Hepatotoxicity of Herbal Preparations

Strader, Doris B.; Seeff, Leonard B.

doi:10.1016/b978-1-4160-3258-8.50032-2

Cited by 12 publications

(15 citation statements)

References 97 publications

(96 reference statements)

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“…These two diterpenoid glucosides are capable of inhibiting mitochondrial oxidative phosphorylation by interaction with a mitochondrial protein, the adenine nucleotide translocator . More than hundred cases of liver and renal injury associated with A. gummifera ingestion have been reported, and they frequently involved children . In addition, toxicity is reported with the cutaneous application .…”

Section: Herbal Products That Have Been Linked To Hepatotoxicitymentioning

confidence: 99%

“…In addition, toxicity is reported with the cutaneous application . The onset of toxicity usually begins within few hours after ingestion, and is characterised by headache, anxiety, vomiting, abdominal pain, diarrhoea, and convulsion, which then often leads to acute liver and renal failure, neurovegetative state and death . There is no specific pharmacological treatment for A. gummifera intoxication available and all the current therapeutic approaches are only symptomatic, with LT being an option.…”

Section: Herbal Products That Have Been Linked To Hepatotoxicitymentioning

confidence: 99%

“…Dai‐saiko‐to (Sho‐saiko‐to, TJ‐19, Da‐chai‐hu‐tang, Xiao‐chai‐hu‐tang) is a Chinese herbal medicine that has been used widely in Japan for the treatment of liver diseases and is part of the Japanese Kampo medical system . Dai‐saiko‐to differs from Sho‐saiko‐to only in the proportion of herbal constituents and which contains bupleuri, pinelliae, scutellaria, ginseng, ginger, glycyrrhiza and jujube fruits . Several in vitro and in vivo studies suggested that this product may be effective in preventing hepatic inflammation, fibrosis and hepatocellular carcinoma .…”

Section: Herbal Products That Have Been Linked To Hepatotoxicitymentioning

confidence: 99%

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Review article: herbal and dietary supplement hepatotoxicity

Bunchorntavakul

Reddy

2012

Aliment Pharmacol Ther

267

191

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Summary Background Herbal and dietary supplements are commonly used throughout the World. There is a tendency for underreporting their ingestion by patients and the magnitude of their use is underrecognised by Physicians. Herbal hepatotoxicity is not uncommonly encountered, but the precise incidence and manifestations have not been well characterised. Aims To review the epidemiology, presentation and diagnosis of herbal hepatotoxicity. This review will mainly discuss single ingredients and complex mixtures of herbs marketed under a single label. Methods A Medline search was undertaken to identify relevant literature using search terms including ‘herbal’, ‘herbs’, ‘dietary supplement’, ‘liver injury’, ‘hepatitis’ and ‘hepatotoxicity’. Furthermore, we scanned the reference lists of the primary and review articles to identify publications not retrieved by electronic searches. Results The incidence rates of herbal hepatotoxicity are largely unknown. The clinical presentation and severity can be highly variable, ranging from mild hepatitis to acute hepatic failure requiring transplantation. Scoring systems for the causality assessment of drug‐induced liver injury may be helpful, but have not been validated for herbal hepatotoxicity. Hepatotoxicity features of commonly used herbal products, such as Ayurvedic and Chinese herbs, black cohosh, chaparral, germander, greater celandine, green tea, Herbalife, Hydroxycut, kava, pennyroyal, pyrrolizidine alkaloids, skullcap, and usnic acid, have been individually reviewed. Furthermore, clinically significant herb–drug interactions are also discussed. Conclusions A number of herbal medicinal products are associated with a spectrum of hepatotoxicity events. Advances in the understanding of the pathogenesis and the risks involved are needed to improve herbal medicine safety.

