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Name
Eucalyptus Oil

Scientific Name
Eucalyptus species

Scientific Family
Myrtaceae (myrtle)

Common Name(s)
Eucalypt; Eucalyptus; Gum tree; Neelgiri; Sugandh Patra

Related Information
Quercetin

Clinical Overview: Uses

Eucalyptus oil has been studied for potential CNS and respiratory effects. However, clinical information is
limited to recommend use for any indication.

Clinical Overview: Dosing

Eucalyptus oil at low concentrations is used for inhalation aromatherapy. Do not give orally; small amounts of
eucalyptus oil can be fatal when ingested orally.

Clinical Overview: Contraindications

Eucalyptus oil must not be taken orally and is contraindicated in cases of hypersensitivity to the oil or any of its
components.

Clinical Overview: Pregnancy/Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.
Clinical Overview: Interactions
See drug interactions database for more information.

Clinical Overview: Adverse Reactions

Information regarding potential adverse reactions is limited. Contact dermatitis has been reported, as well as
hypersensitivity pneumonitis–induced hypercalcemia.

Clinical Overview: Toxicology

Toxicity of eucalyptus oil has been documented following oral ingestion, but poisoning can also occur by
inhalation, intranasal instillation, and massage.

Botany
The Eucalyptus genus includes approximately 900 species and subspecies of shrubs and tall trees in the myrtle
family (Myrtaceae) that are native to Australia, Tasmania, and nearby islands. However, it is cultivated in many
areas of the world with subtropical and Mediterranean climates. The Greek origin of the name translates to
"well-covered" and refers to the eucalyptus seed pods.(Ref)
Eucalypti, commonly known in Australia as gum tree or stringybark tree, grow rapidly, with giant gum tree
(Eucalyptus regnans) attaining a height of approximately 90 m and a circumference of 7.5 m. Many species
shed the outermost layer of bark as flakes or ribbons, whereas other species have thick and textured bark.
Most species are evergreen and have leathery leaves that hang obliquely or vertically. When the flower
expands, the petals cohere to form a cap. The fruit is surrounded by a woody cup-shaped receptacle that
contains numerous small seeds and can grow up to 5 to 6 cm in diameter.(Ref)
Though classification of the species Eucalyptus citriodora (lemon eucalyptus) was changed to Corymbia
citriodora in the mid-1990s, literature still refers to E. citriodora.(Ref)

History
Eucalyptus oil is considered one of the world's first traded oils, with E. citriodora oil ranked as the highest in
trade volume.(Ref)
Traditionally, the Australian Aboriginal people used eucalyptus leaves in the form of teas to treat fevers, colds,
and body aches. In 1788, the first distillation of Eucalyptus piperita was performed, and the essential oil was
used to treat respiratory conditions in convicts in an Australian settlement. The essential oil eventually became
known as Sidney peppermint and was a popular remedy for fevers and skin problems (ie, ulcers, burns,
wounds). By the 1880s, it had become a popular antiseptic in surgeries, and it gained peak use in the 1918 flu
pandemic.(Ref) Eucalyptus oil also has a long history of use as a repellent against insects, pests, and nematodes.
(Ref)
The main bioactive ingredient in eucalyptus oil (1,8-cineole) is a registered product in several European
countries, where it is known as Soledum forte capsules, and was registered in Germany in 2019 as Soledum
addicur capsules.(Ref)

Chemistry
At least 300 Eucalyptus species contain volatile oils in their leaves; Eucalyptus globulus (Tasmanian bluegum),
Eucalyptus polybractea, and Eucalyptus smithii are most commonly used for medicinal purposes due to the
high concentration of eucalyptol (1,8-cineole). Eucalyptol, the main bioactive monoterpene, is approximately
84% of the total essential oil for these 3 species. The constituents of the essential oils that make up another 5%
to 15% are limonene or limolene, alpha-pinene, cymene, alpha-terpinyl acetate, terpinene-4-ol, and/or alpha-
terpineol.(Ref)
Other Eucalyptus species providing oils used mainly for medicinal purposes are Eucalyptus maidenii,
Eucalyptus biscostata, Eucalyptus sideroxylon, Eucalyptus cinerea, Eucalyptus leucoxylon (yellow gum),
Eucalyptus caesia, Eucalyptus camaldulensis, Eucalyptus tereticornis, and Eucalyptus grandis. For the first 6
species, eucalyptol is the primary chemical constituent of the essential oils (range, 40% to 84%), whereas for
the last 3 species, gamma-terpinene (72.5%), beta-pinene (39.4%), and alpha-pinene (30.4%) are the main
compounds.(Ref) E. citriodora (lemon eucalyptus), Eucalyptus gamphocephala, Eucalyptus macarthurii, and
Eucalyptus staigeriana are common species used for oil of essence and aroma. Their respective major
components are beta-citronella (71.77%), dihydrocarveol acetate (50.82%), geranyl acetate (50.49%), and (+)-
limonene (28.82%).(Ref)

