WHO monographs on selected medicinal plants - travolekar.ru

Oleum Ricini
Adverse reactions
Exanthema may occur. In this case, treatment with the oil should be discontinued
and should not be used again. Furthermore, castor oil may
cause stomach upset, and at higher doses nausea, vomiting, painful abdominal
cramps and severe diarrhoea with loss of water and electrolytes.
In this case it is necessary to reduce the dosage or to discontinue use of the
oil. Continuous use and misuse may increase fluid and electrolyte loss,
requiring intravenous rehydration and replacement of electrolytes. Excessive
potassium loss may lead to disorders of heart function and muscle
weakness (21).
A 26-year-old woman, who had had recurrent vulvo-vaginitis for
1 year, was treated with a topical pessary of meclocycline sulfosalicylate.
After a 7-day treatment period, the following symptoms appeared: oedema
of the labia, widespread irregular abdominal dermatitis in the right
iliac fossa and numerous generalized small weals. These symptoms were
treated with dexchlorpheniramine maleate without results and it was necessary
to prescribe prednisone tablets. Patch tests at 4, 12, 24, 48 and 96 h
found a positive response to hydrogenated castor oil, with associated erythema,
infiltration and papules after 48 h.
There have been several reports of allergy to castor beans from which
castor oil is derived. Cases of asthma have been reported not only in
employees in the oil industry, but also in seamen and laboratory workers
exposed to the beans. Three important allergens from the crude drug
have been identified: a 2S storage albumin of 11 kDa, a 11S crystalloid
protein with bands at 50 kDa and a protein doublet of 47 and 51 kDa.
These allergens have been named Ric c 1, Ric c 2 and allergen 3. Castor
oil extractors, fertilizer workers and farmers may acquire occupational
dermatitis from handling plants or beans. Castor oil may be used in cosmetics,
particularly lipsticks, because of its superior moisturizing characteristics,
and may rarely produce allergic contact dermatitis. Sporadic
case-reports of allergy have implicated ricinoleic acid as the causative
agent (36).
A woman at 39 weeks gestation who had had a previous cesarean delivery
had severe abdominal pains and rupture of the membranes shortly
after ingesting 5 ml of castor oil. Forty-five minutes later, repetitive variable
decelerations prompted a cesarean delivery. During surgery, a portion
of the umbilical cord was found to be protruding from a 2-cm rupture
of the lower transverse scar (37).
Contact dermatitis and a number of cases of chelitis have also been
reported following exposure of patients to the crude drug (38, 39).
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