Health Canada Issues Advisories on Kava, Comfrey

OTTAWA--Health Canada (www.hc-sc.gc.ca)is warning Canadian consumers to avoid the use of kava and comfrey because ofcontinued concerns about their impact on liver health.

The first advisory, issued Dec. 12, concerns internal use of comfrey,particularly those species that possibly contain the hepatotoxic compoundechimidine. While there have been no cases of liver toxicity related to comfreyreported in Canada, there have been reports from other countries. In the UnitedStates, the botanical industry and Food and Drug Administration (FDA) agreed in2001 to only permit sale of comfrey products free of pyrrolizidine alkaloidssuch as echimidine. Health Canada is asking manufacturers of approved products(those carrying a Drug Identification Number) to submit evidence that theirproducts do not contain echimidine or the two prohibited comfrey species.Products without a DIN number must be removed from sale in Canada.

Health Canada's second advisory, issued Dec. 23, was a reminder that thestop-sale order on products containing kava is still in effect. This comes afteran independent market survey showed many retail outlets are continuing to sellkava products. Health Canada issued its initial recall and stop-sale order inAugust 2002, after it received four reports of liver toxicity associated withthe use of kava products in Canada. The new advisory noted the agency willconvene an expert scientific panel to review any new scientific informationregarding the safety of kava as it becomes available.