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Nerium oleander is an evergreen ornamental shrub native to the Mediterranean region and parts of Asia. It contains several toxic cardiac glycosides—most notably oleandrin—which have a mechanism of action similar to digoxin by inhibiting the Na+, K+-ATPase enzyme in cell membranes. This inhibition increases intracellular sodium and calcium concentrations in cardiac cells. Traditionally used in folk medicine for conditions such as cardiac illness, asthma, diabetes mellitus, cancer, leprosy, and wound healing among others; however its extreme toxicity limits any clinical use. Oleandrin has been studied for potential anticancer effects due to its ability to induce apoptosis via NF-kB suppression and other pathways (including PI3k/Akt/mTOR downregulation), but there is no clinical evidence supporting safe or effective therapeutic use. All parts of the plant are highly poisonous; ingestion can cause severe gastrointestinal symptoms and life-threatening cardiac arrhythmias[1][2][3][4][5][6][8].
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