Pharmacokinetics
GI absorption of eucalyptus oil after oral administration is rapid and is thought to be enhanced by lipids and
milk. Metabolism is primarily oxidative and may require induction of the CYP-450 system. Elimination
appears to be mostly through the GI tract and lungs, with subsequent urinary excretion. After inhalation, 1,8-
cineole (which has also been found to exhibit CYP-450–inducing activity) is well absorbed, with peak plasma
levels reported at 18 minutes. A component of E. globulus essential oil, verbenone, was found to be
hydroxylated primarily by CYP2A6.(Ref)

Uses and Pharmacology

Potential pharmacological effects, described primarily via in vitro and animal studies, include activity against
malaria, diabetes, allergies, respiratory diseases, pain, and wound infections via antimicrobial, antiviral,
antiseptic, larvicidal, anti-inflammatory, antioxidant, analgesic, and cytotoxic mechanisms.(Ref)

Analgesic effects

Clinical data
Inhalation of eucalyptus oil 3 times daily for 1 month significantly improved mean pain severity scores
(P<0.001) as early as week 3 compared to placebo among 70 patients with rheumatoid arthritis randomly
assigned to treatment. Quality of life scores were also significantly improved in the eucalyptus group
compared to controls (P<0.001).(Ref)

Antimicrobial activity

In vitro data
Eucalyptus oil demonstrated antibacterial activity against multidrug-resistant strains of Pseudomonas
aeruginosa, Proteus vulgaris, Klebsiella pneumoniae, and Citrobacter koseri with minimum inhibitory
concentrations (MICs) of 1.25% for all except P. aeruginosa, which was 2.5%. Bactericidal activity was also
observed against all except P. aeruginosa (minimum bacterial concentrations, 1.25% each). MICs against
drug-resistant Candida albicans and 2 strains of C. parapsilosis were 2.5%.(Ref)

Antioxidant activity

In vitro and animal data

Total antioxidant activity of eucalyptus essential oil was dose-dependent and less than that of essential
oils from cassia, oregano, melaleuca, thyme, clove, and clary sage, but higher than arborvitae, lavender,
and lemongrass.(Ref)

Antiparasitic activity

Animal data
A nano-emulsion of eucalyptus oil showed activity against both larvae and eggs of the pathogenic and
drug-resistant sheep parasite Haemonchus contortus.(Ref)

Antiviral activity

Animal and in vitro data

Activity of Eucalyptus essential oils against herpes simplex viruses 1 and 2, influenza A virus, SARS-CoV-2,
mumps virus, coxsackieviruses B4 and B3 (strain Nancy), and rotavirus (strain Wa) has been
demonstrated via in vitro and/or animal models. Mechanisms of action included direct binding to free
virus (all viruses except SARS-CoV-2); binding with the virus surface hemagglutinin protein, thus
preventing binding of the virus to the host cell (influenza A); attenuation of pulmonary inflammatory
responses (influenza A); and interaction with the active site of Mpro (SARS-CoV-2).(Ref)

Cardiovascular effects

Clinical data
Neither expectations nor perceived pleasantness of inhaled eucalyptus oil (Eucalypti aetheroleum)
impacted any cardiovascular variables (ie, systolic and diastolic blood pressure, heart rate, heart rate
variability) in 33 volunteers enrolled in a double-blind, randomized crossover study.(Ref)

