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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Non-Standardized Food Allergenic Extract [EPC]
Convallaria Majalis, commonly known as Lily of the Valley, is utilized primarily as a non-standardized plant allergenic extract for diagnostic testing and immunotherapy, belonging to a broad class of plant-derived medicinal substances.
Name
Convallaria Majalis
Raw Name
CONVALLARIA MAJALIS
Category
Non-Standardized Food Allergenic Extract [EPC]
Drug Count
31
Variant Count
40
Last Verified
February 17, 2026
About Convallaria Majalis
Convallaria Majalis, commonly known as Lily of the Valley, is utilized primarily as a non-standardized plant allergenic extract for diagnostic testing and immunotherapy, belonging to a broad class of plant-derived medicinal substances.
Detailed information about Convallaria Majalis
This page is for informational purposes only and does not replace medical advice. Consult a qualified healthcare professional before using any medication containing Convallaria Majalis.
Convallaria Majalis, widely recognized by its common name, Lily of the Valley, is a perennial flowering plant that has been utilized in various medicinal and diagnostic capacities for centuries. In contemporary clinical practice, it is primarily classified as a Non-Standardized Plant Allergenic Extract [EPC]. This classification indicates that the substance is used by allergists and immunologists to diagnose sensitivities to plant proteins or to induce desensitization through immunotherapy. Beyond its allergenic applications, the plant is pharmacologically complex, containing over 38 different cardiac glycosides (compounds that affect the heart's pumping action), which historically linked it to the treatment of heart failure, similar to the action of Digitalis (foxglove).
According to the FDA's Established Pharmacologic Class (EPC) system, Convallaria Majalis is categorized under several headings, including Non-Standardized Food Allergenic Extract, Non-Standardized Plant Allergenic Extract, and interestingly, it shares properties with Adrenergic Agonists and Nitrate Vasodilators due to its multifaceted chemical constituents. The FDA has historically permitted the use of these extracts in controlled clinical settings for skin prick testing and subcutaneous immunotherapy. However, it is vital to note that as a 'non-standardized' extract, the potency can vary between batches, necessitating extreme caution and expert administration by a board-certified allergist.
The mechanism of action for Convallaria Majalis depends entirely on its clinical application. When used as an allergenic extract, it works by introducing minute amounts of plant proteins to the patient's immune system. In diagnostic skin testing, these proteins interact with specific Immunoglobulin E (IgE) antibodies bound to mast cells in the skin. If the patient is sensitized, this interaction triggers the release of histamine and other inflammatory mediators, resulting in a 'wheal and flare' reaction (a raised bump and surrounding redness).
At a molecular level, the plant's systemic effects are driven by its cardiac glycosides, most notably convallatoxin, convallamarin, and convalloside. These compounds inhibit the sodium-potassium adenosine triphosphatase (Na+/K+-ATPase) enzyme pump. By inhibiting this pump, the drug increases intracellular sodium, which in turn leads to an increase in intracellular calcium via the sodium-calcium exchanger. This increase in calcium enhances the force of myocardial contraction (positive inotropy). Furthermore, the extract exhibits Adrenergic alpha-Agonist and beta-Agonist activities, which can influence vascular tone and heart rate, though these are typically considered secondary or toxicological effects in the context of allergenic use.
The pharmacokinetics of Convallaria Majalis are complex due to the mixture of proteins and glycosides present in the extract.
Convallaria Majalis is primarily indicated for:
Convallaria Majalis is available in the following formulations:
> Important: Only your healthcare provider can determine if Convallaria Majalis is right for your specific condition. The use of allergenic extracts carries a risk of severe systemic reactions and must be performed in a facility equipped to handle anaphylaxis.
Dosage for Convallaria Majalis is highly individualized and must be determined by a specialist based on the patient's sensitivity levels.
For diagnostic purposes, a single drop of the 1:10 or 1:20 w/v (weight/volume) extract is applied to the skin during a prick test. If an intradermal test is required, the concentration is significantly reduced, often to 0.02 mL of a 1:1000 or 1:10,000 dilution.
The dosage follows a 'build-up' phase and a 'maintenance' phase:
Convallaria Majalis extracts are generally not recommended for children under the age of 5 due to the difficulty in communicating symptoms of an impending systemic reaction. For children over 5, the dosage is similar to adult protocols but may be adjusted based on the child's weight and the severity of their allergic profile. Pediatric immunotherapy must be managed by a pediatric allergist.
Because the cardiac glycoside components are renally excreted, patients with a Glomerular Filtration Rate (GFR) below 30 mL/min should be monitored closely for signs of systemic toxicity, even when receiving small doses for immunotherapy.
No specific dosage adjustments are provided for hepatic impairment in the context of allergenic extracts; however, caution is advised in patients with end-stage liver disease due to altered protein metabolism.
Elderly patients often have reduced cardiac reserve and increased sensitivity to glycosides. Dosing should begin at the lowest possible concentration, and heart rate should be monitored during the 30-minute post-injection observation period.
