title: [Effects of long term administration of Shakuyaku-kanzo-To and Shosaiko-To on serum potassium levels].
abstract: Typical adverse effects of Shakuyaku-kanzo-To (SKT), an herbal medicine containing licorice, is a licorice-induced pseudoaldosteronism with hypokalemia and hypertension. The risk factors for this side effect are still unclear. To identify the risk factors, we surveyed 37 cases of licorice-induced pseudoaldosteronism in the literature and serum potassium levels in our patients receiving SKT and Shosaiko-To (SST), which contain 6 g and 1.5 g of licorice in the daily dose, respectively. In the case report survey, pseudoaldosteronism developed a median 35 (range 2-231) days after the administration of SKT, which is shorter than after SST (450, range 150-2190 days) and other licorice products including glycyrrhizin (210, range 14-730 days). A significant correlation was observed between the glycyrrhizin contents in the licorice preparations and the dosing periods for developing pseudoaldosteronism (r=-0.700, p<0.01). A negative correlation was also observed between serum potassium level and dosing period for SKT, but not for SST. The difference in age (65.3+/-11.6 vs. 57.2+/-17.3 y) and dosing period (57.3+/-66.3 vs. 19.0+/-24.3 days) between the patients with and without hypokalemia after the administration of SKT was statistically significant (p<0.05). The occurrence rate of hypokalemia including pseudoaldosteronism was around 80% with SKT administration for more than 30 days for patients exceeding 60 years old. It was suggested that patient age (>60 y) and dosing period of SKT (>30 days) might be risk factors for developing pseudoaldosteronism or hypokalemia as well as coadministration of drugs inducing hypokalemia.
authors.affiliation: Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, and Department of Pharmacy, Tsukuba University Hospital, Ibaraki, Japan. masatoh@md.tsukuba.ac.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Homma
authors.forename: Miya
authors.initials: M
authors.lastname: Ishihara
authors.forename: Wen
authors.initials: W
authors.lastname: Qian
authors.forename: Yukinao
authors.initials: Y
authors.lastname: Kohda
mesh_terms: D000367:Age Factors; D000368:Aged; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006035:Glycyrrhiza; D006801:Humans; D006929:Hyperaldosteronism / Q000139:chemically induced; D007008:Hypokalemia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D029596:Paeonia; D008517:Phytotherapy / Q000009:adverse effects*; D011188:Potassium / Q000097:blood*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; C038462:shakuyaku-kanzoh-toh; C461320:shosaiko-to; D011188:Potassium