Kava, kavapyrones and toxic liver injury

Zeitschrift für Gastroenterologie
Rolf Teschke

Abstract

Kava extracts are obtained from the rhizoma of the kava shrub (Piper methysticum) and contain various pyrones which are used as herbal anxiolytic remedies for generalized anxiety syndromes of low and intermediate grades. The commonly recommended daily dose of 60-120 mg kavapyrones and the duration of the therapy of up to 3 months should not be increased without consultation of a physician and were not followed by most patients, since herbal drugs are considered by the population not only as effective but also as safe. Whereas kava extracts are well tolerated by most patients and rare side effects are rapidly reversible upon drug discontinuation, there are suspected hepatotoxic reactions reported during the last years in temporal and not necessarily causal association with a therapy with kava extracts. Almost 80 % of the patients took kavapyrones in overdose (maximally 480 mg/d) and/or for a prolonged time of more than 3 months up to 2 years. Additional risks factors include co-medication with up to 5 other chemically defined or herbal drugs with in part potentially hepatotoxic properties as well as a genetic deficiency of the hepatic microsomal cytochrome P450 2D6. Severe clinical courses with liver transplantation and possible...Continue Reading

Citations

Nov 2, 2004·Nature Reviews. Immunology·Martin H Goldrosen, Stephen E Straus
May 16, 2007·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Amy C BrownJonathan D Baker
Feb 5, 2009·Journal of Travel Medicine·Stefan U ChristlDirk Seeler
Jun 16, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Alex SparreboomWilliam D Figg
May 29, 2004·Integrative Cancer Therapies·Keith I BlockMark N Mead

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