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Section: Herbal Products That Have Been Linked To Hepatotoxicitymentioning

confidence: 99%

Section: Herbal Products That Have Been Linked To Hepatotoxicitymentioning

confidence: 99%

Section: Herbal Products That Have Been Linked To Hepatotoxicitymentioning

confidence: 99%

See 1 more Smart Citation

Review article: herbal and dietary supplement hepatotoxicity

Bunchorntavakul

Reddy

2012

Aliment Pharmacol Ther

267

191

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“…9,10 For example, organ toxicity associated with formulations that contain ephedra as a major ingredient has led to their removal by regulatory authorities in some Western European countries, 11,12 and recent reports from the United States have emphasized the risks of use of extracts of Chinese green tea ( Camellia sinensis ) that contain catechins as a major ingredient. 13–15 Because numerous dietary supplements are consumed by large numbers of US adults on a regular basis, 16 the hepatotoxicity of dietary supplements may be significantly underestimated.…”

mentioning

confidence: 99%

Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury in the United States

et al. 2008

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Background & Aims Idiosyncratic drug-induced liver injury (DILI) is among the most common causes of acute liver failure in the United States, accounting for approximately 13% of cases. A prospective study was begun in 2003 to recruit patients with suspected DILI and create a repository of biological samples for analysis. This report summarizes the causes, clinical features, and outcomes from the first 300 patients enrolled. Methods Patients with suspected DILI were enrolled based on predefined criteria and followed up for at least 6 months. Patients with acetaminophen liver injury were excluded. Results DILI was caused by a single prescription medication in 73% of the cases, by dietary supplements in 9%, and by multiple agents in 18%. More than 100 different agents were associated with DILI; antimicrobials (45.5%) and central nervous system agents (15%) were the most common. Causality was considered to be definite in 32%, highly likely in 41%, probable in 14%, possible in 10%, and unlikely in 3%. Acute hepatitis C virus (HCV) infection was the final diagnosis in 4 of 9 unlikely cases. Six months after enrollment, 14% of patients had persistent laboratory abnormalities and 8% had died; the cause of death was liver related in 44% Conclusions DILI is caused by a wide array of medications, herbal supplements, and dietary supplements. Antibiotics are the single largest class of agents that cause DILI. Acute HCV infection should be excluded in patients with suspected DILI by HCV RNA testing. The overall 6-month mortality was 8%, but the majority of deaths were not liver related.

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“…4, 22,000 from which 50,000 have medicinal values 2 . In under developed countries traditional herbal drugs have a great demand due to their lesser adverse effects, efficacy and low cost 3 and for biological and pharmacological assessment at least 20% of plants are used 4 and they play an important role in the cure of respiratory diseases but clinical trials are required to assess the role of medicinal herbs. In developing countries 80% of people depend on natural products especially from plants for their health issues 5 .…”

Section: Introductionmentioning

confidence: 99%

Anti-Tussive Effect and Gross Toxicities of Methanol Extract of Mucuna Pruriens (L) Dc in Comparison of Codeine Phosphate

Sultana¹,

Khan²,

Azhar³

2013

Int. Res. J. Pharm.

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The aim of the current study is to evaluation of plant seed extract of Mucuna pruriens for its gross toxicities and antitussive activity. Anti-tussive effect was observed by inducing cough using sulfur dioxide gas and counts the number of cough before and after administration of extract and centrally acting cough suppressant (codeine phosphate) given orally. Mucuna pruriens seed extract showed highly significant antitussive effect (**p<0.005) and compare to control and reference drug codeine phosphate and may act on opioid receptor that may located in airway passage and produces inhibitory effect. The results suggest that Mucuna pruriens seed may contains cough protective agent and have potential therapeutic value.

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Hepatotoxicity of Herbal Preparations

Cited by 12 publications

References 97 publications

Review article: herbal and dietary supplement hepatotoxicity

Review article: herbal and dietary supplement hepatotoxicity

Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury in the United States

Anti-Tussive Effect and Gross Toxicities of Methanol Extract of Mucuna Pruriens (L) Dc in Comparison of Codeine Phosphate

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