by Eric Yarnell, ND, RH(AHG)
Last updated 14 Nov 2022
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Table of Contents
Clinical Highlights
Aconite is one of the most potent herbs in the entire materia medica, to used with great caution. Aconite overdose is potentially lethal due to arrhythmias.
At usual therapeutic doses, there are no adverse effects. Early signs of overdose include paresthesias, nausea, vertigo, and anxiety. Death can result from overdose.
Aconite, in very small doses, is a potent analgesic, febrifuge, and sedative.
Aconite is primarily used to control severe pain (especially neuropathic pain) and high fevers.
At usual therapeutic doses, there are no adverse effects. Early signs of overdose include paresthesias, nausea, vertigo, and anxiety. Death can result from overdose.
Aconite, in very small doses, is a potent analgesic, febrifuge, and sedative.
Aconite is primarily used to control severe pain (especially neuropathic pain) and high fevers.
Aconitum carmichaelii leaves (photo copyright E. Yarnell)
Aconitum napellus leaf (photo copyright E. Yarnell)
Surface of Aconitum carmichaeli
i prepared root (photo copyright Heron Botanicals, used with permission)
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Aconitum carmichaelii flower (photo copyright E. Yarnell)
Aconitum napellus flower (photo copyright E. Yarnell)
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Clinical Fundamentals
Part Used: The safest form of the herb is dried lateral root (as opposed to the main taproot) of Aconitum carmichaelii that has been decocted or cooked in some way to alter and deplete alkaloid levels. Higher doses are then required of this medicine to get clinical effects, though overdose is less likely to occur. It is also recommended roots be dried and processed of any other species.
Fresh root (or, much less commonly, flowering tops) has also been used to make tinctures, though far less of this should be used due to much higher alkaloid levels or relative lack of knowledge of which alkaloids are present and how they will act (Wang, et al. 2003a). Products made from unprocessed or fresh Sichuan aconite roots (川烏 chuān wū) and processed wild Sichuan aconite lateral roots (製草烏 zhì cǎo wū) are far more dangerous and should be avoided (or, if used, at extremely low doses).
Taste: Numbing, acrid
Major Actions:
Major Organ System Affinities
Major Indications:
In one open randomized trial, a combination of oral Chinese licorice and Sichuan aconite was as effective as diclofenac for reducing pain due to knee osteoarthritis (Deng 2008).
Major Constituents:
Fresh root (or, much less commonly, flowering tops) has also been used to make tinctures, though far less of this should be used due to much higher alkaloid levels or relative lack of knowledge of which alkaloids are present and how they will act (Wang, et al. 2003a). Products made from unprocessed or fresh Sichuan aconite roots (川烏 chuān wū) and processed wild Sichuan aconite lateral roots (製草烏 zhì cǎo wū) are far more dangerous and should be avoided (or, if used, at extremely low doses).
Taste: Numbing, acrid
Major Actions:
- Analgesic (Hikino, et al. 1979)
- Not a prostaglandin inhibitor (Murayama and Namiki 1989)
- Febrifuge, antipyretic (Hikino, et al. 1979)
- Sedative
Major Organ System Affinities
- Nervous system
Major Indications:
- Arthritis, topical and internal (Deng 2008)
- Fever, high or uncontrolled
- Headache, severe, non-migraine
- Neuralgia, topical and internal (Tai, et al. 2015)
- Posherpetic neuralgia (Nakanishi, et al. 2012)
- Pain, severe (Tai, et al. 2015)
- Cancer-related pain
- Neuropathic pain such as trigeminal neuralgia
In one open randomized trial, a combination of oral Chinese licorice and Sichuan aconite was as effective as diclofenac for reducing pain due to knee osteoarthritis (Deng 2008).
Major Constituents:
- Diterpenoid alkaloids (also called norditerpenoid alkaloids)
- Diester: most potent, but also unacceptably toxic
- Monoester: moderate potency with moderate but avoidable toxicity
- Alkylolamine (non-ester): low potency, non-toxic
- There are additional structural differences between various alkaloids that affect safety and activity. See the Advanced Clinical Information section for more information.
- Flavonoids (Braca, et al. 2003)
Aconitine, a toxic diester norditerpenoid alkaloid
Adverse Effects: Though generally none occur at therapeutic doses, aconite can cause nausea, paresthesias and numbness of the mouth and lips (only if the medicine actually touches them; this doesn't occur with capsules), restlessness, or palpitations. See the overdose section below for more on this.
All aconite products should be kept out of reach of children and, ideally, in child-proof containers. They should be clearly marked as poisonous.
If palpitations occur, treatment should be immediately ceased and the patient closely monitored as these may be early signs of overdose.
The toxic effects of aconite are mediated through voltage-gated sodium channels, modulation of neurotransmitter release, lipid peroxidation, and induction of apoptosis of various cells (Fu, et al. 2006).
Contraindications:
Drug Interactions: Though there is little information from human studies on drug interactions, caution is warranted when combining aconite with proarrhythmic drugs and particularly those that prolong the QT interval (dofetilide, ibutilide, procainamide, quinidine, sotalol, fluoroquinolone antibiotics, ketoconazole, tricyclic antidepressants, fluoxetine, sertraline, venlafaxine, antipsychotics, triptans, dolasetron, and methadone).
