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Author: Admin | 2025-04-28
Interaction Details Finasteride, Tadalafil is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates Kratom might increase the levels and clinical effects of drugs metabolized by CYP3A4. In vitro research shows that kratom extract inhibits CYP3A4 enzyme activity. A pharmacokinetic study in adults shows that taking kratom tea 2 grams modestly increases the plasma concentration time-curve (AUC) and maximum concentration (Cmax) of CYP3A4 probe midazolam by 40-50% and its CYP3A4-mediated metabolites 18-27%. However, a lack of change in the half-life of midazolam and a simulation of the kratom-midazolam interaction suggest that kratom inhibits CYP3A4 enzymes in the small intestine but not the liver. Additionally, there is one case report of a 27-year-old male who died from neuroleptic malignant-like symptoms after concomitant use of kratom and quetiapine, a CYP3A4 substrate. Although it did not appear that the patient had consumed large quantities of quetiapine, postmortem plasma levels were in the lethal range, indicating possible inhibition of CYP3A4 by kratom. In another case report, a 63-year-old male presented with possible serotonin syndrome after taking an unknown dose of kratom for up to 3 months along with serotonergic prescription medications bupropion, buspirone, desvenlafaxine, trazodone, and ziprasidone. It is hypothesized that CYP3A4 inhibition by kratom reduced metabolism of desvenlafaxine, trazodone, and ziprasidone and consequently increased systemic exposure to serotonin. Interaction Rating Moderate Likelihood of Occurrence Possible Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists References Kong WM, Chik Z, Ramachandra M, et al. Evaluation of the effects of Mitragyna speciosa alkaloid extract on cytochrome P450 enzymes using a high throughput assay. Molecules. 2011;16(9):7344-7356. Hughes RL. Fatal combination of mitragynine and quetiapine - a case report with discussion of a potential herb-drug interaction. Forensic Sci Med Pathol. 2019 Mar;15(1):110-113. Eudaley ST, Brooks SP, Hamilton LA. Case Report: Possible Serotonin Syndrome in a Patient Taking Kratom and Multiple Serotonergic Agents. J Pharm Pract 2022. Tanna RS, Nguyen JT, Hadi DL, et al. Clinical Assessment of the Drug Interaction Potential of the Psychotropic Natural Product Kratom. Clin Pharmacol Ther 2023;113(6):1315-1325. Kratom Overview Kratom is a tropical tree from Southeast Asia, and its leaves are known for their potent effects. The leaves contain mitragynine and 7-hydroxymitragynine, which interact with the brain's opioid receptors, producing effects similar to opioids. Mitragynine acts as a partial agonist, providing pain relief and mood enhancement, while 7-hydroxymitragynine is even more potent, estimated to be about 10 times stronger than morphine. These compounds can stimulate opioid receptors, leading to effects such as euphoria and pain relief at lower doses, while higher doses can cause sedation and opioid-like effects. Kratom's safety and legal status are hotly debated, and it's banned or restricted in many places. See More Information Regarding Kratom Kratom - More Interactions Kratom interacts with 966 drugs Moderate 954 Interactions Minor 71 Interactions Unknown 1784 Interactions Interaction Rating Key These severity listings are for informational use only. Never start,
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