Medscape is available in 5 Language Editions – Choose your Edition here.


Castor Bean and Jequirity Bean Poisoning Follow-up

  • Author: William Gluckman, DO, MBA, FACEP; Chief Editor: Timothy E Corden, MD  more...
Updated: Apr 29, 2015

Further Outpatient Care

See the list below:

  • Maintain adequate hydration
  • Antispasmodics, such as loperamide, are contraindicated.

Further Inpatient Care

See the list below:

  • Whole bowel irrigation (WBI) is continued until the rectal effluent is clear or all of the beans have been recovered.
  • Continue intravenous (IV) fluids at a rate that maintains adequate hydration and replacement of electrolytes.
  • All symptomatic patients should be admitted to the hospital. Clinical course after ingestion and inhalation typically progresses over 4-36 hours, and monitoring in an ICU may be warranted.


See the list below:

  • Transfer children with severe systemic toxicity to a center that is capable of handling critically ill children.
  • Transfer should occur after the child has been stabilized and whole bowel decontamination has been initiated.


See the list below:

  • Keep all potentially poisonous and injurious plants and plant-related products away from children.
  • Homes should be purged of all potentially toxic plant items, just as they are for medications and cleaning supplies.
  • Specifically instruct children to never eat plants, beans, or wild berries.
  • Vaccine development has been attempted in animal studies, with evidence that either active immunization or passive prophylaxis is effective against IV or intraperitoneal intoxication only if given within a few hours of exposure. Vaccination is ineffective against aerosolized forms of the toxin.
  • Ricin toxin vaccine (RiVax; DOR BioPharma, Miami, FL) has been shown in one small pilot study to be safe; it elicited ricin neutralizing antibodies, but larger studies are needed.[4]


See the list below:



See the list below:

  • Prognosis for patients who develop symptoms is generally good with appropriate fluid management (and possibly with continuous WBI).
  • Studies are limited, and accurate statistics are not known.

Patient Education

See the list below:

  • Instruct parents or guardians to childproof homes from all potentially toxic plants and plant-related items.
Contributor Information and Disclosures

William Gluckman, DO, MBA, FACEP President and CEO, FastER Urgent Care

William Gluckman, DO, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Association for Physician Leadership

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Jeffrey R Tucker, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center

Disclosure: Received salary from Merck for employment.

Chief Editor

Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, Wisconsin Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

Michael E Mullins, MD Assistant Professor, Division of Emergency Medicine, Washington University in St Louis School of Medicine; Attending Physician, Emergency Department, Barnes-Jewish Hospital

Michael E Mullins, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians

Disclosure: Received stock ownership from Johnson & Johnson for none; Received stock ownership from Savient Pharmaceuticals for none.


Gregory S Sugalski, MD Staff Physician, Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey Hospital

Gregory S Sugalski, MD is a member of the following medical societies: American Medical Association and Emergency Medicine Residents Association

Disclosure: Nothing to disclose.


The authors would like to thank John Kashani, DO, FACEP, for his review and comments.

  1. Audi J, Belson M, Patel M, et al. Ricin poisoning: a comprehensive review. JAMA. 2005. Nov 9;294(18):2342-51. [Medline].

  2. Bronstein AC, Spyker DA, Cantilena LR Jr, Green J, Rumack BH, Heard SE. 2006 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS). Clin Toxicol (Phila). 2007 Dec. 45(8):815-917. [Medline].

  3. Røen BT, Opstad AM, Haavind A, Tønsager J. Serial ricinine levels in serum and urine after ricin intoxication. J Anal Toxicol. 2013 Jun. 37(5):313-7. [Medline].

  4. Doan LG. Ricin: mechanism of toxicity, clinical manifestations, and vaccine development. A review. J Toxicol Clin Toxicol. 2004. 42(2):201-8. [Medline].

  5. Challoner KR, McCarron MM. Castor bean intoxication. Ann Emerg Med. 1990 Oct. 19(10):1177-83. [Medline].

  6. Coopman V, De Leeuw M, Cordonnier J, Jacobs W. Suicidal death after injection of a castor bean extract (Ricinus communis L.). Forensic Sci Int. 2009 Aug 10. 189(1-3):e13-20. [Medline].

  7. Fernando C. Poisoning due to Abrus precatorius (jequirity bean). Anaesthesia. 2001 Dec. 56(12):1178-80. [Medline].

  8. Ferraz AC, Angelucci ME, Da Costa ML, et al. Pharmacological evaluation of ricinine, a central nervous system stimulant isolated from Ricinus communis. Pharmacol Biochem Behav. 1999 Jul. 63(3):367-75. [Medline].

  9. Jang DH, Hoffman RS, Nelson LS. Attempted suicide, by mail order: Abrus precatorius. J Med Toxicol. 2010 Dec. 6(4):427-30. [Medline].

  10. Kinamore PA, Jaeger RW, de Castro FJ. Abrus and ricinus ingestion: management of three cases. Clin Toxicol. 1980 Oct. 17(3):401-5. [Medline].

  11. Krenzelok EP, Jacobsen TD. Plant exposures ... a national profile of the most common plant genera. Vet Hum Toxicol. 1997 Aug. 39(4):248-9. [Medline].

  12. Lim H, Kim HJ, Cho YS. A case of ricin poisoning following ingestion of Korean castor bean. Emerg Med J. 2009 Apr. 26(4):301-2. [Medline].

  13. Navarro-Rouimi R, Charpin D. Anaphylactic reaction to castor bean seeds. Allergy. 1999 Oct. 54(10):1117. [Medline].

  14. Olsnes S. The history of ricin, abrin and related toxins. Toxicon. 2004. Sep 15;44(4):361-70. [Medline].

  15. Palatnick W, Tenenbein M. Hepatotoxicity from castor bean ingestion in a child. J Toxicol Clin Toxicol. 2000. 38(1):67-9. [Medline].

  16. Rauber A. Plantlore revisited. J Toxicol Clin Toxicol. 1999. 37(4):521-4. [Medline].

  17. Schwenk M, Kluge S, Jaroni H. Toxicological aspects of preparedness and aftercare for chemical-incidents. Toxicology. 2005. 214(3):232-48. [Medline].

  18. Spivak L, Hendrickson RG. Ricin. Crit Care Clin. 2005. Oct;21(4):815-24, viii. [Medline].

  19. Vitetta ES, Smallshaw JE, Coleman E, et al. A pilot clinical trial of a recombinant ricin vaccine in normal humans. Proc Natl Acad Sci USA. 2006. 103(7):2268-73. [Medline].

Castor bush.
Castor beans.
Jequirity bush.
Jequirity beans.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.