Cedar leaf oil poisoning

The substance in cedar leaf oil that can be harmful is thujone (a hydrocarbon).

Cedar leaf oil is used in:

• Some furniture polishes
• Some homeopathic medicines
• Thuja oil

Below are symptoms of cedar leaf oil poisoning in different parts of the body.

EYES, EARS, NOSE, AND THROAT

• Loss of vision
• Severe pain in the throat
• Severe pain or burning in the nose, eyes, ears, lips, or tongue

STOMACH AND INTESTINES

• Abdominal pain
• Blood in the stool
• Chest pain from burns of the esophagus
• Painful or swallowing difficulty
• Vomiting
• Vomiting blood

HEART AND BLOOD VESSELS

• Collapse
• Low blood pressure and weakness which develop rapidly

LUNGS AND AIRWAYS

• Breathing difficulty
• Throat swelling (may also cause breathing difficulty)

NERVOUS SYSTEM

• Coma (decreased level of consciousness and lack of responsiveness)
• Seizures (convulsions)
• Stupor (decreased level of consciousness)

SKIN

• Burn
• Irritation

Seek medical help right away. Do not make the person throw up unless poison control or a health care provider tells you to. If the oil is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the person swallowed the oil, give them water or milk right away, unless a provider tells you not to. Do not give anything to drink if the person has symptoms that make it hard to swallow. These include vomiting, convulsions, or a decreased level of alertness.

Have this information ready:

• Person's age, weight, and condition
• Name of the product (ingredients, if known)
• Time it was swallowed
• Amount swallowed

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container to the hospital with you, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.

The person may receive:

• Blood and urine tests
• Breathing support, including a tube through the mouth into the lungs, and a breathing machine (ventilator)
• Bronchoscopy: camera placed down the throat to look for burns in the airways and lungs
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)
• Endoscopy: camera placed down the throat to look for burns in the esophagus and the stomach
• Fluids through the vein (by IV)
• Medicine to treat symptoms
• Washing of the skin (irrigation), perhaps every few hours for several days

How well someone does depends on how much cedar leaf oil they swallowed and how quickly they receive treatment. The faster medical help is given, the better the chance for recovery.

Delayed injury may occur, including a hole forming in the throat, esophagus, or stomach. This can lead to severe bleeding and infection. Surgery may be needed to treat these complications.

Graeme KA. Toxic plant ingestions. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 65.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Wang GS, Buchanan JA. Hydrocarbons. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 147.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.