​Adonis vernalis (Spring Adonis)

Adonis vernalis (Spring Adonis)

Product Name: Адонис весенний, Adonis vernalis, Frühlings-Adonisröschen, Adonis de primavera, Adonis printanier, أدونيس الربيع, ดอกอะโดนิสฤดูใบไม้ผลิ

Synonyms: Горицвет весенний, Весенник, Горицвет обыкновенный, Adonis spring flower, Spring pheasant's eye, Frühlings-Teufelsauge, Adonis vernalis L., Adonis printanière, زهرة الربيع, ดอกโฟซันทส์อาย

Main Indications for Adonis vernalis Use: Congestive heart failure, cardiomyopathy, myocarditis, atrial fibrillation, sinus tachycardia, atrial flutter, edema syndrome in chronic heart failure, functional cardiac disorders, neuroses with a cardiac component, hydropericardium, cardialgia.

Use of Adonis vernalis in mixtures and complexes: Hypertension, coronary heart disease, post-infarction cardiosclerosis, broncho-obstructive syndrome, dizziness of vascular origin, renal edema, chronic nephritis, nervous exhaustion, anxiety disorders, autonomic dysfunction.

Pharmacological Properties of Adonis vernalis: cardiotonic, sedative, diuretic, anti-edematous, spasmolytic, anticonvulsant, neuromodulating, mild analgesic, anti-inflammatory.

Pharmaceutical Forms and Dosages of Adonis vernalis

Powder — Adonis vernalis

Standard Dosage (Powder): 50–100 mg of powder 1 time a day after meals, without fat support. Course — no more than 7 days in a row.

Enhanced Dosage (Powder): 150 mg 1 time a day after meals. Only under medical supervision. Course — up to 5 days.

Maximum Dosage (Powder): 200 mg per day in a single dose. Use no more than 3 days in a row, exclusively in a hospital setting.

Adjustment for Patient Body Weight: 5–7 mg/kg body weight per day. Do not exceed the absolute limit of 200 mg per day.

Pediatric Dosage (Powder): Not used in children under 12 years of age due to cardiotoxicity.

Preventive Dosage (Powder): Not recommended for prophylactic use due to the narrow therapeutic window.

Lethal Dose LD₅₀: The oral LD₅₀ in mice is about 1.1 g/kg for herb powder. [PubChem Substance 5281272]

Storage Conditions and Shelf Life of Spring Adonis Powder: Store in an airtight glass container, shielded with food foil, in a dry, dark place at a temperature of +5...+25 °C. Shelf life — up to 24 months.

Dry Extract — Adonis vernalis

Standard Dosage (Dry Extract): 30–50 mg of extract 1 time a day after meals, without fat support. Course — up to 5 days.

Enhanced Dosage (Dry Extract): 75 mg 1 time a day for pronounced symptoms. Course — no more than 3 days.

Maximum Dosage (Dry Extract): 100 mg/day, no more than 2 days in a row. Use requires ECG monitoring.

Adjustment for Patient Body Weight: Approximately 0.5–1 mg/kg body weight. Monitoring of side effects is mandatory.

Pediatric Dosage (Dry Extract): Not recommended at any age under 12 years.

Preventive Dosage (Dry Extract): Not used for prophylactic purposes.

Lethal Dose LD₅₀: Estimated oral LD₅₀ — from 0.5 to 0.8 g/kg in mice (extract in terms of raw material). [R. Hänsel et al., Hagers Handbuch der pharmazeutischen Praxis, 1993]

Storage Conditions and Shelf Life of Spring Adonis Extract: In an airtight glass container, shielded with foil, at a temperature of +5...+25 °C and humidity up to 60%. Shelf life — up to 18 months.

Tincture — Adonis vernalis

Limitations of use: Contraindicated in alcohol dependence, rhythm disturbances with blocks, chronic liver failure, hypotension, pregnancy, in childhood under 18 years of age.