Herbal Incompatibilities: According to traditional Chinese medicine, Sichuan aconite is not to be combined with Bulbus Fritillariae, Rhizoma Pinelliae, Rhizoma Bletillae, Radix Ampelopsis, and Radix Trichosanthis.
Overdose: Note that patients who survive overdoses generally have no lasting negative effects (Tai, et al. 1992). In Hong Kong, there were 31 reported cases of aconite-associated poisonings at public hospitals and 2 patients died of ventricular arrhythmias from 1989–1991 (Chan 2002). After public awareness campaigns and media awareness increased, particularly about using unprocessed Sichuan aconite roots (川烏 chuān wū) and processed wild Sichuan aconite lateral roots (製草烏 zhì cǎo wū), herbalists seemed to use lower doses of these herbs and poisonings markedly decreased. A review of cases in mainland China found 53 deaths due to aconite use from 2004 to 2015, 77% of which were related to medicinal use of various aconite products and the rest from intentional or accidental ingestion of the roots as vegetables (Li, et al. 2016). Given the massive, widespread use of aconite in Chinese medicine, these rates of death are still extremely low, and do not suggest that appropriate, well-managed use of aconite clinically is significantly dangerous.
Signs of overdose:
See the Advanced Clinical Information section for overdose case reports.
All aconite products should be kept out of reach of children and, ideally, in child-proof containers. They should be clearly marked as poisonous.
If palpitations occur, treatment should be immediately ceased and the patient closely monitored as these may be early signs of overdose.
The toxic effects of aconite are mediated through voltage-gated sodium channels, modulation of neurotransmitter release, lipid peroxidation, and induction of apoptosis of various cells (Fu, et al. 2006).
Contraindications:
- Suicidal ideation
- Pregnancy
- Lactation
- Use caution in patients with arrhythmias.
Drug Interactions: Though there is little information from human studies on drug interactions, caution is warranted when combining aconite with proarrhythmic drugs and particularly those that prolong the QT interval (dofetilide, ibutilide, procainamide, quinidine, sotalol, fluoroquinolone antibiotics, ketoconazole, tricyclic antidepressants, fluoxetine, sertraline, venlafaxine, antipsychotics, triptans, dolasetron, and methadone).
Herbal Incompatibilities: According to traditional Chinese medicine, Sichuan aconite is not to be combined with Bulbus Fritillariae, Rhizoma Pinelliae, Rhizoma Bletillae, Radix Ampelopsis, and Radix Trichosanthis.
Overdose: Note that patients who survive overdoses generally have no lasting negative effects (Tai, et al. 1992). In Hong Kong, there were 31 reported cases of aconite-associated poisonings at public hospitals and 2 patients died of ventricular arrhythmias from 1989–1991 (Chan 2002). After public awareness campaigns and media awareness increased, particularly about using unprocessed Sichuan aconite roots (川烏 chuān wū) and processed wild Sichuan aconite lateral roots (製草烏 zhì cǎo wū), herbalists seemed to use lower doses of these herbs and poisonings markedly decreased. A review of cases in mainland China found 53 deaths due to aconite use from 2004 to 2015, 77% of which were related to medicinal use of various aconite products and the rest from intentional or accidental ingestion of the roots as vegetables (Li, et al. 2016). Given the massive, widespread use of aconite in Chinese medicine, these rates of death are still extremely low, and do not suggest that appropriate, well-managed use of aconite clinically is significantly dangerous.
Signs of overdose:
- Neurological (>95% of patients experience these symptoms in Chan 2009)
- Paresthesias and numbness of limbs
- Weakness
- Tetraplegia (Chan, et al. 1994a)
- Anxiety
- Blurred vision
- Cardiovascular (~80% of patients experience these symptoms in Chan 2009)
- Hypotension
- Palpitations
- Chest pain
- Bradycardia
- Tachycardia (Tai, et al. 1992)
- Arrhythmias, including (Chan 2009):
- Ventricular ectopic beats
- Heart block
- Atrial fibrillation
- Ventricular arrhythmias (including torsade de pointes and fibrillation), potentially lethal (Imazio, et al. 2000)
- Gastrointestinal (50–75% of patients experience these symptoms in Chan 2009)
- Nausea
- Vomiting
- Diarrhea
- Respiratory
- Decreased respiratory rate
- Respiratory paralysis, potentially lethal (Li, et al. 2016)
- In the case series of 13 Japanese patients with aconite overdose (9 attempting suicide, 4 accidental ingestion), all of them developed nausea, vomiting, tachyarrhythmias, hypotension, and chest pain (Terui, et al. 2008).
- Cases of suspected fatal anaphylaxis after exposure to very small doses of aconite have been reported, with petechial skin rashes and widespread eosinophilic infiltration of internal organs (Li, et al. 2016).
See the Advanced Clinical Information section for overdose case reports.