Convallaria Majalis allergenic extracts are never for self-administration. They must be administered by a healthcare professional in a clinical setting.
If an immunotherapy dose is missed, do not double the next dose. If the lapse is brief (less than one week), the previous dose may be repeated. If the lapse is longer, the dose may need to be reduced to ensure safety. Contact your allergist immediately to reschedule.
An overdose of Convallaria Majalis, whether through clinical error or accidental ingestion of the plant, is a medical emergency.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or attempt to administer this medication at home without medical guidance.
Most patients receiving Convallaria Majalis extracts will experience some form of local reaction. These are generally not dangerous but can be uncomfortable.
> Warning: Stop taking Convallaria Majalis and call your doctor immediately or seek emergency care if you experience any of these symptoms.
With prolonged use of allergenic extracts, some patients may develop persistent nodules at the injection site (granulomas). There is also a theoretical risk of developing autoimmune-like symptoms if the immune system is over-stimulated, although this is extremely rare. Long-term cardiac effects are unlikely with the low doses used in extracts, but patients with pre-existing heart disease should be monitored for changes in EKG patterns over time.
Convallaria Majalis extracts can cause severe, life-threatening systemic reactions, including anaphylaxis. This medication must only be administered by healthcare providers experienced in the treatment of anaphylaxis and the management of allergen immunotherapy. Patients must be observed for at least 30 minutes following administration. Patients with unstable asthma or those taking beta-blockers may be at increased risk for severe outcomes and may be less responsive to epinephrine.
Report any unusual symptoms to your healthcare provider immediately. Even a minor increase in local reaction size can be a predictor of a future systemic reaction.
Convallaria Majalis is a potent biological substance. It is not a standard pharmaceutical drug but a complex biological extract. Patients must be aware that the 'non-standardized' nature of this product means that different vials may have varying levels of potency. Always ensure your provider checks the vial's expiration date and lot number before administration.
No FDA black box warnings are currently mandated for the specific 'Convallaria Majalis' label in the same way they are for standardized extracts like Grass Pollen; however, the General Warning for Allergenic Extracts applies. This includes the mandatory 30-minute observation period and the requirement for available emergency resuscitation equipment (epinephrine, oxygen, IV fluids).
To ensure safety while using Convallaria Majalis, the following may be required:
Most patients can drive after the 30-minute observation period. However, if you experience dizziness, fatigue, or any systemic symptoms, do not operate heavy machinery until you have fully recovered and consulted your doctor.
Alcohol should be avoided on the day of the injection. Alcohol can dilate blood vessels and potentially increase the rate of allergen absorption, increasing the risk of a systemic reaction. It can also mask the early signs of anaphylaxis.
Do not stop your immunotherapy schedule without consulting your allergist. Stopping suddenly during the build-up phase may result in a loss of progress. If you decide to stop, no tapering is usually required, but you will lose the desensitization benefits, and your allergy symptoms may return to their baseline severity.
> Important: Discuss all your medical conditions with your healthcare provider before starting Convallaria Majalis.
Convallaria Majalis can cause a false-positive result in Digoxin blood level tests. If you are tested for digoxin levels while using this extract, the results may appear high even if you are not taking Lanoxin. Always inform the lab and your doctor about your use of this extract.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Convallaria Majalis must NEVER be used in the following circumstances:
These conditions require a careful risk-benefit analysis by your physician:
Patients allergic to Convallaria Majalis may also react to other members of the Asparagaceae family or plants containing similar proteins. There is also a known cross-reactivity with other cardiac glycoside-containing plants like Digitalis purpurea (Foxglove) and Nerium oleander (Oleander).
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Convallaria Majalis.
Convallaria Majalis is classified as FDA Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Animal reproduction studies have not been conducted.
It is unknown whether the proteins or glycosides from Convallaria Majalis pass into human breast milk. Because many drugs are excreted in human milk, caution should be exercised. The risk to the infant is likely low given the small doses used in extracts, but breastfeeding mothers should monitor their infants for any unusual changes in heart rate or gastrointestinal upset.
Patients over 65 years of age may have undiagnosed coronary artery disease or reduced kidney function.
In patients with kidney disease, the clearance of the plant's glycosides is reduced.
While the liver metabolizes the steroidal components, hepatic impairment does not significantly change the risk profile of the allergenic extract. However, patients with severe cirrhosis may have altered immune responses, potentially making immunotherapy less effective or more unpredictable.
> Important: Special populations require individualized medical assessment.
Convallaria Majalis acts through two distinct pathways:
| Parameter | Value |
|---|---|
| Bioavailability | 10-40% (oral glycosides); <1% (percutaneous) |
| Protein Binding | 20% - 25% |
| Half-life | 12 - 24 hours (Convallatoxin) |
| Tmax | 1 - 2 hours (subcutaneous absorption) |
| Metabolism | Hepatic (minor); primarily unchanged |
| Excretion | Renal 70%, Fecal 30% |
Convallaria Majalis is a Non-Standardized Plant Allergenic Extract. It is related to other cardiac-active plant extracts like Digitalis and Strophanthus, though its primary modern use is in the field of Allergy and Immunology.
