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Kava extracts: safety and risks including rare hepatotoxicity.
Phytomedicine. 2003; 10(5):440-6.P

Abstract

Kava is a perennial shrub native to some islands of the South Pacific and has been cultivated for centuries to prepare a psychoactive beverage from its rhizoma by means of extraction. Subsequently, kava extracts are commonly used as herbal anxiolytic drugs also in many other countries all over the world including European ones and the USA. Toxicological and clinical studies have shown that kava extracts are virtually devoid of toxic effects with the exception of rare hepatotoxic side effects reported in few patients. When assessed primarily by the British regulatory authority MCA but also by us, a critical analysis of the suspected cases (n = 19) in Germany reveals that only in 1 single patient a very probable causal relationship could be established between kava treatment and the development of toxic liver disease due to a positive result of an unscheduled reexposure test, whereas in another patient there might be a possible association. Out of the remaining 17 cases 12 patients were not yet assessable due to insufficient data and in 5 other cases a causal relationship was unlikely or could be excluded. The German regulatory authority might therefore well be advised to provide now additional information for those 12 patients with so far unsatisfactory data, facilitating a more appropriate assessment of causality. Nevertheless, in the meantime physicians and patients should continue to keep an eye on possible hepatotoxic side effects in the course of kava treatment, to stop the treatment alredy at first suspicion and to start with a careful diagnostic work up ruling out all other causes.

Authors+Show Affiliations

Medical Department II, City Hospital Hanau, Teaching Hospital of the Johann Wolfgang Goethe University, Frankfurt/Main, Germany.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12834011

Citation

Teschke, R, et al. "Kava Extracts: Safety and Risks Including Rare Hepatotoxicity." Phytomedicine : International Journal of Phytotherapy and Phytopharmacology, vol. 10, no. 5, 2003, pp. 440-6.
Teschke R, Gaus W, Loew D. Kava extracts: safety and risks including rare hepatotoxicity. Phytomedicine. 2003;10(5):440-6.
Teschke, R., Gaus, W., & Loew, D. (2003). Kava extracts: safety and risks including rare hepatotoxicity. Phytomedicine : International Journal of Phytotherapy and Phytopharmacology, 10(5), 440-6.
Teschke R, Gaus W, Loew D. Kava Extracts: Safety and Risks Including Rare Hepatotoxicity. Phytomedicine. 2003;10(5):440-6. PubMed PMID: 12834011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kava extracts: safety and risks including rare hepatotoxicity. AU - Teschke,R, AU - Gaus,W, AU - Loew,D, PY - 2003/7/2/pubmed PY - 2003/8/6/medline PY - 2003/7/2/entrez SP - 440 EP - 6 JF - Phytomedicine : international journal of phytotherapy and phytopharmacology JO - Phytomedicine VL - 10 IS - 5 N2 - Kava is a perennial shrub native to some islands of the South Pacific and has been cultivated for centuries to prepare a psychoactive beverage from its rhizoma by means of extraction. Subsequently, kava extracts are commonly used as herbal anxiolytic drugs also in many other countries all over the world including European ones and the USA. Toxicological and clinical studies have shown that kava extracts are virtually devoid of toxic effects with the exception of rare hepatotoxic side effects reported in few patients. When assessed primarily by the British regulatory authority MCA but also by us, a critical analysis of the suspected cases (n = 19) in Germany reveals that only in 1 single patient a very probable causal relationship could be established between kava treatment and the development of toxic liver disease due to a positive result of an unscheduled reexposure test, whereas in another patient there might be a possible association. Out of the remaining 17 cases 12 patients were not yet assessable due to insufficient data and in 5 other cases a causal relationship was unlikely or could be excluded. The German regulatory authority might therefore well be advised to provide now additional information for those 12 patients with so far unsatisfactory data, facilitating a more appropriate assessment of causality. Nevertheless, in the meantime physicians and patients should continue to keep an eye on possible hepatotoxic side effects in the course of kava treatment, to stop the treatment alredy at first suspicion and to start with a careful diagnostic work up ruling out all other causes. SN - 0944-7113 UR - https://www.unboundmedicine.com/medline/citation/12834011/Kava_extracts:_safety_and_risks_including_rare_hepatotoxicity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0944-7113(04)70246-9 DB - PRIME DP - Unbound Medicine ER -