CNS effects

It has been suggested that active compounds from inhaled essential oils (including Eucalyptus oils) may
be absorbed through the nasal mucosa and impact neural activity directly after crossing the blood-brain
barrier; however, the full effect of essential oils on memory function, pain perception, alertness, and
mood has yet to be explained based solely on pharmacological effects. Effects may include changes in
mood evoked by odors, expectancy effects, and associative learning/conditioning effects.(Ref)
Clinical data
In a double-blind, randomized, crossover study conducted in 33 volunteers, inhalation of eucalyptus oil
(E. aetheroleum) significantly increased alertness compared with baseline (P<0.001) and compared with
lavender oil and rosemary oil (P<0.05 each). All 3 oils were perceived mainly as "pleasant" by participants.
Although expectations ranged from sedative to arousing for all oils, the average scores were in the
stimulant domain for eucalyptus and rosemary oils and in the sedative domain for lavender. Expectation
was a significant predictor for actual changes observed in alertness for rosemary and lavender oils but
not for eucalyptus oil. However, neither expectations nor perceived pleasantness impacted any
cardiovascular variables (ie, systolic and diastolic blood pressure, heart rate, heart rate variability).(Ref)
In a quasi-randomized pilot study in adult patients scheduled to undergo chemotherapy and randomly
assigned to essential oil inhalation aromatherapy (N=123), no significant differences in procedural pain or
anxiety scores were observed between eucalyptus (E. globulus) and control. In contrast, mean pain
scores were significantly lowered with lavender essential oil aromatherapy compared with control
(P<0.05).(Ref)

Insect repellent

Animal data
A systematic review of plant-based repellents against the malaria mosquito vector Anopheles species
identified 5 studies that reported on the effects of eucalyptus essential oil. The essential oils of narrow-
leafed eucalyptus (Eucalyptus radiata), lemon-scented eucalyptus (E. citriodora), and broad-leaved
eucalyptus (Eucalyptus dives) were effective against Anopheles stephensi for up to 8 hours. E. globulus oil
was effective against A. stephensi for 5.5 hours and against Anopheles dirus for 1.58 to 3.4 hours
depending on the concentrations or dose applied. Additionally, E. citriodora oil repelled Anopheles
minimus for 0.5 hours.(Ref) Another paper reported a mean complete-protection time of 120.1 minutes
(range, 60 to 217 minutes) against laboratory-raised Aedes aegypti mosquitos among 5 volunteers who
used eucalyptus oil repellents. The mean complete-protection time reported for comparators among 15
volunteers included DEET (301.5 minutes), ethyl butylacetylaminopropionate (IR3535; 22.9 minutes),
other botanical repellents (less than 20 minutes), and repellent-impregnated wristbands (no protection).
(Ref)

Respiratory effects

Clinical data
A systematic review identified 3 clinical studies conducted with 1,8-cineole (the major bioactive
compound of Eucalyptus oil) that demonstrated efficacy in patients diagnosed with severe bronchial
asthma and chronic obstructive pulmonary disease (COPD).(Ref) Another review of 1,8-cineole in asthma
and COPD described significant improvements in symptom scores in patients with acute nonpurulent
sinusitis as well as in patients with acute bronchitis after administration of 1,8-cineole compared with
placebo. Additionally, adjunctive use of 1,8-cineole significantly reduced prednisolone treatment
requirements by 36% in patients with severe steroid-dependent asthma and reduced the number of
COPD exacerbations by 38.5% in 2 other placebo-controlled trials.(Ref)
In a randomized experiment in healthy volunteers (N=106), eucalyptus oil (E. aetheroleum) aromatherapy
administered in a room at 1 drop per 1 m3 of air in 27 patients did not affect spirometry measures (ie,
forced vital capacity [FVC], FEV1:FVC ratio, peak expiratory flow) compared with the control group.
However, eucalyptus oil evoked a significantly higher positive expectation than controls (P<0.05).(Ref)
A review of herbal medicines traditionally used to relieve cold and flu symptoms, and which were listed by
a health authority in Europe or the Americas (eg, the WHO, European Medicines Agency, Brazilian
Pharmacopoea, Government of Canada) noted that E. globulus essential oil is indicated for cough related
to respiratory disease, as a respiratory antiseptic, and an expectorant due to the presence of 1,8-cineol.
Overall medium level clinical evidence was reported for eucalyptus essential oil for bronchitis and cough
but low for the herbal drug as a whole. In the context of COVID-19, E. globulus essential oil is considered
promising as an adjunctive treatment based on emerging evidence for efficacy and a reasonable safety
 profile. Safety is considered high overall; however 1,8-cineol-containing preparations should not be used
in children under 30 months of age due to the potential for laryngospasm. Dosing based on traditional
use is 1.5 to 3 g of dried leaves in 150 mL up to 4 times a day.(Ref)