Medications containing this ingredient
Common questions about Convallaria Majalis
Convallaria Majalis, or Lily of the Valley, is primarily used in clinical settings as an allergenic extract for the diagnosis and treatment of plant-related allergies. Doctors use it in skin prick tests to determine if a patient is allergic to the plant's proteins. If an allergy is confirmed, it may be used in 'allergy shots' (immunotherapy) to help the patient build tolerance over time. Historically, it was also used for heart conditions due to its cardiac glycoside content, but this is rare in modern medicine. Always consult an allergist to see if this extract is appropriate for your diagnostic needs.
The most common side effects are localized to the area where the extract was applied or injected. Patients frequently experience redness, itching, and a raised bump (wheal) at the injection site, which usually resolves within a day. Some people may also feel slightly fatigued or develop a mild headache after their appointment. While these local reactions are common, they are generally not dangerous. However, any reaction larger than a few centimeters should be reported to your healthcare provider before your next dose. Always stay for the full 30-minute observation period after an injection.
It is strongly recommended to avoid alcohol on the days you receive a Convallaria Majalis injection. Alcohol can increase blood flow to the skin and may cause the allergenic extract to be absorbed more quickly into your system, which increases the risk of a severe allergic reaction. Additionally, alcohol can mask early symptoms of anaphylaxis, such as dizziness or flushing, making it harder for you or your doctor to recognize an emergency. To ensure your safety during immunotherapy, wait at least 24 hours after your shot before consuming alcoholic beverages. Discuss your lifestyle habits with your doctor for personalized advice.
Convallaria Majalis is generally not recommended to be started during pregnancy because of the risk of anaphylaxis, which can be dangerous for both the mother and the developing baby. If a mother has a severe allergic reaction, the resulting drop in blood pressure can reduce the oxygen supply to the fetus. However, if a woman is already on a stable maintenance dose of the extract and becomes pregnant, her doctor may decide to continue the treatment at the same dose. Decisions regarding immunotherapy during pregnancy are made on a case-by-case basis by a specialist. Always inform your allergist immediately if you become pregnant or are planning to conceive.
The timeframe for Convallaria Majalis to work depends on whether it is being used for testing or treatment. For allergy testing, results are visible within 15 to 20 minutes of application to the skin. For immunotherapy (allergy shots), it takes much longer to see a benefit; most patients do not notice a reduction in their allergy symptoms until they reach the 'maintenance phase,' which typically takes 3 to 6 months of weekly injections. Full effectiveness and long-term desensitization usually require 3 to 5 years of consistent treatment. Patience and adherence to the schedule are key to the success of this therapy.
Yes, you can stop taking Convallaria Majalis allergenic extracts suddenly without experiencing physical withdrawal symptoms like those seen with some other medications. However, stopping your allergy shots will halt the process of desensitization, and your allergy symptoms are likely to return to their original severity over time. If you stop during the 'build-up' phase, you will lose any progress you have made toward building tolerance. If you need to stop treatment due to side effects or life changes, always discuss it with your allergist first. They can help you weigh the pros and cons of discontinuing the therapy.
If you miss a scheduled dose of Convallaria Majalis, you should contact your allergist's office as soon as possible to reschedule. Do not try to make up for the missed dose by taking a higher dose later. The safety of immunotherapy depends on a very specific schedule of gradual increases. If too much time passes between doses, your sensitivity to the extract may increase, and your doctor may need to reduce your next dose to prevent a reaction. Most clinics have specific protocols for missed doses based on how many days have passed since your last injection.
There is no clinical evidence to suggest that Convallaria Majalis allergenic extracts cause weight gain. The doses used in skin testing and immunotherapy are extremely small and consist primarily of proteins and glycerin, which do not affect metabolism or appetite. Unlike systemic corticosteroids, which are sometimes used to treat allergies and are known to cause weight gain, allergenic extracts work specifically on the immune system's tolerance. If you experience unexpected weight changes while on this treatment, it is likely due to other factors or medications, and you should discuss it with your primary care physician.
Convallaria Majalis can interact with several types of medications, so a full review of your current drugs is essential. It is particularly dangerous when taken with Digoxin, as both affect the heart in similar ways and can cause toxicity. It also interacts with beta-blockers, which can make it harder to treat a severe allergic reaction if one occurs. Diuretics that lower potassium can also increase the risk of heart-related side effects from the plant's natural components. Always provide your doctor with a complete list of prescription drugs, over-the-counter medicines, and herbal supplements before starting this extract.
Convallaria Majalis is a biological product, and the concept of 'generic' versions is slightly different than for standard chemical drugs. It is produced by various specialized biological laboratories as a non-standardized extract. While different companies may manufacture 'Lily of the Valley' extracts, they are not considered identical or interchangeable because the manufacturing processes and the source material can vary. Your allergist will typically stick with one manufacturer's product for the duration of your treatment to ensure consistency in your dosing. It is usually referred to by its scientific name rather than a brand name.