<http://news.bbc.co.uk/1/hi/health/2595897.stm>

Saturday, 21 December, 2002, 00:17 GMT
Herbal stress remedy banned

Remedies containing the herb Kava-kava have been banned after it was
linked to four deaths.

The herb is used as a natural tranquiliser and as an alternative to
Valium.

It was voluntarily removed from the shelves a year ago after almost 70
cases of suspected liver damage associated with the herbal medicine were
reported, four in the UK. Seven patients needed liver transplants.

The UK's Committee on Safety of Medicines (CSM) and the Medicines
Commission have now recommended a ban.

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"It is not possible to predict who is at risk before they use
Kava-kava." - Dr Liz Williamson, London School of Pharmacy
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The Medicines Control Agency, (MCA) which monitors the safety of all
herbal medicines, including unlicensed ones, is now acting on that
advice.

An order prohibiting the sale of Kava-kava will come into force on 13
January next year.

But the ban will be reconsidered in two years time.

The MCA said investigations had been unable to say what might put people
at risk of adverse reactions to Kava-kava.

How the remedy damages the liver is also unknown.

Professor Alasdair Breckenridge, chairman of the CSM, said: "Given the
expert advice from the CSM and Medicines Commission following the recent
public consultation it is clear that this ban is necessary.

"The issues surrounding today's decision have been very carefully
considered.

"A prohibition on safety grounds can be reviewed at any time if new
evidence emerges and the MCA will be undertaking a specific review in
two years time to assess whether this ban remains justified."

'Idiosyncratic'
==========

Dr Liz Williamson, a herbal expert from the London School of Pharmacy,
said: "The liver toxicity associated with Kava-kava, although rare, is
idiosyncratic.

"No specific risk factors have been identified and it is not possible to
predict who is at risk before they use Kava-kava.

"In addition, no measures to reduce the risk, or the severity of liver
reactions, are available. It is therefore in the best interests of
patients that the herb be withdrawn at present."

She added: "There are other useful herbal products which can be used for
stress and related disorders."

Complementary health campaigners have protested against a complete ban,
saying Kava-kava has none of the addiction problems associated with
conventional tranquilisers like Valium.