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评估 kratom 使用中的药物相互作用:临床应用

Evaluating the drug interactions in kratom usage: clinical application.

作者信息

Dhoble Leena R, Gour Abhishek, McCurdy Christopher R, Sharma Abhisheak

机构信息

Department of Pharmaceutics, University of Florida, Gainesville, FL, USA.

Translational Drug Development Core, Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA.

出版信息

Expert Opin Drug Metab Toxicol. 2025 Jun 22:1-11. doi: 10.1080/17425255.2025.2521045.

Abstract

INTRODUCTION

(Korth.) Havil. (Rubiaceae), commonly known as kratom, is a tropical tree native to Southeast Asia, traditionally used for its diverse ethnopharmacological activities, including analgesic and anxiolytic effects. Kratom's unique pharmacological profile allows it to function as a stimulant at low doses and produces opioid-like effects at high doses, making it a potential alternative for pain management and mitigation of opioid use disorder.

AREAS COVERED

Google Scholar and PubMed, along with FAERS database, were systematically searched to evaluate the clinical applications of kratom by examining its drug interactions, which can significantly impact the pharmacokinetics and pharmacodynamics of concomitant medications. By examining current evidence, this review aims to highlight the importance of establishing safe clinical practices and protocols for healthcare providers and patients.

EXPERT OPINION

Evaluating drug interactions in kratom usage is clinically imperative because kratom's bioactive alkaloids can interact with the pharmacokinetic and pharmacodynamic processes of concurrent medications, potentially resulting in adverse effects or compromised therapeutic outcomes. This review presents an expert opinion on the clinical relevance of kratom's interactions with drugs, aiming to inform clinical practice, highlight ethical and regulatory considerations, and propose future research directions to improve the understanding of kratom's pharmacological profile and enhance user safety.

摘要

引言

(科思)哈维尔。(茜草科),通常被称为 kratom,是一种原产于东南亚的热带树木,传统上因其多种民族药理学活性而被使用,包括镇痛和抗焦虑作用。Kratom 独特的药理学特性使其在低剂量时起兴奋剂作用,在高剂量时产生类阿片样作用,使其成为疼痛管理和减轻阿片类药物使用障碍的潜在替代药物。

涵盖领域

通过检索谷歌学术、PubMed 以及 FAERS 数据库,系统评估 kratom 的临床应用,研究其药物相互作用,这些相互作用会显著影响同时使用药物的药代动力学和药效动力学。通过审视现有证据,本综述旨在强调为医疗保健提供者和患者建立安全临床实践和方案的重要性。

专家意见

评估 kratom 使用中的药物相互作用在临床上至关重要,因为 kratom 的生物活性生物碱可与同时使用药物的药代动力学和药效动力学过程相互作用,可能导致不良反应或治疗效果受损。本综述就 kratom 与药物相互作用的临床相关性提出专家意见,旨在为临床实践提供信息,突出伦理和监管考量,并提出未来研究方向,以增进对 kratom 药理学特性的理解并提高使用者安全性。

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