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Liver toxicity, allergic reaction, anaphylaxis [3] Kava: awa, kava-kava [4] Piper methysticum: Potentiates CNS sedatives, [3] chronic use might cause a reversible dry skin condition. [18] Khat: qat Catha edulis: Chronic liver dysfunction [3] [19] Kratom: Mitragyna speciosa: Hepatotoxicity [20] [19] Liquorice root Glycyrrhiza glabra
Kava or kava kava (Piper methysticum: Latin 'pepper' and Latinized Greek 'intoxicating') is a plant in the pepper family, native to the Pacific Islands. [1] The name kava is from Tongan and Marquesan, meaning 'bitter.’ [1] Other names for kava include ʻawa (), [2] ʻava (), yaqona or yagona (), [3] sakau (), [4] seka (), [5] and malok or malogu (parts of Vanuatu). [6]
Later analyses of the implicated drug materials and products revealed that medical kava extracts contain less than 45 ppm of this alkaloid, while the leaves contain about 0.2% (2000 ppm). Based on this retrospective study, pipermethystine is an unlikely cause for the observed hepatotoxicity of commercial kava preparations. [2]
Methysticin is one of the six major kavalactones found in the kava plant. [1] Research suggests that methysticin and the related compound dihydromethysticin have CYP1A1 inducing effects which may be responsible for their toxicity. [2]
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The herb kava has caused a number of cases of idiosyncratic liver injury, ranging everywhere from asymptomatic to fatal. Oral use of the antifungal ketoconazole has been associated with hepatic toxicity, including some fatalities; [ 10 ] however, such effects appear to be limited to doses taken over a period longer than 7 days.
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Kavalactones are a class of lactone compounds found in kava roots and Alpinia zerumbet (shell ginger). [1] and in several Gymnopilus, Phellinus and Inonotus fungi. [2] Some kavalactones are bioactive. They are responsible for the psychoactive, analgesic, euphoric and sedative effects of kava. [3] [4]
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