Treatment of Aconite Poisoning:
General
Antidotes for arrhythmias (Chan 2009):
Antidotes, other
Ineffective treatments
General
- Discontinue aconite intake.
- Keep patient still.
- Administer tannins or activated charcoal, or pump the stomach, after recent ingestion.
- Continuously monitor heart rhythms and blood pressure for 24 h after ingestion (Chan 2009)
- Avoid contact with an overdosed patient's vomitus, bodily fluids, aspirate, or any plant parts (Stetzenbach, et al. 2017).
Antidotes for arrhythmias (Chan 2009):
- Preferred: magnesium, flecainide and/or amiodarone (if tachycardic), atropine (if bradycardic)
- Magnesium: successful given intravenously, loading dose 1–6 g, may need to repeat 1–3 g per day for up to 3 days for recurrent symptoms (Clara, et al. 2015; Gottignies, et al. 2009; Weijters, et al. 2008; Moritz, et al. 2005)
- Class I anti-arrthymics (sodium channel blockers), most specific to aconite toxicity (which is characterized by persistent sodium channel activation):
- Class Ia agents: not recommended due to high risk of long QT syndrome
- Class Ib agents: lidocaine IV, mexiletene. Widely used but with poor efficacy (Lin, et al. 2004; Yeih, et al. 2000; Tai, et al. 1992). Relatively mild sodium channel blockers with some risk of shortening the QTc interval. NOT recommended.
- Class Ic agents: flecainide or propafenone. Experience is limited, but they are the most potent sodium channel blockers and do not affect the QT interval so should be safest.
- Class II anti-arrhythmics (autonomic effects):
- Class IIc: Atropine (used only if the patient is bradycardic or has heart block)
- Class III anti-arrthymics (potassium channel blockers, mostly shouldn't help):
- Amiodarone: mixed efficacy with limited clinical use (Sheth, et al. 2015; Chan 2009; Weijters, et al. 2008; Yeih, et al. 2000). A typical IV dose is 150 mg.
- This drug has mixed inhibitory effects on sodium, potassium, and calcium channels and is sympatholytic.
- The high iodine content in this drug runs the risk of exacerbating pre-existing hypothyroidism, or causing new-onset hypothyroidism.
- Bretylium: limited efficacy combined with other drugs with limited clinical use (Chan 2009), largely unavailable
- Amiodarone: mixed efficacy with limited clinical use (Sheth, et al. 2015; Chan 2009; Weijters, et al. 2008; Yeih, et al. 2000). A typical IV dose is 150 mg.
Antidotes, other
- Charcoal hemoperfusion reported helpful in very limited cases (Lin, et al. 2002)
- Ethanol and digitalis, onset slow, should only be used if modern medical facilities are not available (Felter 1922)
- Mechanical ventilation, cardiopulmonary bypass, and/or extracorporeal membrane oxygenation in refractory cases (Chan 2009)
- Do NOT administer potassium (unless hypokalemic and considering using flecainide)
Ineffective treatments
- Calcium channel blockers
- Cardioversion (Chan 2009; Weijters, et al. 2008)
- Dialysis (Chan 2009)
Pharmacy Essentials
Critical notes on the importance of processing aconite:
Boiling aconite roots can reduce alkaloid content up to 90% (Chan and Critchley 1996). Cooking the roots changes diester diterpenoid alkaloids into lipoalkaloids and monoester alkaloids, thereby significantly reducing toxicity (Wang, et al. 2003b).
Though fresh aconite products can be used, albeit at very low doses, they are very much more risky than using processed ones. Therefore, only products made from the far better characterized and understood dried and cooked lateral roots are recommended.
Tincture of processed lateral root: The safest version of aconite is dried then decocted lateral roots, 1:3–1:5 w:v ratio, 30–45% ethanol. Note: if using a 1:10 w:v tincture, then the doses below should be doubled.
Dose:
Acute, adult: 3–5 gtt q2–3h, adjusted for body size and sensitivities, for no more than 3 days
Chronic, adult: 3–5 gtt tid
Child: not recommended
Glycerite: not recommended for use as you do not want to cover the taste or make this more appealing to children, and it is not clear if the alkaloids would extract well in this menstruum.
Decoction: 500–1,500 mg processed root per 250 ml water simmered for 1–2 h in a closed container; strain and drink 0.5–1 cup tid. Up to 6 g per day of processed lateral root is recommended in many Chinese herbal formula recipes.
Dose:
Acute adult: 1 cup up to q2–3h for 1–2 days
Chronic, adult: 0.5–1 cup tid
Child: not recommended
If you need help formulating with this herb, or any other, you can use the formulation tool. Remember that when using this herb in a formula, due to synergy, you can usually use less.
Boiling aconite roots can reduce alkaloid content up to 90% (Chan and Critchley 1996). Cooking the roots changes diester diterpenoid alkaloids into lipoalkaloids and monoester alkaloids, thereby significantly reducing toxicity (Wang, et al. 2003b).
Though fresh aconite products can be used, albeit at very low doses, they are very much more risky than using processed ones. Therefore, only products made from the far better characterized and understood dried and cooked lateral roots are recommended.
