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Contraindications, Interactions, and Side Effects

Class 2d Externally; not for use on broken skin; Class 2b Internally (AHP). Commission E reports contraindications of hypersensitivity and adverse effects of local reactions. Contraindications of hypersensitivity to sesquiterpene lactones and adverse effects of allergic reactions also reported.

The tincture should not be applied in undiluted form (AEH). Irritant and allergic reactions from topical applications of arnica preparations. CAN caution that sesquiterpene lactones (SL), aromatic compounds widely distributed in certain plant families, with highest concentrations generally found in leaves and flowers, may cause dermatosis and GI tract irritation.

Sheep and cattle poisonings due to SL-containing species have been reported. Cases of allergic contact dermatosis in humans have also been reported (AHED1). “Arnica is poisonous if taken internally. It is irritant to mucous membranes and ingestion may result in fatal gastroenterosis, muscle paralysis (voluntary and cardiac), increase or decrease in pulse rate, palpitation of the heart, shortness of breath, and may even result in death” (CAN).

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It contains cardiotonic principles and an adrenaline-like pressor substance (CAN). Vomiting, rapid pulse, redness of the face, stinging pains, heart and respiratory dysfunction, cerebral symptoms, rigor, severe diarrhea, abdominal pains, and bloody expectoration result from abuse of the flower tincture or decoction as an abortifacient possibly fatal.

Conclusion

Children should not use internally or on open wounds (WAM). Because of the oxytocic sesquiterpene lactones, to be avoided when pregnant (BIS). Internal use not recommended anymore. Risk:benefit ratio probably not good. One fatal case resulted from ingestion of 70 g arnica tincture (SHT).

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