Kava-containing supplements may cause liver damage - Evidence For Practice - Brief Article

AORN Journal, August, 2002

Using kava-containing dietary supplements carries the potential risk of severe liver injury, according to a March 25, 2002, consumer advisory from the US Food and Drug Administration. A plant indigenous to the South Pacific, kava (ie, Piper methysticum) is used in supplements that aid in relaxation, sleeplessness, and menopausal symptoms, among others.

Regulatory agencies in several countries, including Germany, Switzerland, France, Canada, and the United Kingdom, have taken action against kava as well. These actions range from warning consumers to removing kava-containing products from shelves. Liver-related injuries have been linked to kava in more than 25 reports of adverse events in other countries. Officials in the United States have received reports of a previously healthy female who took kava and required a liver transplantation.

People with liver disease or problems and those taking medications that affect the liver should consult a physician before taking kava. People using kava-containing products who experience signs of illness associated with liver disease also should consult a physician. These symptoms include jaundice, brown urine, nausea, vomiting, light-colored stool, unusual tiredness, weakness, stomach or abdominal pain, and loss of appetite.

Kava's presence in a supplement should be noted on the product's label. Many names commonly are used for kava, including

* ava,

* ava pepper,

* awa,

* intoxicating pepper,

* kava,

* kava kava,

* kava pepper,

* kava root,

* kava-kava,

* kawa,

* kawa kawa,

* kawa-kawa,

* kew,

* Piper methysticum,

* Piper methysticum Forst.f.,

* Piper methysticum G. Forst.,

* rauschpfeffer,

* sakau,

* tonga,

* wurzelstock, and

* yangona.

Kava-containing Dietary Supplements May Be Associated with Severe Liver Injury (consumer advisory, Rockville, Md: Center for Food Safely and Applied Nutrition, US Food and Drug Administration, March 25, 2002) http://www.cfsan.fda.gov/~dms/addskava.html (accessed 9 April 2002).