Related Experiment Video
Updated: Aug 2, 2026
11:14
Rapid High-throughput Species Identification of Botanical Material Using Direct Analysis in Real Time High Resolution Mass Spectrometry
Published on: October 2, 2016
Kava extracts: safety and risks including rare hepatotoxicity.
1Medical Department II, City Hospital Hanau, Teaching Hospital of the Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
Summary
Kava, used for anxiety, rarely causes liver damage. A review found only one probable case of kava-induced liver injury among 19 suspected patients in Germany.
Area of Science:
- Pharmacology
- Hepatology
- Ethnobotany
Background:
- Kava (Piper methysticum) is a South Pacific shrub used for its psychoactive beverage.
- Kava extracts are globally recognized herbal anxiolytics.
- Previous studies indicate kava is generally safe, with rare reports of hepatotoxicity.
Purpose of the Study:
- To critically analyze suspected cases of kava-induced liver injury in Germany.
- To assess the causal relationship between kava consumption and hepatotoxic side effects.
- To provide recommendations for regulatory authorities and healthcare providers.
Main Methods:
- Review of 19 suspected cases of kava-related liver toxicity reported in Germany.
- Causality assessment based on clinical data and re-exposure tests.
- Analysis conducted by the British regulatory authority (MCA) and the study authors.
Main Results:
- Only one out of 19 patients showed a probable causal link between kava treatment and liver disease.
- Another patient had a possible association, while 5 cases were unlikely or excluded.
- Data for 12 patients were insufficient for definitive causality assessment.
Conclusions:
- Kava extracts exhibit a low incidence of severe hepatotoxicity.
- Further data collection is recommended for 12 patients with insufficient information.
- Physicians and patients should remain vigilant for potential liver side effects and conduct thorough diagnostics.
Related Concept Videos
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
01:00Drug Toxicity: Overview
Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
01:24Drug Toxicity: Risk factors
Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
01:24Drug Toxicity: Dose-Dependent Reactions
Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
01:30Drug toxicity: Drug–Drug Interaction
Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...