Significance and Importance of Kava kava as a nutraceutical

1. Introduction
2. Phytochemical constituents
3. Uses of Kava-kava
4. Specific use of a few phytoconstituents of Kava kava
5. Other uses of Kava kava
6. Marketed Formulations
7. Dosing & Side effects
8. Drug interactions
9. References
10. Thanks you

1. Kava-Kava Submitted To- Prof. Maninder Karan Submitted By- Prerna (1737), Priyansha (1738) B. Pharm 3 rd Year

2. Biological Name : Piper methysticum G. Forst Family : Piperaceae Habitat : Native to South Pacific Islands, western Pacific, Historically  it has been grown in Hawaii, Federated States of Micronesia, Vanuatu, Fiji, the Samoas , and Tonga. It is a cash crop in Vanuatu and Fiji. Description : Perennial shrub, around 1-5 m tall. Other Names : kava, awa (Hawaii), ava (Samoa), yaqona (Fiji), sakau (Pohnpei), and malok or malogu (parts of Vanuatu). Parts Used: Rootstock Introduction

3. Chemical Constituents Kavalactones or Kavapyrones ( Methysticin , Dihydromethysticin or DMH, Yangonin, Dihydrokawain or DHK, Kawain , Demethoxyyangonin ): active ingredients responsible for about 96% of plant’s pharmacological activity. Flavonoids (chalcones, flavokavin A, B and C): minor Alkaloids (pipermethystine: toxic component not present in consumable parts): generally present in roots and leaves in small amounts. Kawain is considered as one of the principle biologically active components of Kava.

4. Uses Of Kava-Kava Its roots have a number of benefits, they include- Uses due to kavalactone: Effective in treating anxiety (anxiolytic), tension, restlessness and depression. Act primarily on the limbic system, thus promoting sleep Protects the brain against damage due to ischemia, limits necrosis of affected brain area. Uses specifically due to kawain , methysticin , yangonin: Anesthetic, anti-convulsant, antidote, anti-inflammatory, antiseptic, anti-spasmodic, fungicide, myorelaxant, sedative, and tranquilizer. Neuro-protective action Anti bacterial

5. Uses specifically due to Dihydrokavain and Dihydromethysticin : analgesic effectiveness comparable to that of aspirin, without the side effect of peptic ulcers. Other uses: When consumed in large amounts, it imparts a euphoric state, so regarded as an aphrodisiac. Used for both acute and chronic gonorrhea, vaginitis, syphilis, leucorrhoea, nocturnal incontinence, urinary infections, irritable bladder, gout, rheumatism, bronchial ailments, and other ailments resulting from heart trouble. Beneficial in treating menstrual cramps as the Kava Kava will relax the uterus. used to prevent, relieve or even cure rheumatism.  used externally for ringworm and athlete’s foot.  Traditionally, Kava Kava was given to feverish or restless children to help them go to sleep.

6. Traditionally used by Hawaiian healers to help sufferers of asthma and other bronchopulmonary ailment.  To treat kidney infections, or other urinary disorders.  Blood-cleansing herb, and also as a diaphoretic.

7. FORMULATIONS

8. Dosing ORAL ADMINISTRATION- For Anxiety : 50-100 mg of a specific kava extract (WS 1490, Dr. Willmar Schwabe Pharmaceuticals), taken thrice daily for up to 25 weeks. Also, 400 mg of another specific kava extract (LI 150, Lichtwer Pharma ) taken daily for 8 weeks. Five kava tablets each containing 50 mg of kavalactones have been taken in three divided doses daily for one week. One to two kava extract tablets has been taken twice daily for 6 weeks. Calcium supplements plus 100-200 mg of kava taken daily for 3 months has also been used.

9. Parkinson’s Disease patients have been reported to be adversely affected by this. Inflammation of the body and eyes, leprous ulcers; the skin becoming parched and peeling off in scales.  This condition is known as Kani , named by the Pacific Islanders. FDA is trying to ban Kava kava claiming its role in liver damage, however no scientific published studies have proven the same, but still contraindicated in patients with renal disease, bile-duct obstruction, and hepatic diseases. SIDE EFFECTS

10. DRUG INTERACTIONS All medications metabolized by CYP450 in liver interacts with Kava Kava .  6 major interactions reported for Kava are with: Buprenorphine, Leflunomide, Teriflunomide, Lomitapide , Mipomersen and Pexidartinib . Contraindicated for people using anti-coagulant medications, such as Warfarin . Should not be taken with alcohol, barbiturates and other CNS depressants or anti-psychotic medications, such as Haldol or Mellaril . Should also not be used by people taking anti-anxiety medications, such as Xanax (Alprazolam) and other sedatives; as it can lead to too much drowsiness. It interacts with Levodopa, thus decreasing its effectiveness.

11. Kava may cause weaken muscle tone in the uterus, so not given in pregnancy. Kava may pass into breast milk and may harm the nursing baby, so Kava avoided during breast feeding. KAVA AND PREGNANCY HERBAL INTERACTIONS Avoid using Kava together with other herbal/health supplements that can also harm the liver. This includes Niacin(Vitamin B3), red yeast, androstenedione, DHEA, etc. Avoid using Kava with other herbal/health supplements that can also cause drowsiness. This includes California poppy, catnip, gotu kola, melatonin, St. John’s wort, valerian, etc.

12. References https://www.herballegacy.com/Wolsey_Chemical.html Evans.W.C ; Trease And Evans Pharmacognosy ; 6 th ed ; Saunders Elsevier; 2009; pp- 27, 492, 495. https://www.webmd.com/vitamins/ai/ingredientmono-872/kava

13. THANK YOU!