Kava, Kava-Pyrone und toxische Leberschäden

摘要: Kava extracts are obtained from the rhizoma of kava shrub (Piper methysticum) and contain various pyrones which used as herbal anxiolytic remedies for generalized anxiety syndromes low intermediate grades. The commonly recommended daily dose 60-120 mg kavapyrones duration therapy up to 3 months should not be increased without consultation a physician were followed by most patients, since drugs considered population only effective but also safe. Whereas well tolerated patients rare side effects rapidly reversible upon drug discontinuation, there suspected hepatotoxic reactions reported during last years in temporal necessarily causal association with extracts. Almost 80 % took overdose (maximally 480 mg/d) and/or prolonged time more than 2 years. Additional risks factors include co-medication 5 other chemically defined or part potentially properties genetic deficiency hepatic microsomal cytochrome P450 2D6. Severe clinical courses liver transplantation possible fatal outcome occurred 7 long kavapyrones. Preventive measures therefore 120, maximally 210 per day 1 month, months, prescription physician. Laboratory test (ALT gamma-GT) done before therapy, alcohol consumption avoided. With these under treatment might minimized available via internet abroad severe consequences when taken medical supervision.