood potassium is called hypokalemia. Symptoms of hypokalemia can include:

  • Abdominal cramps
  • Constipation
  • Low blood pressure
  • Muscle weakness
  • Nausea
  • Vomiting
  • Hallucinations
  • Respiratory failure
  • Heart stoppage

Non-prescription Drugs

If squill is taken at the same time as calcium supplements, too much calcium may accumulate in the blood, possibly causing a condition known as hypercalcemia. Symptoms of hypercalcemia may include confusion, constipation, fatigue, loss of appetite, nausea, and vomiting. The amount of calcium in the blood does not necessarily relate to the severity of symptoms. Some individuals may experience symptoms when blood calcium levels are only slightly high; others develop symptoms only at very high calcium levels.

Both squill and stimulant laxatives such as bisocadyl (Dulcolax), casanthranol (Doxidan, Peri-Colace), castor oil, and senna (Senokot) may promote the loss of potassium from the body. As a result, the levels of potassium in the blood may become too low resulting in a condition called hypokalemia. Symptoms of hypokalemia may include:

  • Abdominal cramps
  • Constipation
  • Low blood pressure
  • Muscle weakness
  • Nausea
  • Vomiting
  • Hallucinations
  • Respiratory failure
  • Heart stoppage

Herbal Products

If squill is taken in large amounts as an herbal supplement, it can lead to potassium loss from the body. In addition, some herbal products that cause a laxative effect by stimulating the gastrointestinal tract may also cause potassium loss. They include aloe, buckthorns, cascara, rhubarb, senna, and yellow dock. Like all these other herbals, squill may also decrease potassium levels, possibly causing hypokalemia — too little potassium in the blood. Symptoms of hypokalemia may include:

  • Abdominal cramps
  • Constipation
  • Low blood pressure
  • Muscle weakness
  • Nausea
  • Vomiting
  • Hallucinations
  • Respiratory failure
  • Heart stoppage

If squill is taken at the same time as other herbs that also affect the heart, potentially dangerous changes in heart function may result. Some herbal products with heart effects are:

  • European mistletoe
  • Ginger (in large doses)
  • Hawthorn
  • Motherwort
  • Panax ginseng
  • Pleurisy root

Foods

Both squill and caffeine may affect heart rhythm. Squill should not be taken if beverages or medications containing caffeine are also being used.

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals.

Should I take it?

Squills are members of the lily family of plants. They are native to dry, sandy areas around the Mediterranean Sea. Because they have ornamental flowers and attractive foliage, however, they may be found in gardens throughout much of the temperate climates of the world — including the United States and Canada. The plants have long narrow leaves surrounding a central stem that bears a cluster of white or reddish flowers that identify the two main types — white squill and red squill.

All types of squill have large bulbs that resemble onions — with several layers called scales. White squill has off-white or yellowish scales, while red squill has darker reddish or brown scales. The bulbs are the parts that were formerly used in medicine after they had been peeled, sliced, dried, and powdered. Today, the use of squill as a medicine or for any other purpose is very rare because better and safer alternatives are available for all the former uses of any type of squill.

Dosage and Administration

Taking squill by mouth is not recommended.

Although squill preparations were formerly applied to treat certain skin conditions, no topical uses currently are recommended for any type of squill.

Summary

Squill is not recommended in any form for medicinal purposes.

Risks

Taking squill by mouth can cause serious effects on the heart. Individuals with heart conditions, those who may have high calcium levels or low potassium levels in their blood, and those who have severe or prolonged diarrhea should not take it. Squill can cause miscarriages, so pregnant women or women who suspect they are pregnant should avoid using it. Individuals with stomach or intestinal conditions also should not take squill because it may irritate the gastrointestinal tract.

Handling or touching squill can result in rashes or blistering.

Side Effects

In large amounts, squill has caused:

  • Confusion
  • Vision disturbances
  • Seizures
  • Dangerous changes in heart rhythm
  • Heart Stoppage
  • Death

Other side effects from squill include:

  • Diarrhea
  • Erratic Pulse
  • Headache
  • Upset stomach

Interactions

Squill may increase the risk of changes in heart function if it is taken with:

  • caffeine
  • calcium
  • digoxin
  • diuretics
  • licorice (in large amounts)
  • stimulant laxative drugs and herbals
  • theophylline and related drugs for asthma
  • Viagra

If it is used with long-term oral corticosteroids, squill could increase the chance of side effects such as elevated cholesterol and decreased immune function.

Last Revised: March 3, 2004

References

Anon: Squill. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. April 1991.

Cowen DL. Squill in the 17th and 18th centuries. Bulletin of the New York Academy of Medicine. 1974;50(6):714-722.

Garth D. Hypokalemia. eMedicine. Last Updated July 21, 2001. Available at: http://www.emedicine.com/EMERG/topic273.htm. Accessed April 25, 2003.

Gemmill CL. The pharmacology of squill. Bulletin of the New York Academy of Medicine. 1974;50(6):747-750.

Grieve M. Squill. In: A Modern Herbal. New York: Dover Publishers, 1971. Available at: http://www.botanical.com/botanical/mgmh/mgmh/s/squill86.html Posted 1995. Accessed March 31, 2003.

Hakim FS, Bowery NG, Evans FJ. Comparative potencies of European and Indian squill. [letter] Journal of Pharmacy and Pharmacology. 1976;28(1):81-82.

Jellin JM, Gregory P, Batz F, Hitchens K, et al, eds. Pharmacist's Letter/Prescriber's Letter. Natural Medicines Comprehensive Database, 3rd Edition. Stockton CA: Therapeutic Research Facility, 2000.

Khafagy SM, Sabri NN, el-Salam NA, el-Din AA. Isolation of a sesamin-like compound and acacetin 7-o neohesperidoside from Otanthus maritimus. Planta Medica. 1979;35(2):186-187.

Peirce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: Stonesong Press; 1999.

Stannard J. Squill in ancient and medieval materia medica, with special reference to its employment for dropsy. Bulletin of the New York Academy of Medicine. 1974;50(6):684-713.

Tuncok Y, Kozan O, Cavdar C, Guven H, Fowler J. Urginea maritima (squill) toxicity. Journal of Toxicology and Clinical Toxicology. 1995;33(1):83-86.


(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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