Tincture of processed lateral root: The safest version of aconite is dried then decocted lateral roots, 1:3–1:5 w:v ratio, 30–45% ethanol. Note: if using a 1:10 w:v tincture, then the doses below should be doubled.
Dose:
Acute, adult: 3–5 gtt q2–3h, adjusted for body size and sensitivities, for no more than 3 days
Chronic, adult: 3–5 gtt tid
Child: not recommended
Glycerite: not recommended for use as you do not want to cover the taste or make this more appealing to children, and it is not clear if the alkaloids would extract well in this menstruum.
Decoction: 500–1,500 mg processed root per 250 ml water simmered for 1–2 h in a closed container; strain and drink 0.5–1 cup tid. Up to 6 g per day of processed lateral root is recommended in many Chinese herbal formula recipes.
Dose:
Acute adult: 1 cup up to q2–3h for 1–2 days
Chronic, adult: 0.5–1 cup tid
Child: not recommended
If you need help formulating with this herb, or any other, you can use the formulation tool. Remember that when using this herb in a formula, due to synergy, you can usually use less.
Other Names
Latin synonyms:
Current correct Latin binomial: Aconitum carmichaelii Debeaux
Aconitum bodinieri H Lév & Vaniot
Aconitum jiulongense WT Wang
Aconitum kusnezoffii var bodinieri (H Lév & Vaniot) Finet & Gagnep
Aconitum lushanense Migo
Aconitum wilsonii Stapf ex Mottet
English Common Names: Sichuan aconite, Chinese aconite
Asian Common Names: see table
Current correct Latin binomial: Aconitum carmichaelii Debeaux
Aconitum bodinieri H Lév & Vaniot
Aconitum jiulongense WT Wang
Aconitum kusnezoffii var bodinieri (H Lév & Vaniot) Finet & Gagnep
Aconitum lushanense Migo
Aconitum wilsonii Stapf ex Mottet
English Common Names: Sichuan aconite, Chinese aconite
Asian Common Names: see table
| Product | Chinese (Mandarin) | Japanese | Korean |
| A. carmichaelii processed lateral root (only form recommended for use) | 附子 fù zǐ ("appendage") | shuchi-bushi-matsu | |
| A. carmichaelii prepared main root | 川烏 chuān wū ("Sichuan crow's head") | ||
| A. carmichaelii plant | 烏頭 (traditional), 乌头 (simplified) wū tóu ("raven/black head") | bushi | puja, buja |
| A. kusnezoffii prepared lateral root | 製草烏 zhì cǎo wū ("prepared black grass") | ||
| A. kusnezoffii fresh root | 草烏 cǎo wū ("black grass") | ||
Latin synonyms:
Current correct Latin binomial: Acontium napellus L
Aconitum ampliflorum Rchb
Aconitum anglicum Stapf
Aconitum confertum Rchb
Aconitum fornicatum Gilib
Aconitum funckii Rchb
Aconitum grandiflorum Pall
Aconitum halleri Rchb
Aconitum microstachyum Rchb
Aconitum neubergense DC
Aconitum spicatum Donn
Aconitum venustum Rchb
Aconitum willdenowii Rchb
Delphinium napellus Baill
Napellus vulgaris Fourr
English common names: monkshood, monks-hood, monk’s-hood, monk's blood, monk's hood (all referring to shape of the flower), aconite, auld wife's huid, bear's-foot, blue rocket, European blue-monkshood, friar's cap, garden monk's-hood, garden monkshood, helmet flower, Turk's-cap, Venus' chariot, wolf's bane, wolfsbane, devil's helmet
Albanian common name: spineri
Arabic common names: بيش, قاتل النمر, هلهل
Azerbaijani common name: turpabənzər kəpənəkçiçəyi
Basque common name: irabelar
Catalan common names: acònit blau, escanyallops, herba tora, herba verinosa, matallops blau, siuet o sivet, tora, tora blava, xiuet
Czech common name: oměj šalamounek
Danish common names: blå stormhat, blå venusvogn, stormhat, venusvogn, ægte stormhat ægte stormhat ægte stormhat, ægte stormhat
Dutch common names: blauwe monnikskap, duivelskruid, monnikskap, monnikskapsoort, gewone akoniet
Esperanto common names: blua akonito, akonito blua, akonito napela, kaskofloro blua
Estonian common name: sinine käoking
Finnish common names: ukonhattu, aitoukonhattu
French common names: aconit napel, capuchon-de-moine, casque bleu, casque de jupiter, char de vénus, napel
German common names: blauer Eisenhut, blaue Mönchskappe, echter Eisenhut, echter Sturmhut, Eisenhut, Fischerkappe, Fuchswurz, Gifthut, Giftkraut, Mönchshut, Reiterkappe, Sturmhut, Tübeli, Venuswagen, Wolfskraut, Wolfswurz, Würgling, Ziegentod
Hungarian common names: havasi sisakvirág, kék sisakvirág
Icelandic common names: bláhjálmur, venusarvagn, venusvagn
Irish common name: dáthabha, dáthabha-dubh
Italian common names: aconito napello, aconitum napellus, erba luparia
Kurdish common name: çirnûkê gur
Latvian common name: zilā kurpīte
Lithuanian common name: mėlynoji kurpelė
Malayalam common name: വത്സനാഭി
Nepali common name: madhu bikh
Norwegian common names: storhjelm , venusvogn
Persian common name: اقونیطون
Polish common names: tojad mocny, tojad, tojam mocny
Portuguese common name: acônito (continental and Brazilian)
