Khat-drug interactions: A systematic review

Abstract

Context: Consumption of khat leaves has been disseminated worldwide with the migration of its users from Arabia and Africa. Despite numerous reports regarding the associations of khat chewing with serious health impacts, a significant number of people worldwide uses khat daily, especially in its origin countries. The risk of co-administration of khat and drugs (prescription and over the-counter medications) is high among these individuals, leading to increase probability of adverse khat-drug interactions. The likelihood of khat-drug interactions could be higher than drug-drug interactions because drugs usually contain single chemical entities while almost all herbs (including khat) contain mixtures of pharmacologically active constituents. Aims: To review the literatures on how khat interacts with some drugs and whether it is favorable or not. Methods: The study was conducted as a systematic review. The electronic literature searches were made in Google search engine to access publications from databases like PubMed, Google Scholar, and Cochrane using the keywords ‘khat’, ‘Catha edulis’ in combination with the terms ‘drug interaction’, ‘adverse-effects’, ‘side effects’, ‘adverse drug reaction’, ‘safety’, and ‘toxicity’ to identify relevant articles. Results: A total of 250 articles was identified, and these articles were checked in terms of title, abstract, and content according to inclusion and exclusion criteria. Finally, 18 articles were included in the study. The khat use significantly interact with most drugs and may cause unpredictable pharmacological sequences. Conclusions: Healthcare providers suggest patients` khat abstinence during medication process. Future studies need to investigate the khat- clinical drugs interactions especially with chronic used drugs.

In vitro and In silico studies of interactions of cathinone with human recombinant cytochrome P450 CYP(1A2), CYP2A6, CYP2B6, CYP2C8, CYP2C19, CYP2E1, CYP2J2, and CYP3A5

“…Besides cathinone, khat contains other less psychoactive components including cathine S,S-(+)-norpseudoephedrine, R,S-(-)-norephedrine, catheduline and cathidine [24] , [27] . After the young leaves matures, cathinone is metabolised into cathine and norephedrine [6] . Older khat leaves are lacking in cathinone but they have less active cathine and norephedrine [38] .…”

Impact of Khat (Catha Edulis Forsk), During Chewing Session, on Serum RBG Level in T2DM Patients Treated with Metformin

“…It causes pancreatic beta cells to release insulin, delays gastric emptying, prevents beta cell glucagon release, and creates a sensation of satiety (Nasri & Rafieian-Kopaei, 2014). There are few studies about the effects of khat chewing on clinical drugs (Albaser et al, 2021). For our knowledge, this is first study about effect of khat chewing on metformin, which was a preliminary study to evaluate the effect of khat (Catha edulis Forsk) chewing on serum Random Blood Sugar (RBG) level in Type 2 Diabetic Mellitus (T2DM) patients treated with metformin.…”

Effect of Khat on Blood Coagulation

“…Khat chewing may be associated with increased risk of cardiovascular and blood coagulation disorders. It also may interfere with absorption , metabolism and mechanism action of some orally administered drugs [1][2][3][4]. Khat contains on glycosides and tannis in khat in addition to the alkaloids namely phenylalkaminens cathine (norpseudoephedrine) and cathinone {S(-)-alphaaminopropiaphenone)}that have amphetamine like effect [6,7].…”