&lt;b&gt;Relationship Between Incidence of Pseudoaldosteronism and Daily Dose of Glycyrrhiza : Review of the L&lt;/b&gt;&lt;b&gt;iterature&lt;/b&gt;

Mantani, Naoki; Oka, Hiroshi; Sahashi, Yoshiro; Suzuki, Ayao; Ayabe, Motoko; Suzuki, Mayumi; Kono, Hiroshi; Osada, Uruu; Kimura, Yoko; Ito, Takashi

doi:10.3937/kampomed.66.197

Cited by 17 publications

(18 citation statements)

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“…For example, excessive and sustained use of Ephedra herb containing ephedrine alkaloids may induce palpitations, sleep disturbances, or urinary retention. Moreover, Glycyrrhiza may induce pseudoaldosteronism (hypokalemia, hypertension, and edema) [87][88][89]. In addition, SST may induce liver dysfunction and intestinal pneumonia in rare cases [90,91].…”

Section: Discussionmentioning

confidence: 99%

Kakkonto, shosaikoto, Platycodon grandiflorum root, and gypsum (a Japanese original combination drug known as saikatsugekito): Pharmacological review of its activity against viral infections and respiratory inflammatory conditions and a discussion of its applications to COVID‐19

Arita

Ono

Saito

et al. 2020

Traditional & Kampo Medicine

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Aim Traditional Japanese (Kampo) medicine has been used to treat viral infectious diseases. In particular, saikatsugekito (a combination drug of kakkonto, shosaikoto, Platicodon glandiflorum root, and gypsum) has been reported to be useful during the past influenza pandemic. The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has spread worldwide, causing the novel coronavirus disease (COVID‐19) to emerge as a pandemic. In this article, we conducted a literature review on the pharmacological activities of the components present in saikatsugekito against viral infection and respiratory inflammation. Methods We searched PubMed and the Cochrane Library for English articles, as well as Ichushi and J‐stage for Japanese articles. Articles published until January 1, 2000 were retrieved using the keywords ‘kakkonto’, ‘shosaikoto’, ‘Platycodon’, and ‘gypsum’. We then extracted articles on basic research investigating viral infections, inflammation, cytokine, the immune response, and lung tissue damage. Results We extracted 28 eligible articles. Kampo medicines have antiviral activities by interfering with the attachment, internalization, replication, progeny virion release, and cell‐to‐cell spreading of single‐strand RNA viruses. They also enhance the immunomodulating activities of the host, including cytokine production, regulation of multiple immune cells, and protection from lung tissue injury. Furthermore, Kampo medicine has been found to regulate body temperature and airway mucin release. Conclusion The results demonstrated that Kampo medicine has therapeutic activities against single‐strand RNA virus infections and respiratory inflammation, and may also have activities against SARS‐CoV‐2. Further research is required to investigate the activity of Kampo medicines, such as saikatsugekito, against SARS‐CoV‐2.

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Section: Discussionmentioning

confidence: 99%

Kakkonto, shosaikoto, Platycodon grandiflorum root, and gypsum (a Japanese original combination drug known as saikatsugekito): Pharmacological review of its activity against viral infections and respiratory inflammatory conditions and a discussion of its applications to COVID‐19

Arita

Ono

Saito

et al. 2020

Traditional & Kampo Medicine

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“…Mantani et al . analyzed cases of pseudoaldosteronism caused by licorice‐containing kampo medicines and suggested that the incidence of pseudoaldosteronism tends to depend on the dose of licorice . Of the kampo products currently in clinical use in Japan, shakuyakukanzoto contains the highest daily dose of licorice (5–6 g); therefore, the exclusive association of pseudoaldosteronism with shakuyakukanzoto in the present study indicates that licorice dosage is correlated with pseudoaldosteronism incidence.…”

Section: Discussionmentioning

confidence: 47%

“…Mantani et al . reviewed reports of pseudoaldosteronism in clinical papers on shakuyakukanzoto, but they did not determine the incidence of pseudoaldosteronism .…”

Section: Discussionmentioning

confidence: 99%

Estimated incidence of adverse reactions to Kampo medicines in randomized controlled clinical trials