Russian common names: боре́ц клобучко́вый, аконит, акони́т клобучко́вый, борец клобучковый, садовый аконит
Scottish Gaelic common names: currac-sagairt, currac-manaich, flùr an t-sagairt, tàthabha (generic term for many poisonous plants), fuath-mhadaidh, fuath a' mhadaidh, tàthabha-dubh
Slovak common name: prilbica modrá
Slovenian common names: preobjeda repičasta, repičasta preobjeda
Spanish common names: acónito común, acónito, aconitum napellus, acotnito, anapelo, matalobos, nabillo del diablo, napelo
Swedish common name: äkta stormhatt
Turkish common names: boğanotu, kaplanboğanotu, migferotu
Welsh common names: cwcwll y mynach, bleidd-dag, cwfl y mynach, llysiau'r blaidd
Aconite is derived from the Greek name for the plant, ἀκόνιτον (akóniton). This literally means, "without struggle or without dust" (κόνις = dust). It may be derived from the ancient name of the city of Acona in Turkey, related to the Greek word akona, "rock," possibly related to the predilection of the herb for growing near rocky hills and mountains (Benigni et al. 1971). It was Latinized as Aconitum. The species name napellus is <Latin and means "small turnip," describing the shape of the root. The species name carmichaelii is after J. R. Carmichael (1838–1870), an English physician and plant collector who also worked as a Christian missionary in China. The species name kusnezoffii is after Russian botanist Nikolai Kuznetsov (1864–1932).
Latin synonyms:
Current correct Latin binomial: Aconitum columbianum Nutt
Aconitum arizonicum Greene
Aconitum bakeri Greene
Aconitum geranioides Greene
Aconitum glaberrimum Rydb
Aconitum leibergii Greene
Aconitum lutescens A Nelson
Aconitum macilentum Greene
Aconitum mogollonicum Greene
Aconitum nivatum A Nelson
Aconitum obtusiflorum Greene
Aconitum ochroleucum Rydb
Aconitum oregonsense Raf
Aconitum patens Rydb
Aconitum platysepalum Greene
Aconitum porrectum Rydb
Aconitum ramosum A Nelson
Aconitum robertianum Greene
Aconitum subcaesium Greene
Aconitum tricorne Greene
Aconitum vestitum Greene
Native American Common Names: none identified
Current correct Latin binomial: Acontium napellus L
Aconitum ampliflorum Rchb
Aconitum anglicum Stapf
Aconitum confertum Rchb
Aconitum fornicatum Gilib
Aconitum funckii Rchb
Aconitum grandiflorum Pall
Aconitum halleri Rchb
Aconitum microstachyum Rchb
Aconitum neubergense DC
Aconitum spicatum Donn
Aconitum venustum Rchb
Aconitum willdenowii Rchb
Delphinium napellus Baill
Napellus vulgaris Fourr
English common names: monkshood, monks-hood, monk’s-hood, monk's blood, monk's hood (all referring to shape of the flower), aconite, auld wife's huid, bear's-foot, blue rocket, European blue-monkshood, friar's cap, garden monk's-hood, garden monkshood, helmet flower, Turk's-cap, Venus' chariot, wolf's bane, wolfsbane, devil's helmet
Albanian common name: spineri
Arabic common names: بيش, قاتل النمر, هلهل
Azerbaijani common name: turpabənzər kəpənəkçiçəyi
Basque common name: irabelar
Catalan common names: acònit blau, escanyallops, herba tora, herba verinosa, matallops blau, siuet o sivet, tora, tora blava, xiuet
Czech common name: oměj šalamounek
Danish common names: blå stormhat, blå venusvogn, stormhat, venusvogn, ægte stormhat ægte stormhat ægte stormhat, ægte stormhat
Dutch common names: blauwe monnikskap, duivelskruid, monnikskap, monnikskapsoort, gewone akoniet
Esperanto common names: blua akonito, akonito blua, akonito napela, kaskofloro blua
Estonian common name: sinine käoking
Finnish common names: ukonhattu, aitoukonhattu
French common names: aconit napel, capuchon-de-moine, casque bleu, casque de jupiter, char de vénus, napel
German common names: blauer Eisenhut, blaue Mönchskappe, echter Eisenhut, echter Sturmhut, Eisenhut, Fischerkappe, Fuchswurz, Gifthut, Giftkraut, Mönchshut, Reiterkappe, Sturmhut, Tübeli, Venuswagen, Wolfskraut, Wolfswurz, Würgling, Ziegentod
Hungarian common names: havasi sisakvirág, kék sisakvirág
Icelandic common names: bláhjálmur, venusarvagn, venusvagn
Irish common name: dáthabha, dáthabha-dubh
Italian common names: aconito napello, aconitum napellus, erba luparia
Kurdish common name: çirnûkê gur
Latvian common name: zilā kurpīte
Lithuanian common name: mėlynoji kurpelė
Malayalam common name: വത്സനാഭി
Nepali common name: madhu bikh
Norwegian common names: storhjelm , venusvogn
Persian common name: اقونیطون
Polish common names: tojad mocny, tojad, tojam mocny
Portuguese common name: acônito (continental and Brazilian)
Russian common names: боре́ц клобучко́вый, аконит, акони́т клобучко́вый, борец клобучковый, садовый аконит
