Hellebore, Black

Black hellebore, Christe herbe, Christmas rose, Helleborus niger, malampode

The active ingredients of black hellebore are obtained from the rhizome and root of HelIeborus niger. The whole black hellebore plant is considered poisonous. Black hellebore root contains glycosides with cardioactive properties similar to digitalis. It also contains saponins that can cause irritation to the mucous membranes. Topical application of the plant may cause serious skin irritation. Black hellebore is available as liquid extract, powder, and tincture.

Safety Risk Medicinal use isn’t recommended because of the poisonous nature of the black hellebore plant and its highly toxic adverse effects. Its use has been associated with arrhythmias, bradycardia, and respiratory failure.

Reported uses

Black hellebore is used to treat nausea, worm infestations, amenorrhea, and anxiety. It’s also used as a laxative and as an abortifacient. Because of its possible immunostimulatory effects, black hellebore is used as adjuvant therapy in cancer patients. It’s used in homeopathy to treat eclampsia, epilepsy, meningitis, encephalitis, and mental disorders.


The average daily dose in one source in 0.05 g, with a maximum single dose of 0.2 g.


Adverse reactions to black hellebore include dizziness, irregular pulse, blindness, burning sensations in the mouth and pharynx, increased salivation, sneezing, abdominal pain, diarrhea, nausea, VOmiting, and shortness of breath. Use With cardiac drugs such as antiarrhythmics, beta blockers, and cardiac glycosides could increase the potential for increased or decreased effects of these drugs. Increased sedation and respiratory depression may be seen with CNS depressants.

Clinical considerations

  • Advise patient that black hellebore is unsafe for use because it is toxic.
  • Advise patient to keep the herb away from children and pets.
  • Signs and symptoms of toxic reaction include burning of mouth and throat, inability to swallow, abdominal pain, cardiac abnormalities, seizures, impaired vision, nausea, shortness of breath, loss of consciousness, and paralysis. Monitor patient closely for adverse reactions.
  • Tell patient to notify pharmacist of any herbal or dietary supplement that he’s taking when obtaining a new prescription.
  • Advise patient to consult his health care provider before using an herbal preparation because a conventional treatment with proven efficacy may be available.

Research summary

The concepts behind the use of black hellebore and the claims made regarding its effects haven’t yet been validated scientifically.

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