Kava-Kava

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 08.10.2024

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Synonym(s)

Kava-Kava; Kawa-Kawa; Kawap pepper; Peppers; piper methysticum

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DefinitionThis section has been translated automatically.

The kava is a plant species of the pepper genus (probably originally from New Guinea) from the pepper family (Piperaceae), which is an evergreen, shrub-like plant that grows to a height of around 3 meters. The kava has heart-shaped leaves up to 20 cm in size. It is native to the South Sea islands, especially New Guinea.

Kava kava was used in religious ceremonies on the Pacific islands as long as 3000 years ago. The relaxing, performance-enhancing and anxiety-relieving effects, including euphoria, were known to the natives of Australia and Hawaii as far away as the USA.

Kava kava extracts contain 5-12% 6-substituted beta-methoxy-lactones, the so-called kavapyrones (or kavalactones). These include: kavaine, methysticine. Kavain and dihydrokavain have sedative and analgesic effects. Flavokawain A. has an antiproliferative, anticarcinogenic and angiogenesis-inhibiting effect.

The peeled and chopped, dried rhizome(kava-kava rhizoma ) is used phytotherapeutically.
The drug mostly originates from cultures in Polynesia and Melanesia.

HMPC: Risk exceeds benefit, due to liver damage, additional carcinogenic potential.

ESCOP monograph: states of anxiety, tension and restlessness of non-psychotic origin. Cave: Hepatotoxic effect.

Commission E monograph: Nervous states of anxiety, tension and restlessness, liver toxicity not yet known in 1990

Dosage and method of useThis section has been translated automatically.

No longer recommended.

Limitation to 120 mg Kavalaktone, maximum duration of use of two months, control of liver values, prescription only. see also under Notes!

InteractionsThis section has been translated automatically.

Comatose states have been described following the combination of kava with alprazolam, a diazepine derivative.

Note(s)This section has been translated automatically.

The approval of kava kava extracts was initially revoked by the Federal Ministry for Drugs and Medical Devices (BfArM ) in 2002 due to hepatotoxic side effects and a lack of efficacy and new investigations were initiated. In a decision dated December 20, 2019, the approval of medicinal products containing kava kava was definitively revoked. Based on the scientific assessment of the Committee for Herbal Medicinal Products(HMPC) of the European Medicines Agency, the benefit-risk ratio is assessed as unfavorable.

LiteratureThis section has been translated automatically.

  1. Abu N et al (2014) Flavokawain A induces apoptosis in MCF-7 and MDA-MB231 and inhibits the metastatic process in vitro. PLoS One 9:e105244.
  2. Brown AC (2016) Liver toxicity related to herbs and dietary supplements: online table of case reports. Part 3 of 6. Food Chem Toxicoldoi:10.1016/j.fct.2016.07.001.
  3. Kuchta K et al. (201) German Kava Ban Lifted by Court: The Alleged.
  4. Hepatotoxicity of Kava (Piper methysticum) as a Case of Ill-Defined Herbal Drug Identity, Lacking Quality Control, and Misguided Regulatory Politics. Planta Med 81:1647-1653.
  5. Loew D (2012) In: Beer A M et al [eds] Leitfaden Naturheilverfahren für die ärztliche Praxis, Urban und Fischer Verlag p 170.
  6. Savage KM et al (2015) Kava for the treatment of generalised anxiety disorder (K-GAD): study protocol for a randomised controlled trial. Trials 16:493.
  7. Sarris J et al. (201) Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. J Clin Psychopharmacol 33:643-648.
  8. https://arzneipflanzenlexikon.info/kava-kava.php.
  9. Almeida JC et al (1996) Coma from the health food store: interaction between kava and alprazolam. Ann Intern Med. 1;125(11):940-1. doi: 10.7326/0003-4819-125-11-199612010-00023. PMID: 8967683.

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Last updated on: 08.10.2024