Scottish Gaelic common names: currac-sagairt, currac-manaich, flùr an t-sagairt, tàthabha (generic term for many poisonous plants), fuath-mhadaidh, fuath a' mhadaidh, tàthabha-dubh
Slovak common name: prilbica modrá
Slovenian common names: preobjeda repičasta, repičasta preobjeda
Spanish common names: acónito común, acónito, aconitum napellus, acotnito, anapelo, matalobos, nabillo del diablo, napelo
Swedish common name: äkta stormhatt
Turkish common names: boğanotu, kaplanboğanotu, migferotu
Welsh common names: cwcwll y mynach, bleidd-dag, cwfl y mynach, llysiau'r blaidd
Aconite is derived from the Greek name for the plant, ἀκόνιτον (akóniton). This literally means, "without struggle or without dust" (κόνις = dust). It may be derived from the ancient name of the city of Acona in Turkey, related to the Greek word akona, "rock," possibly related to the predilection of the herb for growing near rocky hills and mountains (Benigni et al. 1971). It was Latinized as Aconitum. The species name napellus is <Latin and means "small turnip," describing the shape of the root. The species name carmichaelii is after J. R. Carmichael (1838–1870), an English physician and plant collector who also worked as a Christian missionary in China. The species name kusnezoffii is after Russian botanist Nikolai Kuznetsov (1864–1932).
Latin synonyms:
Current correct Latin binomial: Aconitum columbianum Nutt
Aconitum arizonicum Greene
Aconitum bakeri Greene
Aconitum geranioides Greene
Aconitum glaberrimum Rydb
Aconitum leibergii Greene
Aconitum lutescens A Nelson
Aconitum macilentum Greene
Aconitum mogollonicum Greene
Aconitum nivatum A Nelson
Aconitum obtusiflorum Greene
Aconitum ochroleucum Rydb
Aconitum oregonsense Raf
Aconitum patens Rydb
Aconitum platysepalum Greene
Aconitum porrectum Rydb
Aconitum ramosum A Nelson
Aconitum robertianum Greene
Aconitum subcaesium Greene
Aconitum tricorne Greene
Aconitum vestitum Greene
Native American Common Names: none identified
Interchangeability of Species
Many, probably all, aconite species are medicinal, with varying degrees of potency and potential toxicity. The best understood of all these species is Aconitum carmichaelii. It has a long record of use in traditional Asian medicine, and in particular is the basis of the knowing that cooked lateral roots are much safer to use than fresh or dried lateral or main roots. Overall, there is much better, clearer scientific and traditional information about this species, making it the primary species recommended for use.
A. kusnezoffii has also been used in traditional Asian medicine, though it is considered much more potent and thus toxic than A. carmichaelii. Its use is not recommended.
The standard species used in Europe is A. napellus. Information about it is much less clear, though fairly abundant, and so it is considered at best a second-tier choice after A. carmichaelii.
Aconitum columbianum, native to the mountains of the Pacific Northwest, is also available and is moderately less potent than A. napellus. Again, due to severe lack of clear information, this species is not recommended for use.
A. kusnezoffii has also been used in traditional Asian medicine, though it is considered much more potent and thus toxic than A. carmichaelii. Its use is not recommended.
The standard species used in Europe is A. napellus. Information about it is much less clear, though fairly abundant, and so it is considered at best a second-tier choice after A. carmichaelii.
Aconitum columbianum, native to the mountains of the Pacific Northwest, is also available and is moderately less potent than A. napellus. Again, due to severe lack of clear information, this species is not recommended for use.
Advanced Clinical Information
Additional Actions:
In rats, the Sichuan aconite portion of the formula gosha-jinki-gan decreased bladder sensation by stimulating κ-opioid receptors, and did not affect bladder contractility and thus force of the urine stream (Gotoh, et al. 2004).
Diterpenoid alkaloids from aconite are believed to act primarily by activating sodium channels in excitable cells, notably neurons, cardiac myocytes, and skeletal myocytes, thereby inhibiting repolarization (Jouglard et al, 1977). This tends to induce excessive parasympathetic activity, which can cause nausea, vomiting, paresthesias, hypotension, and bradycardia. However, many other complex actions of these compounds on alpha-adrenergic and other receptors have been demonstrated (Isono, et al. 1994).
Additional Indications:
Herbalist Michael Moore has utilized processed root tincture of western aconite to help some people withdraw from amphetamines and cocaine. He has also used this product for treating people with chronic allergies not responding to other treatments.
