• Anemonic acid, anemonin, bear's-foot, cardioactive saponins, Christ Herbe, Christmas flower, Christmas herb, Christmas rose, Christmas rose plant, helleborein, helleborin, Helleborus niger, Helleborus nigra, melampode, protoanemoni, Ranunculin, ranunculosides, Ranunculaceae (family), saponins, sesquiterpene lactone glycosides, setter grass, setter wort, unsaturated lactone, winter rose.

• Black hellebore (Helleborus niger, Helleborus nigra) is a perennial plant, native to Central and Southern Europe, Greece, and Asia Minor, and is cultivated largely in the United States as a garden plant. Black hellebore is not the same as false hellebore, American hellebore, white hellebore, or other Veratrum species.
• Black hellebore is a poisonous plant that is toxic when taken in even small-to-moderate doses and should not be used without the supervision of a medical professional. It was formerly used for palsy, insanity, dropsy, and epilepsy but is seldom currently used for these or any other uses.

• Abortion inducing, amenorrhea (lack of menstruation), antispasmodic, bleeding, common cold, diuretic, edema, emetic, epilepsy, headache, heart disease, irregular menstrual cycles, kidney disease, laxative, lice, local anesthesia, menstrual flow stimulant, mental illness, nausea, neurological disorders, parasitic worm infections, psychological disorders.

Adults (18 years and older)

• There is no proven safe or effective dose for black hellebore. Black hellebore has been taken by mouth as a fluid extract, solid extract, powered root, or decoction. Black hellebore is known to be toxic when taken in even small-to-moderate doses and should not be used without the supervision of a medical professional.

Children (under 18 years old)

• There is no proven safe or effective dose for black hellebore, and use in children is not recommended.

Allergies

• Avoid in patients with a known allergy or sensitivity to black hellebore, its constituents, or members of the Ranunculaceae family.

Side Effects and Warnings

• Black hellebore should only be used under supervision of a medical professional due to its potential toxic effects.
• Symptoms of black hellebore poisoning include scratchy throat or mouth, salivation, nausea, vomiting, diarrhea, dizziness, shortness of breath, heart rate or heart rhythm changes, and suffocation. Black hellebore may cause irritation, bruises, redness of the skin or inflammation when the skin comes in contact with the fresh plant.
• Avoid in patients with heart disease or stomach irritation.

Pregnancy and Breastfeeding

• Avoid in pregnant or breastfeeding women. Black hellebore may have abortion inducing properties.

Interactions with Drugs

• Black hellebore may have additive effects with heart stimulants (digoxin), heart depressants (quinine), diuretics, laxatives, drugs used for the stomach, or narcotics.

Interactions with Herbs and Dietary Supplements

• Black hellebore may have additive effects with heart stimulants (Foxglove, Digitalis spp.), heart depressants (Cinchona pubscens), diuretics (horsetail, licorice), laxatives, or herbs and supplements used for the stomach.

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

1. Schep, LJ, Schmierer, DM, and Fountain, JS. Veratrum poisoning. Toxicol Rev. 2006;25(2):73-78.