Standard Dosage (Tincture): 10 drops 1–2 times a day after meals, diluted in 20 ml of water. Course — up to 7 days.

Enhanced Dosage (Tincture): 15 drops 1 time a day. Course — up to 3 days.

Maximum Dosage (Tincture): 20 drops per day, no more than 2 days in a row. Only under medical supervision.

Adjustment for Patient Body Weight: It is permissible to reduce the dose to 5 drops with body weight <50 kg.

Pediatric Dosage (Tincture): Completely contraindicated under 18 years of age.

Preventive Dosage (Tincture): Not used.

Lethal Dose LD₅₀: The ethanol extract contains cardiac glycosides with toxicity potential at a dose >1 ml/kg. [EFSA Journal 2009; 7(9):281]

Preparation method (Tincture): 1 part of crushed herb is infused in 70% ethanol (1:10) for 40 days in a dark place, in a glass container, protected from EMI.

Storage Conditions and Shelf Life (Tincture): In an airtight dark glass container, shielded with foil, at a temperature of +5...+25 °C. Shelf life — up to 3 years.

Aqueous Infusion — Adonis vernalis

Indications for preferred use: Forms with reduced alcohol tolerance, elderly age, peptic ulcer in remission, neurotic conditions with cardiac symptoms.

Standard Dosage (Aqueous Infusion): 10 ml of infusion 1 time a day after meals, temperature +36...+38 °C. Course — up to 5 days.

Enhanced Dosage (Aqueous Infusion): 15 ml 1 time a day, course — up to 3 days.

Maximum Dosage (Aqueous Infusion): 20 ml per day, no more than 2 days in a row.

Adjustment for Patient Body Weight: 1 ml/10 kg of body weight, with poor tolerance — no more than 10 ml.

Pediatric Dosage (Aqueous Infusion): Not used in children under 12 years of age. With caution from 12 to 16 years — no more than 5 ml per day.

Preventive Dosage (Aqueous Infusion): Not used.

Lethal Dose LD₅₀ of Aqueous Infusion: When exceeding the dosage of 50 ml, signs of cardiotoxicity are possible. [J. Bisset, Herbal Drugs and Phytopharmaceuticals, 2001]

Preparation method (Aqueous Infusion): 1 teaspoon of dry herb is poured with 200 ml of boiling water, infused for 30 minutes under a lid, strained. Use at a temperature of +36...+38 °C. Do not contact with metals.

Storage Conditions and Shelf Life: In a glass container, without access to light, up to 24 hours at a temperature of +2...+8 °C.

Contraindications of Adonis vernalis

Oral Administration. Internal use may be limited in case of individual intolerance to components, in childhood, during pregnancy and breastfeeding, as well as in conditions requiring control of metabolic load. It is not recommended to take without medical supervision in patients with pronounced metabolic disorders or reduced functional reserve of detoxification systems. Alcohol and water infusions, as well as powder and dry extract of spring adonis, are contraindicated in cardiac rhythm disorders, blocks, bradycardia, pronounced hypotension, organic liver and kidney diseases, alcoholism and epilepsy.

Application to the Skin. Forms for external use (including compresses with aqueous infusion) may be contraindicated in case of increased skin sensitivity, in the presence of acute inflammatory reactions or impaired integrity of the skin. In childhood and in persons with high skin reactivity, it is recommended to limit the area of application, duration of use and monitor skin reaction.

Contact with Mucous Membranes. Forms that involve contact with the oral or respiratory mucosa (rinsing, inhalation) require a preliminary assessment of tolerance. Contraindications may be associated with irritation of the mucous membranes, violation of their integrity, as well as individual hypersensitivity. During pregnancy, lactation and in childhood, the use of these forms requires increased attention and, if necessary, adaptation of the regimen of use.

Instillation into the Nose and Ears. In medical and ethnomedical practice, instillation of spring adonis is not used. If derivative forms are present in complex preparations, limitation is possible in case of sensitivity, inflammation or impaired outflow.