A human trial has shown that fu zi increases nitric oxide production, perhaps leading to vasodilation and explaining its use for "cold" syndromes with poor cirulation in traditional Asian medicine (Yamada, et al. 2005).
Allapinin (allapinine) is a semi-synthetic derivative of the diterpenoid alkaloid aconitine developed in Russia. It has been used successfully to treat various types of arrhythmias in clinical trials, such as atrial fibrillation (Kadyrova, et al. 1990).
Intravenous injection of 100 ml of a solution containing 800 mcg ginsenoside and 1.8 mcg aconitine per ml, mixed with 500 ml of 5% glucose (known as shenfu injection), into patients with aplastic anemia, along with stanozol and cyclosporin A, was not significantly different than stanozol and cyclosporin A alone in treating patients with aplastic anemia (Wang, et al. 2005).
In several places in China, A. carmichaelii roots are actually consumed as a root vegetable (Kang, et al. 2012). In all documented cases, it is cooked for a very long time, until any mouth- or tongue-numbing properties are lost.
Advanced Chemistry:
Maximum allowed diester alkaloid content in aconite in the Chinese Pharmacopoeia is 0.01%.
Monoester alkaloids are 100 times less toxic and less potent than diester alkaloids (Singhuber, et al. 2009; Wada, et al. 2005).
Alkylolamines (non-ester) alkaloids are essentially non-toxic but also inactive (Singhuber, et al. 2009; Wada, et al. 2005).
Those aconite diterpenoid alkaloids with aroyloxy group at R4 position (and of significantly lower molecular weight), including N-deacetyllappaconitine, lappaconitine, ranaconitine, N-deacetylfinaconitine, and N-deacetylranaconitine, were far less toxic yet still significantly anesthetic compared to alkaloids with an aroyl/aroyloxy group at the R14 position, including yunaconitine, bulleyaconitine, aconitine, beiwutine, nagarine, 3-acetyl aconitine, and penduline (Bello-Ramirez and Nava-Ocampo 2004).
Overdose Case Reports:
A 21-year-old French man took 3 caps with 237 mg root (containing 19 mcg aconitine in total) to sleep. He awoke in 5 h with general paresthesia, nausea, diarrhea, vertigo, dyspnea, chest pain, and dyschromatopsia (disrupted color vision). He went to the emergency room 7 h after ingestion, and was shown to have bradycardia with ventricular arrhythmia. He was treated with 1 g intravenous magnesium. Within 13 h all cardiovascular and neurological symptoms cleared (Moritz, et al. 2005).
A healthy 25-year-old Canadian man ate some Aconitum napellus flowers (believed to be a case of mistaken plant identification) while hiking on an uninhabited island off the coast of Newfoundland. Approximately 2.5 h later he developed nausea and abdominal pain, and 30 min after that he vomited. Approximately 45 min later he suddenly collapsed and could not be resuscitated, consistent with ventricular arrhythmia (though this could not be formally diagnosed). Necropsy revealed cyanotic nail beds, severe congestion of all internal organs, and severe intrapulmonary bleeding and edema. His postmortem blood level of aconitine was 3.6 mcg/L with a urine level of 149 mcg/L (Pullela, et al. 2008).
A previously healthy 39-year-old Dutch man ate a homemade salad of wild greens (mistaking Aconitum napellus for celery) and developed sweating, paresthesias in his tongue and hands, nausea, vomiting, and severe diarrhea (Weijters, et al. 2008). He had profound hypotension and ventricular tachycardia (heart rate 220 beats/min). Several attempts at cardioversion were unsuccessful and he progressed to ventricular fibrillation and required resuscitation with intravenous epinephrine, magnesium 5 g, and amiodarone 450 mg. Within 12 h he had completely recovered.
In rats, the Sichuan aconite portion of the formula gosha-jinki-gan decreased bladder sensation by stimulating κ-opioid receptors, and did not affect bladder contractility and thus force of the urine stream (Gotoh, et al. 2004).
Diterpenoid alkaloids from aconite are believed to act primarily by activating sodium channels in excitable cells, notably neurons, cardiac myocytes, and skeletal myocytes, thereby inhibiting repolarization (Jouglard et al, 1977). This tends to induce excessive parasympathetic activity, which can cause nausea, vomiting, paresthesias, hypotension, and bradycardia. However, many other complex actions of these compounds on alpha-adrenergic and other receptors have been demonstrated (Isono, et al. 1994).
Additional Indications:
- Amphetamine or cocaine withdrawal
- Allergies, chronic
- Benign prostatic hyperplasia
- Cold syndromes (Yamada, et al. 2005)
Herbalist Michael Moore has utilized processed root tincture of western aconite to help some people withdraw from amphetamines and cocaine. He has also used this product for treating people with chronic allergies not responding to other treatments.
A human trial has shown that fu zi increases nitric oxide production, perhaps leading to vasodilation and explaining its use for "cold" syndromes with poor cirulation in traditional Asian medicine (Yamada, et al. 2005).
Allapinin (allapinine) is a semi-synthetic derivative of the diterpenoid alkaloid aconitine developed in Russia. It has been used successfully to treat various types of arrhythmias in clinical trials, such as atrial fibrillation (Kadyrova, et al. 1990).
