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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Adonis Vernalis, Convallaria Majalis, Helleborus Niger Root, Digitalis, Crataegus Laevigata Fruit, And Drimia Maritima Bulb
Brand Name
D-58
Generic Name
Adonis Vernalis, Convallaria Majalis, Helleborus Niger Root, Digitalis, Crataegus Laevigata Fruit, And Drimia Maritima Bulb
Active Ingredient
Adonis VernalisCategory
Other
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 2 [hp_X]/mL | SOLUTION | SUBLINGUAL | 58264-0058 |
Detailed information about D-58
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for D-58, you must consult a qualified healthcare professional.
Adonis Vernalis is a botanical cardiac glycoside used traditionally for mild heart insufficiency and functional heart disorders. It acts as a cardiotonic, similar to digitalis, but with a shorter duration of action and lower risk of accumulation.
The dosage of Adonis Vernalis must be highly individualized and should only be determined by a qualified healthcare professional familiar with botanical medicine and cardiology. Standardized preparations are preferred to ensure safety.
Adonis Vernalis is generally NOT approved for pediatric use. The narrow therapeutic index and the potential for severe cardiac rhythm disturbances make it unsuitable for children. There is insufficient safety data regarding the use of cardiac glycosides from Adonis in infants, children, or adolescents. In cases of accidental ingestion by a child, emergency medical services must be contacted immediately.
Since the active glycosides are primarily excreted through the kidneys, patients with impaired renal function (decreased GFR) are at a significantly higher risk for toxicity. Dosage must be reduced, and the dosing interval may need to be extended. Close monitoring of serum electrolytes and cardiac rhythm is mandatory.
While the liver is involved in the metabolism of cardenolides, renal clearance is the primary concern. However, patients with severe liver disease should be treated with extreme caution, as metabolic pathways may be unpredictable.
Geriatric patients often have age-related declines in renal function and may be more sensitive to the effects of cardiac glycosides. Lower starting doses (e.g., 50% of the standard adult dose) and slower titration are recommended for patients over the age of 65.
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and resume your regular schedule. Do not double the dose to catch up, as this significantly increases the risk of cardiac toxicity.
An overdose of Adonis Vernalis is a medical emergency. Signs of toxicity include:
In the event of a suspected overdose, call 911 or your local emergency number immediately. Treatment in a hospital setting may include gastric lavage, activated charcoal, and the administration of Digoxin-specific antibody fragments (DigiFab), which may cross-react with Adonis glycosides to neutralize their effect.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop taking this medication without medical guidance, as sudden changes can destabilize heart function.
While Adonis Vernalis is generally tolerated at low, standardized doses, its nature as a cardiac glycoside means side effects are common, especially during the initial titration phase. The most frequent issues include:
> Warning: Stop taking Adonis Vernalis and call your doctor immediately if you experience any of these serious symptoms:
Prolonged use of Adonis Vernalis without medical supervision can lead to 'cumulative toxicity.' Because the body eliminates these compounds at a specific rate, taking even a slightly excessive dose over many months can lead to a gradual buildup. Long-term effects include chronic gastrointestinal issues, persistent visual changes, and a potential for developing chronic cardiac rhythm instabilities. Regular ECG (electrocardiogram) monitoring and electrolyte checks are essential for anyone using this substance long-term.
No FDA black box warnings for Adonis Vernalis currently exist because it is not an FDA-approved prescription drug. However, if it were regulated as such, it would likely carry warnings similar to Digoxin regarding Narrow Therapeutic Index and Risk of Fatal Arrhythmias. The clinical consensus is that the toxicity of Adonis Vernalis is nearly identical to that of Digitalis species, and it should be treated with the same level of clinical caution. Fatalities have been recorded in the literature from the ingestion of the raw plant or excessive doses of concentrated extracts.
Report any unusual symptoms or changes in your heart rhythm to your healthcare provider immediately. Your safety depends on open communication with your medical team.
Adonis Vernalis is a potent biological substance that affects the electrical and mechanical functions of the heart. It must never be viewed as a 'mild' herbal supplement. The cardenolides it contains are chemically related to those found in the deadly oleander and foxglove plants. Patients must be aware that the difference between a therapeutic dose and a toxic dose is very small. Always ensure you are using a standardized product from a reputable source, as the concentration of active ingredients in wild-harvested plants can vary by up to 300% depending on the soil and time of harvest.
There are no official FDA black box warnings for Adonis Vernalis; however, the medical community recognizes a 'de facto' warning: WARNING: CARDIAC TOXICITY. Adonis Vernalis can cause life-threatening heart rhythm disturbances. Use only under strict medical supervision. Serum potassium levels must be maintained within the normal range to prevent increased sensitivity to the drug's toxic effects.