Arai

Hagiwara

Motoo

2018

Traditional & Kampo Medicine

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Aim: Japanese kampo medicines have a long history of empirical use but have not been clinically validated. Therefore, information about the incidence of adverse drug reactions (ADR) is usually lacking. We estimated the incidence of ADR from reports of randomized controlled trials of kampo products. Methods: Trials of kampo products from the evidence reports of the kampo treatment database were examined to determine the number of patients treated with kampo products, and the number and type of ADR. Results: Data for 20 340 users of kampo products were analyzed. Of ≥1000 patients who took kampo products, the proportions of those with ADR were as follows: bakumondoto, 2/2167 patients (0.09%); maobushisaishinto, 8/1201 patients (0.67%); saireito, 21/1131 patients (1.86%); daikenchuto, 5/1131 patients (0.44%); and rikkunshito, 23/1126 patients (2.04%). Five patients (0.02%) developed pseudoaldosteronism; all had received shakuyakukanzoto. Liver injury was reported in 32 patients (0.16%) and was approximately threefold higher in those treated with Scutellaria root formulae (15/4206; 0.36%) than in those treated with non-Scutellaria formulae (17/16134; 0.11%). Of the Scutellaria root formulae, orengedokuto produced the highest incidence of liver injury (1.97%). No cases of interstitial pneumonia or mesenteric phlebosclerosis were reported. The ADR data for some formulae were similar to data from post-marketing ADR surveys. Conclusion: Examining data from a large number of trials is a useful way of estimating the incidence of kampo medicine ADR.

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“…It has been reported that the incidence of pseudoaldosteronism dose-dependently increased with increasing doses of Glycyrrhiza; e.g., the daily dose (g) of Glycyrrhiza and incidence rates were as follows: 1 g, 1%; 2 g, 1.7%; 4 g, 3.3%; Table 4 Correlations between daily doses of YKS or CZP and changes in individual items on the RBDQ-JP RBDQ-JP and 6 g, 11.1%. 39 From these data, the incidence of pseudoaldosteronism induced by the effective dose of YKS in this study was predicted to be low (perhaps less than 1%), although monitoring potassium concentrations is needed. Given this potential effect, caution is required for the co-administration of potassium-lowering drugs (E.G.…”

Section: Discussionmentioning

confidence: 72%

Efficacy of yokukansan compared with clonazepam for rapid eye movement sleep behaviour disorder: a preliminary retrospective study

et al. 2020

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Aim: Rapid eye movement sleep behaviour disorder (RBD) is characterized by abnormal behaviours accordant with nightmares during rapid eye movement sleep and is considered a prodromal marker of dementia with Lewy body. Most common in the elderly population, RBD is generally treated with clonazepam (CZP), a long-term acting benzodiazepine antiepileptic. As such, alternative drugs for RBD are urgently needed to minimize the adverse effects peculiar to benzodiazepines. The efficacy of yokukansan (YKS), a traditional Japanese herbal medicine, on RBD was initially reported by Shinno et al. in 2008. However, no study has compared YKS with CZP. Therefore, this study aimed to clarify the possibility of using YKS as an alternative to CZP. Methods: This was a retrospective cohort study conducted at Jikei University Affiliated Hospital. The subjects were selected from 36 outpatients who had been diagnosed with RBD based on the International Classification of Sleep Disorders, third edition. Of the 23 who met the inclusion criteria but not the exclusion criteria, 11 were treated with YKS monotherapy, and 12 were treated with CZP monotherapy. The primary outcome was the total score on the Japanese version of the Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ-JP), and the secondary outcomes were the scores from the eight-item Short-Form Health Survey and factors 1 and 2 of the RBDQ-JP. Results: The mean total RBDQ-JP score significantly improved from 52.5 to 21.7 (P = 0.002) after treatment with YKS (mean dosage: 3.0 g/day), which was similar to the change after CZP treatment (from 43.8 to 21.3). On RBDQ-JP factor 1 (dream content), the mean score on five of six items significantly improved after treatment with YKS. There was no significant change in Short-Form Health Survey scores after treatment with either drug. Potassium concentrations were within the normal range in patients treated with YKS. Conclusions: The present results suggest that a small amount of YKS may be an alternative to CZP for RBD, without remarkable adverse events. Further study is needed to prospectively clarify the efficacy and safety of YKS in more detail.

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<b>Relationship Between Incidence of Pseudoaldosteronism and Daily Dose of Glycyrrhiza : Review of the L</b><b>iterature</b>

Cited by 17 publications

References 1 publication

Kakkonto, shosaikoto, Platycodon grandiflorum root, and gypsum (a Japanese original combination drug known as saikatsugekito): Pharmacological review of its activity against viral infections and respiratory inflammatory conditions and a discussion of its applications to COVID‐19

Kakkonto, shosaikoto, Platycodon grandiflorum root, and gypsum (a Japanese original combination drug known as saikatsugekito): Pharmacological review of its activity against viral infections and respiratory inflammatory conditions and a discussion of its applications to COVID‐19

Estimated incidence of adverse reactions to Kampo medicines in randomized controlled clinical trials

Efficacy of yokukansan compared with clonazepam for rapid eye movement sleep behaviour disorder: a preliminary retrospective study

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