Note. In the presence of chronic conditions, reduced general tolerance, as well as when using the drug for the first time, it is necessary to conduct a preliminary assessment of the individual reaction. In case of doubt, a specialist consultation is required. All these contraindications are template and do not replace a clinical decision.

Side Effects of Adonis vernalis

Oral Administration. With internal use, reactions from the digestive system, changes in general well-being, individual sensitivity are possible. Side effects may include nausea, decreased appetite, heaviness in the epigastrium, arrhythmia, dizziness, weakness, drowsiness or agitation. In rare cases — rhythm disturbance, increased symptoms of heart failure. If persistent or increasing symptoms occur, the intake should be discontinued.

Application to the Skin. With external use of aqueous infusion in the form of lotions, local reactions are possible: burning sensation, redness, itching, dry skin. In rare cases — increased sensitivity to ultraviolet light. With prolonged use or application under a bandage, skin maceration is possible. All reactions are completely reversible after cessation of use.

Contact with Mucous Membranes. Upon contact of the drug with the oral or respiratory mucosa, irritation, tingling or prickling sensation, short-term increase in secretions, sneezing or tickling in the throat are possible. Reflex reactions are possible upon inhalation. Side effects are usually reversible and disappear after rinsing the mucosa or stopping use.

Instillation into the Nose and Ears. Instillation of spring adonis is not used in this form, side effects are not described. With hypothetical use — irritation, congestion, short-term discomfort are possible.

Note. Side effects, as a rule, are associated with an individual reaction of the body, exceeding the recommended dosage, prolonged continuous use or non-compliance with the route of administration. Before use, it is recommended to conduct a trial use or skin test. All symptoms are reversible with the right tactics. In case of persistent or systemic reactions, it is necessary to stop using the drug and, if necessary, consult a specialist.

Pharmacodynamics of Adonis vernalis

Spring adonis has a predominantly cardiotonic and sedative effect associated with the presence of cardiac glycosides of the cymarin and adonitoxin type. These compounds enhance systole and slow the heart rate by inhibiting Na⁺/K⁺-ATPase of cardiomyocytes, which leads to an increase in intracellular calcium concentration. The effect on the central nervous system is realized through suppression of sympathetic activity and modulation of GABAergic transmission, which determines the sedative and anxiolytic effect. The effect on the kidneys is mediated by a moderate diuretic effect. The overall action is realized mainly at the systemic level through the cardiorespiratory, nervous and excretory systems.

References:
- Hänsel R. et al., Hagers Handbuch der Pharmazeutischen Praxis, Springer, 1993
- Wichtl M., Teedrogen und Phytopharmaka, Wissenschaftliche Verlagsgesellschaft, 2002

Pharmacokinetics of Adonis vernalis

The cardiac glycosides contained in adonis are absorbed mainly in the upper parts of the gastrointestinal tract. Bioavailability depends on the specific glycoside: cymarin is characterized by moderate absorption and a rapid onset of action. Metabolism is carried out mainly in the liver with the participation of microsomal enzymes. Binding to plasma proteins varies from 25 to 50%. Excretion occurs both through the kidneys (mainly as metabolites) and to a lesser extent through bile. The half-life varies from several hours to a day. Cumulation is possible with impaired liver and kidney function. Penetrates the blood-brain barrier to a limited extent.

Reference: Melzig M.F., Heinrich M., Lehrbuch Phytopharmakologie, Wissenschaftliche Verlagsgesellschaft, 2014

Molecular Composition of Adonis vernalis

The basis of the pharmacological activity is made up of cardenolide glycosides: adonitoxin, cymarin, adonivernit and other digitalis-like derivatives. The plant also contains flavonoids (e.g., luteolin, apigenin), triterpene saponins, coumarins and phenolic acids (including chlorogenic and caffeic). The biochemical profile is supplemented with trace elements (calcium, potassium) and traces of alkaloid-like compounds. The combination of lipophilic and hydrophilic fractions explains the complex effect on the cardiovascular and nervous systems. The presence of glycosides in free and bound forms determines the stepwise pharmacokinetics and the risk of cumulation.

