Valeriana hepatotoxicity

Vassiliadis, Themistoklis; Anagnostis, Panagiotis; Patsiaoura, Kalliopi; Γιουλεμέ, Όλγα; Katsinelos, Panagiotis; Mpoumponaris, Alexandros; Eugenidis, Nikolaos

doi:10.1016/j.sleep.2008.09.009

Cited by 24 publications

(7 citation statements)

References 4 publications

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“…Liver damage associated with Valeriana has been reported in the past [ 17 , 18 , 19 , 20 ], although none of the ingredients of its extracts (e.g., valerenic acid, Figure 1 ) are known to be specifically hepatotoxic [ 21 ]. In our series, all five cases assessed showed a possible causality.…”

Section: Discussionmentioning

confidence: 99%

Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study

Douros

Bronder

Andersohn

et al. 2016

IJMS

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Herb-induced liver injury (HILI) has recently attracted attention due to increasing reports of hepatotoxicity associated with use of phytotherapeutics. Here, we present data on HILI from the Berlin Case-Control Surveillance Study. The study was initiated in 2000 to investigate the serious toxicity of drugs including herbal medicines. Potential cases of liver injury were ascertained in more than 180 Departments of all 51 Berlin hospitals from October 2002 to December 2011. Drug or herb intake was assessed through a standardized face-to-face interview. Drug or herbal aetiology was assessed based on the updated Council for International Organizations of Medical Sciences scale. In ten of all 198 cases of hepatotoxicity included in the study, herbal aetiology was assessed as probable (once ayurvedic herb) or possible (Valeriana five times, Mentha piperita once, Pelargonium sidoides once, Hypericum perforatum once, Eucalyptus globulus once). Mean age was 56.4 ± 9.7 years, and the predominant pattern of liver injury was hepatocellular. No cases of acute liver failure or death were observed. This case series corroborates known risks for ayurvedic herbs, supports the suspected association between Valeriana use and liver injury, and indicates a hepatotoxic potential for herbs such as Pelargonium sidoides, Hypericum perforatum or Mentha piperita that were rarely associated with liver injury before. However, given that possible causality does not prove clinical significance, further studies in this field are needed.

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Section: Discussionmentioning

confidence: 99%

Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study

Douros

Bronder

Andersohn

et al. 2016

IJMS

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“…The US prescribing information of harpagophytum contraindicates this herb for patients suffering from gallstones, but does not indicate a contraindication for patients with pancreatic disease . Furthermore, several cases of hepatotoxicity associated with valerian radix have been published in the past, indicating a broader toxic potential of this herbal remedy. In contrast to herbal hepatotoxicity, reports of AP associated with either herbal medications or dietary supplements are rare, a possible cause being the less stringent surveillance of such remedies.…”

Section: Discussionmentioning

confidence: 99%

Drug-induced acute pancreatitis: results from the hospital-based Berlin case-control surveillance study of 102 cases

Douros

Bronder

Andersohn

et al. 2013

Aliment Pharmacol Ther

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“…Cohen et al[ 82 ] described a young woman who developed self-limiting severe acute cholestatic jaundice after consuming capsules of valerian root extract 300 mg twice daily for 3 mo in the absence of other competing causes. Vassiliadis et al[ 83 ] described a 50-year-old woman with valerian extracts and tea consumption for 3 wk, after which she developed acute hepatitis. The liver biopsy showed mild portal fibrosis, lymphocytic, and eosinophilic inflammation of portal tracts, inflammatory changes of the small bile duct with ductular reaction and necrosis in the perivenular zone.…”

Section: Ayurvedic Herbs With Potential Hepatotoxicitymentioning

confidence: 99%

“…The liver biopsy showed mild portal fibrosis, lymphocytic, and eosinophilic inflammation of portal tracts, inflammatory changes of the small bile duct with ductular reaction and necrosis in the perivenular zone. Liver injury resolved after 10 mo on conservative management[ 83 ]. In a study on herb-induced liver injury in the Berlin Case-Control Surveillance program, possible causality for valerian-induced DILI was notable in five (four females) patients.…”

Section: Ayurvedic Herbs With Potential Hepatotoxicitymentioning

confidence: 99%

Comprehensive review of hepatotoxicity associated with traditional Indian Ayurvedic herbs

Philips

Ahamed

Rajesh

et al. 2020

WJH

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With growing antipathy toward conventional prescription drugs due to the fear of adverse events, the general and patient populations have been increasingly using complementary and alternative medications (CAMs) for managing acute and chronic diseases. The general misconception is that natural herbal-based preparations are devoid of toxicity, and hence short- and long-term use remain justified among people as well as the CAM practitioners who prescribe these medicines. In this regard, Ayurvedic herbal medications have become one of the most utilized in the East, specifically the Indian sub-continent, with increasing use in the West. Recent well-performed observational studies have confirmed the hepatotoxic potential of Ayurvedic drugs. Toxicity stems from direct effects or from indirect effects through herbal metabolites, unknown herb-herb and herb-drug interactions, adulteration of Ayurvedic drugs with other prescription medicines, and contamination due to poor manufacturing practices. In this exhaustive review, we present details on their hepatotoxic potential, discuss the mechanisms, clinical presentation, liver histology and patient outcomes of certain commonly used Ayurvedic herbs which will serve as a knowledge bank for physicians caring for liver disease patients, to support early identification and treatment of those who present with CAM-induced liver injury.

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Valeriana hepatotoxicity

Cited by 24 publications

References 4 publications

Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study

Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study

Drug-induced acute pancreatitis: results from the hospital-based Berlin case-control surveillance study of 102 cases

Comprehensive review of hepatotoxicity associated with traditional Indian Ayurvedic herbs

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