If your healthcare provider prescribes Adonis Vernalis, you will likely require the following monitoring:
Adonis Vernalis may cause dizziness, blurred vision, or 'yellow vision' in some patients. Do not drive or operate heavy machinery until you know how this medication affects you. If you experience any visual changes, stop these activities immediately and contact your doctor.
Alcohol should be avoided or strictly limited while taking Adonis Vernalis. Alcohol can exacerbate the dizziness and irregular heart rhythms associated with cardiac glycosides. Furthermore, chronic alcohol use can lead to electrolyte imbalances that increase the risk of drug toxicity.
Do not stop taking Adonis Vernalis suddenly if you have been taking it for a long period for heart failure. Sudden discontinuation can lead to a rapid worsening of heart failure symptoms (rebound effect). Your doctor will provide a tapering schedule to safely reduce your dose.
> Important: Discuss all your medical conditions, especially any history of kidney disease or heart rhythm problems, with your healthcare provider before starting Adonis Vernalis.
Adonis Vernalis can interfere with the results of certain laboratory tests:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete list is essential for preventing dangerous drug-drug interactions.
Adonis Vernalis must NEVER be used in the following circumstances:
Conditions requiring a careful risk-benefit analysis by a cardiologist:
Patients who have had an allergic reaction to Digitalis purpurea (foxglove), Strophanthus, or Convallaria majalis (Lily of the Valley) should use Adonis Vernalis with extreme caution, as the chemical structures of the glycosides are similar and may cause a cross-allergic response.
> Important: Your healthcare provider will evaluate your complete medical history, including an ECG and blood work, before prescribing Adonis Vernalis to ensure it is safe for you.
Adonis Vernalis should not be used during pregnancy. Cardiac glycosides can cross the placenta. While Digoxin is sometimes used in pregnancy under strict specialist care, Adonis Vernalis lacks the safety data to justify its use. There is a theoretical risk of uterine contractions (oxytocic effect) which could lead to premature labor or miscarriage. Furthermore, the risk of maternal toxicity poses a direct threat to fetal viability. If you become pregnant while taking this medication, contact your doctor immediately.
It is known that cardiac glycosides are excreted into human breast milk. While the amounts may be small, the nursing infant's immature renal system may not be able to clear the drug, leading to potential accumulation and toxicity in the baby. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Adonis Vernalis is not recommended for use in children. The safety and effectiveness of this botanical substance have not been established in pediatric populations. Children are more sensitive to the toxic effects of glycosides, and accidental ingestion can be fatal. All preparations must be stored in child-proof containers and kept out of reach.
Patients over the age of 65 are at the highest risk for adverse effects from Adonis Vernalis. This is due to several factors:
Healthcare providers should use the lowest possible dose in this population.
For patients with a Glomerular Filtration Rate (GFR) below 60 mL/min, the clearance of Adonis glycosides is significantly reduced. Dosage adjustments are mandatory. In patients on dialysis, it is important to note that cardiac glycosides are generally not removed by hemodialysis due to their large volume of distribution. Close monitoring of serum electrolytes is vital in renal patients.
While the liver is not the primary route of elimination, severe hepatic impairment (Child-Pugh Class C) can alter the protein binding and metabolism of cardenolides. Patients with liver failure should be monitored closely for signs of increased drug effect or toxicity.
> Important: Special populations require individualized medical assessment. Never share this medication with others, especially those in high-risk groups.
Adonis Vernalis acts as a positive inotrope and a negative chronotrope. The primary molecular mechanism involves the binding of cardenolides (like adonitoxin) to the extracellular site of the alpha-subunit of the Na+/K+-ATPase pump.
The onset of action for Adonis Vernalis is relatively rapid compared to other botanical glycosides, typically occurring within 1–2 hours of oral administration. The duration of effect is shorter than that of Digoxin, lasting approximately 12–24 hours. This 'fast-in, fast-out' profile makes it slightly easier to manage in terms of toxicity, though it still requires careful dosing. Unlike Digitalis, Adonis is reported to have less of a cumulative effect, meaning it is less likely to build up in tissues over time if the dose is appropriate.
| Parameter | Value |
|---|---|
| Bioavailability | 25% - 40% (Estimated) |
| Protein Binding | 20% - 30% |
| Half-life | 12 - 18 hours |
| Tmax | 1 - 3 hours |
| Metabolism | Hepatic (Minor) |
| Excretion | Renal (>70%) |
Adonis Vernalis is classified as a Cardiac Glycoside within the therapeutic area of Cardiotonics. It is in the same broad family as Digoxin (from Digitalis lanata), Ouabain (from Strophanthus gratus), and Scillaren (from Squill). Within its class, Adonis is noted for its relatively low cumulative toxicity and its mild sedative and diuretic properties compared to the more potent Digitalis species.
