# Oleander extracts (oleandrin, Anvirzel, PBI-05204)

Source: https://onco.cc/technologies/oleandrin-anvirzel/  
OnCo record `oleandrin-anvirzel` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Oleander is a highly poisonous shrub whose heart-acting compound, oleandrin, has been developed into extracts promoted against cancer. An oral extract did not lengthen survival in a study in metastatic pancreatic cancer, and oleander has killed people, including a man with sarcoma who injected an extract daily. MSK says these products should not be used outside clinical trials.

## Summary

Nerium oleander contains oleandrin, a cardiac glycoside that acts like digoxin by inhibiting the sodium-potassium pump. Memorial Sloan Kettering's About Herbs summary describes apoptosis of cancer cells in the laboratory and two developed extracts: Anvirzel, an injectable hot-water extract that appeared safe in a small study apart from injection pain, fatigue and gut symptoms, and an oral extract (PBI-05204) that was tolerated in advanced cancers but did not meet its primary endpoint of overall survival in metastatic pancreatic adenocarcinoma. MSK states these are not approved for cancer in the United States and should not be used outside clinical trials, and that evidence is lacking for any condition. The raw plant is highly toxic: consumption can be fatal, with vomiting, low blood pressure, respiratory paralysis and death, at serum oleandrin levels between 1.0 and 2.0 ng/mL. Case reports include a death suspected from two months of daily intramuscular oleander injections in a 43-year-old with metastatic synovial sarcoma and a fatal arrhythmia after an oleander leaf infusion. It adds to digoxin toxicity and should not be used with low potassium, high calcium, slow heart rate or heart failure.

## Fields

- Kind: Technology
- Status: negative
- Last checked: 2026-11-04
- Also known as: Anvirzel; PBI-05204; Nerium oleander
- Tags: complementary; supportive-care; evidence:harm
- Principle: Cardiac glycoside inhibition of sodium-potassium ATPase, the same mechanism that makes it toxic to the heart.
- Strengths: Tested in a clinical study, so the question has a partial answer
- Limitations: No survival benefit in metastatic pancreatic cancer; Highly toxic; deaths reported; Adds to digoxin toxicity

## Sources

- MSK About Herbs: Oleandrin (page last updated 24 February 2023): https://www.mskcc.org/cancer-care/integrative-medicine/herbs/oleandrin

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