Intravenous injection of 100 ml of a solution containing 800 mcg ginsenoside and 1.8 mcg aconitine per ml, mixed with 500 ml of 5% glucose (known as shenfu injection), into patients with aplastic anemia, along with stanozol and cyclosporin A, was not significantly different than stanozol and cyclosporin A alone in treating patients with aplastic anemia (Wang, et al. 2005).
In several places in China, A. carmichaelii roots are actually consumed as a root vegetable (Kang, et al. 2012). In all documented cases, it is cooked for a very long time, until any mouth- or tongue-numbing properties are lost.
Advanced Chemistry:
Maximum allowed diester alkaloid content in aconite in the Chinese Pharmacopoeia is 0.01%.
Monoester alkaloids are 100 times less toxic and less potent than diester alkaloids (Singhuber, et al. 2009; Wada, et al. 2005).
Alkylolamines (non-ester) alkaloids are essentially non-toxic but also inactive (Singhuber, et al. 2009; Wada, et al. 2005).
Those aconite diterpenoid alkaloids with aroyloxy group at R4 position (and of significantly lower molecular weight), including N-deacetyllappaconitine, lappaconitine, ranaconitine, N-deacetylfinaconitine, and N-deacetylranaconitine, were far less toxic yet still significantly anesthetic compared to alkaloids with an aroyl/aroyloxy group at the R14 position, including yunaconitine, bulleyaconitine, aconitine, beiwutine, nagarine, 3-acetyl aconitine, and penduline (Bello-Ramirez and Nava-Ocampo 2004).
Overdose Case Reports:
A 21-year-old French man took 3 caps with 237 mg root (containing 19 mcg aconitine in total) to sleep. He awoke in 5 h with general paresthesia, nausea, diarrhea, vertigo, dyspnea, chest pain, and dyschromatopsia (disrupted color vision). He went to the emergency room 7 h after ingestion, and was shown to have bradycardia with ventricular arrhythmia. He was treated with 1 g intravenous magnesium. Within 13 h all cardiovascular and neurological symptoms cleared (Moritz, et al. 2005).
A healthy 25-year-old Canadian man ate some Aconitum napellus flowers (believed to be a case of mistaken plant identification) while hiking on an uninhabited island off the coast of Newfoundland. Approximately 2.5 h later he developed nausea and abdominal pain, and 30 min after that he vomited. Approximately 45 min later he suddenly collapsed and could not be resuscitated, consistent with ventricular arrhythmia (though this could not be formally diagnosed). Necropsy revealed cyanotic nail beds, severe congestion of all internal organs, and severe intrapulmonary bleeding and edema. His postmortem blood level of aconitine was 3.6 mcg/L with a urine level of 149 mcg/L (Pullela, et al. 2008).
A previously healthy 39-year-old Dutch man ate a homemade salad of wild greens (mistaking Aconitum napellus for celery) and developed sweating, paresthesias in his tongue and hands, nausea, vomiting, and severe diarrhea (Weijters, et al. 2008). He had profound hypotension and ventricular tachycardia (heart rate 220 beats/min). Several attempts at cardioversion were unsuccessful and he progressed to ventricular fibrillation and required resuscitation with intravenous epinephrine, magnesium 5 g, and amiodarone 450 mg. Within 12 h he had completely recovered.
Botanical Information
Botanical Description: The root of Aconitum napellus tends to be a dark brown, conical tuber with smaller side roots. In cross section, there is usually a distinct gray-white cortex and white medulla separated by a cambrial line that looks like a star with 5–7 arms.
Aconitum columbianum is a perennial subshrub reaching 20 dm in height. Upper leaves are usually deciduous. The leaves are deeply divided, up to 15 cm long and wide, with lobes wedge-shaped and irregularly toothed above the midpoint of the wedges. Flowers have deep purple, white, or yellow-green sepals with hood shape (seen laterally). The fruit is glabrous. It flowers in the summer.
Native range:
A. napellus is native to mountainous regions of central Europe and Asia. Humans spread it into southern Britain.
A. columbianum is native from British Columbia to New Mexico, as far east as South Dakota. Note that none is found on the Olympic peninsula in Washington state, only in the Cascades and possibly other mountainous areas.
Aconitum columbianum is a perennial subshrub reaching 20 dm in height. Upper leaves are usually deciduous. The leaves are deeply divided, up to 15 cm long and wide, with lobes wedge-shaped and irregularly toothed above the midpoint of the wedges. Flowers have deep purple, white, or yellow-green sepals with hood shape (seen laterally). The fruit is glabrous. It flowers in the summer.
Native range:
A. napellus is native to mountainous regions of central Europe and Asia. Humans spread it into southern Britain.
A. columbianum is native from British Columbia to New Mexico, as far east as South Dakota. Note that none is found on the Olympic peninsula in Washington state, only in the Cascades and possibly other mountainous areas.
Harvest, Cultivation, and Ecology
Cultivation:
Wildcrafting:
Ecological Status:
Wildcrafting:
Ecological Status:
References
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