Dosing
Eucalyptus oil at low concentrations is used for inhalation aromatherapy. Do not give orally; small amounts of
eucalyptus oil can be fatal when ingested orally.(Ref)

Pregnancy/Lactation
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions
None well documented.

Adverse Reactions
Information regarding potential adverse reactions is limited. Contact dermatitis on the face and hands
accompanied by rhinoconjunctivitis was reported in a 51-year-old female florist with a 4-month history of a
burning sensation on the hands when working with eucalyptus. Patch tests were positive to eucalyptus stem
and leaf but negative to eucalyptus oil 2%. The patient responded well to topical corticosteroids and tacrolimus
ointment.(Ref)
Hypersensitivity pneumonitis–induced hypercalcemia was reported in a 69-year-old female subsequent to 6-
month use of a eucalyptus oil diffuser for 5 to 6 hours every evening. It was suspected that the essential oil
caused unregulated 1 alpha-hydroxylase activity that led to severe hypercalcemia. Withdrawal of the inhaled
eucalyptus oil led to resolution of hypoxia, abnormal computed tomography findings, and hypercalcemia. The
patient's medical history was significant for lifelong antibiotic suppression therapy (levofloxacin) as a result of
back surgery hardware complications.(Ref)

Toxicology
Extreme toxicity of eucalyptus oil, predominantly following oral ingestion, is well documented dating back to as
early as 1898 and continuing through 2022. Retrospective analyses conducted in Canada and Australia in the
mid-1980s to mid-1990s identified eucalyptus oil or its presence in formulations as a predominant poisoning
agent in infants and children. Several cases of poisonings have also been documented via exposure to
eucalyptus oil by inhalation, intranasal instillation, and massage. Of note, historical standard pharmacopeias
from 1898 to 1977 specifically considered administration of low oral eucalyptus oil doses from 0.06 to 0.2 mL to
be safe.(Ref)
Symptoms of poisoning usually appear rapidly (ie, burning sensation in mouth/throat, abdominal pain,
spontaneous vomiting), with CNS symptoms initially presenting as giddiness, ataxia, and disorientation that are
soon followed by loss of consciousness within 10 to 15 minutes. Seizures are common in children and although
rare in adults, have been reported. In children, seizures can occur as first seizure or as breakthrough in patients
with pre-existing epilepsy and often develop within 10 minutes after ingestion, but generally CNS symptoms
occur within a range of 30 minutes to 4 hours; minor depression of consciousness can occur after ingestion of
2 to 3 mL and is usually significant with 5 mL or more. Death in adults is common after ingestion of 30 mL but
can occur after only 4 to 5 mL. However, some authors have noted no correlation between the presence of
symptoms and the amount of eucalyptus oil that was ingested, and asymptomatic presentation of children
who reportedly swallowed more than 30 mL has also been reported. Treatment is supportive and symptomatic;
stomach washes with normal saline followed by aspiration using a feeding tube and orally administered
ranitidine (to prevent later stage vomiting and dehydration) was used successfully in a 17-month-old infant who
accidentally ingested 0.5 mL of eucalyptus oil. Orotracheal intubation and gastric lavage along with antiseizure
medications and IV bicarbonate were used successfully in 2 adults who presented with seizures. Induction of
emesis is contraindicated due to the risk of aspiration in the context of likely CNS depression. However,
symptomatic vomiting may help eliminate the poison in the early stages. Activated charcoal is unlikely to be of
benefit due to the oil's wide distribution after ingestion.(Ref) Pooled analysis of 110 eucalyptus oil-induced
seizures (49 of which were children) reflected inhalation as the most common doseform inciting a response,
and generalized tonic-clonic seizures as the most commonly manifested type of seizure.(Ref) Recovery from
massive intentional overdose (500 to 1,000 mL) and coma in adults has also been reported.(Ref)

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