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Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
Kava hepatotoxicity: a European view.
Rolf Teschke1, Alexander Schwarzenboeck, Ahmet Akinci
1Department of Internal Medicine II, Klinikum Hanau, Teaching Hospital of the Johann Wolfgang Goethe University of Frankfurt/Main, Leimenstrasse 20, D-63450 Hanau, Germany. rolf_teschke@klinikum-stadt-hanau.de
The New Zealand Medical Journal
|October 9, 2008
Summary
Kava hepatotoxicity, though rare, emerged in 1998. Risk factors include overdose, prolonged use, and other medications, prompting a need for quality control and standardized kava extract production.
Area of Science:
- Phytochemistry and Toxicology
- Pharmacovigilance
- Herbal Medicine Regulation
Background:
- Kava (Piper methysticum) was historically considered safe until reports of liver injury (hepatotoxicity) surfaced in 1998.
- Hepatotoxicity cases were linked to kava extracts, with varying extraction methods and co-medications playing a role.
Purpose of the Study:
- To investigate the causality and risk factors associated with kava-induced hepatotoxicity.
- To address concerns regarding the quality of kava raw material and extract production.
- To propose strategies for improving kava product safety and regulatory oversight.
Main Methods:
- Review of reported hepatotoxicity cases linked to kava consumption.
- Analysis of patient data, including kava dosage, duration of use, and co-medications.
- Examination of regulatory guidelines and quality control measures for kava extracts.
Main Results:
- Kava hepatotoxicity appears rare, with identified risk factors including overdose, prolonged use, and polypharmacy (use of multiple medications).
- Cases were associated with both ethanolic/acetonic and aqueous kava extracts across multiple countries.
- Concerns exist regarding the quality of kava raw material and the lack of standardized production guidelines.
Conclusions:
- Standardized methodologies for quality control in kava extract production are crucial for ensuring safety.
- Clear regulatory guidelines, physician awareness, and manufacturer/producer accountability are needed.
- Medical advisories on product labeling are recommended to inform consumers about potential risks.
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