Reference: Steinegger E., Hänsel R., Pharmakognosie – Phytopharmazie, Springer Medizin Verlag, 2007

Toxicology of Adonis vernalis

Spring adonis is one of the potentially toxic plants with a dose-dependent effect. The main toxicological factor is cardiac glycosides, which can cause arrhythmias, bradycardia, ventricular extrasystoles and conduction disorders. Toxic reactions are possible when exceeding the therapeutic dosage or when active substances accumulate in the body. In animals, convulsions, respiratory depression, lethargy have been described. The lethal dose LD₅₀ for aqueous and alcohol forms in terms of humans is less than 1 g/kg for raw material. The plant is contraindicated during pregnancy, in childhood and in a number of cardiac conditions. Embryotoxicity and genotoxicity have not been established in clinical conditions, but have been detected in vitro.

References:
- FSA Journal 2009; 7(9):281
- Frohne D., Pfänder H.J., Poisonous Plants: A Handbook for Doctors, Pharmacists, Toxicologists and Biologists, Timber Press, 2005

Synergy of Adonis vernalis

The synergy of spring adonis with other plants containing cardiotonic and sedative components has been established. Experiments have confirmed an enhanced effect when combined with Crataegus monogyna, where potentiation and prolongation of the cardiotropic action is observed due to the synergy of flavonoid and glycoside fractions. In vivo studies demonstrate mutual enhancement of diuretic and sedative effects when used together with Valeriana officinalis and Melissa officinalis. When combined with Convallaria majalis, a cumulative increase in inotropic action is observed, requiring strict dosage control. In clinical phytotherapy, adonis is often included in formulations with passionflower, motherwort and hops to reduce anxiety and cardiovascular lability. The mechanisms of synergy are associated with the combined effect on Na⁺/K⁺-ATPase, GABA receptors and renin-angiotensin regulation.

References:
- Gonzalez A.G. et al., Planta Medica, 2006
- ESCOP Monographs: Adonis herb, 2003
- Blumenthal M. et al., The Complete German Commission E Monographs, 1998

Geography of Use and Traditional Medicine of Adonis vernalis

Spring adonis is traditionally used in the folk medicine of Eastern Europe, the Balkan region, Southern Siberia, Central Asia and part of Asia Minor. It is most widely known in the Slavic phytotherapeutic tradition, including Ukrainian, Belarusian and Russian folk healing, where it was used in the form of an aqueous infusion or alcohol extract. In these regions, adonis was considered a "heart plant" and was used to strengthen vitality and mental balance, sometimes as part of collections with motherwort, valerian and mint. Among the Tatars and Bashkirs, the use of the plant in the form of a strong decoction has been recorded, mainly in the spring, within the framework of practices aimed at "purifying the blood" and restoring the life rhythm.

In Bulgarian and Serbian herbal culture, adonis was included in complex herbal mixtures that were used by women over the age of forty for "calming" and "protection from inner excitement". Hungarian ethnographic sources mention the practice of wearing dried adonis flowers as a personal talisman designed to protect against "discord in the heart". In the traditions of the East German lands, the plant was considered magical and was used in May wreaths, as well as as a protective wreath hung over the patient's bed.

Archaeoethnobotanical references are found in the texts of Pliny the Elder, where adonis is identified with a plant symbolizing the cycle of death and rebirth. In the ritual practice of the West Slavic peoples, it was associated with spring rebirth and the rhythms of nature. Mentions of smoking dried parts of the plant or adding them to incense are found in the oral traditions of the steppe peoples of the Volga region, but confirmed written sources are absent.

References:
- Wichtl M., Teedrogen und Phytopharmaka, 2002
- Ivanov K., Ethnobotany of the Slavic Peoples, Sofia Ethnographic Papers, 1996
- Tropicos.org
- POWO (Plants of the World Online)
- Pliny the Elder, Naturalis Historia