Common questions about D-58
Adonis Vernalis is primarily used as a cardiotonic to support heart function in individuals with mild heart insufficiency or 'nervous' heart complaints. It contains cardiac glycosides that help the heart pump more efficiently by increasing the force of contraction while slowing the heart rate. In traditional European medicine, it is often prescribed for patients who do not yet require potent drugs like Digoxin but need mild cardiac support. It is also used to help reduce mild fluid retention (edema) associated with poor circulation. However, it should only be used under the strict guidance of a healthcare professional due to its potential toxicity.
The most common side effects of Adonis Vernalis include gastrointestinal issues such as nausea, vomiting, loss of appetite, and abdominal discomfort. Because it affects the heart rhythm, some patients may also experience a slow pulse (bradycardia) or a feeling of tiredness. These symptoms are often the first signs that the dosage may be too high. If you experience persistent nausea or a pulse rate below 60 beats per minute, you should contact your doctor immediately. Visual changes, such as seeing yellow or green halos, are less common but indicate serious toxicity.
It is strongly recommended to avoid or significantly limit alcohol consumption while taking Adonis Vernalis. Alcohol can interfere with heart rhythms and may worsen the dizziness or lightheadedness caused by cardiac glycosides. Furthermore, chronic alcohol use can lead to imbalances in electrolytes like potassium and magnesium, which dramatically increases the risk of life-threatening drug toxicity. Combining alcohol with heart medications puts unnecessary strain on the cardiovascular system and can mask the early warning signs of an overdose.
No, Adonis Vernalis is not considered safe during pregnancy and should be avoided. The cardiac glycosides in the plant can cross the placenta and potentially affect the developing fetus's heart. There is also a traditional concern that the plant may stimulate uterine contractions, which could lead to miscarriage or premature birth. Because there is a lack of rigorous clinical safety data, the risks to both the mother and the baby far outweigh any potential benefits. Women of childbearing age should discuss alternative treatments with their doctor.
Adonis Vernalis has a relatively quick onset of action compared to some other herbal heart remedies, with effects typically beginning within 1 to 3 hours after an oral dose. However, the full therapeutic benefit for chronic conditions like mild heart failure may take several days of consistent dosing to become apparent. It is important not to increase the dose if you do not feel immediate results, as the drug can accumulate in your system. Your doctor will monitor your progress, often using an ECG to see how the medication is affecting your heart's electrical activity.
You should never stop taking Adonis Vernalis suddenly without first consulting your healthcare provider. If you have been taking it to support your heart function, stopping abruptly can cause a 'rebound' effect where your heart failure symptoms—such as shortness of breath, edema, and fatigue—worsen rapidly. Your doctor will typically recommend a gradual reduction in the dose to allow your cardiovascular system to adjust. If you are experiencing severe side effects, your doctor will provide a safe plan for immediate discontinuation under medical supervision.
If you miss a dose of Adonis Vernalis, take it as soon as you remember. If it is almost time for your next scheduled dose (within a few hours), skip the missed dose entirely and return to your regular schedule. Never take two doses at once to make up for a missed one, as this can lead to a dangerous spike in the level of glycosides in your blood, increasing the risk of heart rhythm disturbances. To help prevent missed doses, try taking your medication at the same time every day, perhaps using a pill organizer or a phone alarm.
Adonis Vernalis itself does not typically cause weight gain in the form of fat. In fact, because it helps the heart pump more effectively and has a mild diuretic effect, it may actually lead to weight loss in patients who were previously retaining fluid due to heart insufficiency. However, if you notice a sudden, rapid increase in weight (such as 2-3 pounds in a single day), this could be a sign that your heart condition is worsening and that fluid is building up in your body. You should report any sudden weight changes to your doctor immediately.
Adonis Vernalis has many significant drug interactions and should only be taken with other medications under a doctor's supervision. It is particularly dangerous when combined with 'water pills' (diuretics) that lower potassium, as this can lead to fatal heart rhythms. It also interacts with beta-blockers, calcium supplements, and other heart medications like Digoxin. Always provide your healthcare provider with a full list of all prescription drugs, over-the-counter medicines, and herbal supplements you are taking to ensure there are no dangerous combinations.
Adonis Vernalis is not a standard 'brand-name' pharmaceutical drug in the United States, so the concept of a 'generic' version doesn't apply in the traditional sense. Instead, it is available as various herbal extracts, tinctures, and homeopathic preparations from multiple manufacturers. Because these products are not regulated as strictly as prescription drugs, the quality and potency can vary significantly between brands. It is crucial to use a standardized product that specifies the concentration of active glycosides and to stay with the same manufacturer to ensure consistent dosing.
Other drugs with the same active ingredient (Adonis Vernalis)