2025 Guidelines for the Evaluation and Management of Adults With Congenital Heart Disease
December 19, 2025
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Brand Name :
N/A
Synonyms :
Cratom, Ithang, Katawan, Biak-Biak, Kedemba, Krathom, Madat, Gratom, Maeng Da Leaf
Class :
Herbals/ Neurology and Psychiatry
Brand Name :
N/A
Synonyms :
Cratom, Ithang, Katawan, Biak-Biak, Kedemba, Krathom, Madat, Gratom, Maeng Da Leaf
Class :
Herbals/ Neurology and Psychiatry
(withdrawal):
kratom is currently being investigated for its potential therapeutic effects in pain management, mood regulation, and opioid addiction treatment. Researchers are exploring its alkaloids' interactions with opioid receptors to better understand its mechanisms of action
may increase the central nervous system depressant effect
it increases the effect of CNS depressants
it increases the effect of CNS depressants
it increases the effect of CNS depressants
it increases the toxicity of sympathomimetics
it increases the toxicity of sympathomimetics
it increases the toxicity of sympathomimetics
it increases the toxicity of sympathomimetics
it increases the toxicity of sympathomimetics
may increase the CNS depressant effect
may increase the CNS depressant effect
may increase the CNS depressant effect
may increase the CNS depressant effect
may increase the CNS depressant effect
it increases the effect of CNS depressants
it increases the effect of CNS depressants
it increases the effect of CNS depressants
it increases the effect of CNS depressants
it increases the effect of CNS depressants
it increases the effect of CNS depressants
may have an increased CNS depressant effect when combined with CNS depressants
may have an increased CNS depressant effect when combined with CNS depressants
may have an increased CNS depressant effect when combined with CNS depressants
may have an increasingly adverse effect when combined with sympathomimetics
may have an increasingly adverse effect when combined with sympathomimetics
It may increase the CNS depressant effect when combined with CNS Depressants
kratom can potentially intensify the central nervous system depressant effect of loperamide
may have an increased risk of serotonin syndrome when combined with kratom
may have an increased risk of serotonin syndrome when combined with kratom
may have an increased risk of serotonin syndrome when combined with kratom
may have an increased risk of serotonin syndrome when combined with kratom
may have an increased risk of serotonin syndrome when combined with kratom
may have an increased risk of serotonin syndrome when combined with kratom
may altering the drug metabolism when combined with kratom
may altering the drug metabolism when combined with kratom
kratom: they may increase the CNS depressant effect of CNS Depressants
kratom: they may increase the CNS depressant effect of CNS Depressants
kratom: they may increase the CNS depressant effect of CNS Depressants
may increase the adverse effect of sympathomimetic drugs
may increase the CNS depressant effect
may increase the central nervous system depressant effect
hydrocodone/chlorpheniramine/pseudoephedrine
may increase the CNS depressant activity of CNS depressants
may increase the CNS depressant effects of CNS depressants
may increase the toxic effect of sympathomimetics
may increase the toxic effect of sympathomimetics
may increase the CNS depressant effect of CNS Depressants
may affecting the metabolism and increase the side effects when combined with kratom
may affecting the metabolism and increase the side effects when combined with kratom
may affecting the metabolism and increase the side effects when combined with kratom
may affecting the metabolism and increase the side effects when combined with kratom
may affecting the metabolism and increase the side effects when combined with kratom
Actions and spectrum:
Kratom (Mitragyna speciosa) is a plant-based supplement taken from a tropical tree that grows in Southeast Asia. Mitragynine and 7-hydroxymitragynine are two of its major constituents that act on opiate receptors. They possess various opioid-like actions that include but are not limited to pain relief, sedation, and euphoria. Kratom can act in a range of ways depending on the dosage and strain used. It might be a stimulant at low dosage, therefore it can increase alertness and sociability. Alternatively, it might have a severe sedative effect on a higher dosage, thus causing relaxation and eases pain.
Adverse reactions
Nausea and Vomiting
Dizziness
Drowsiness
Constipation
Sweating and Chills
Dry Mouth
Rapid Heartbeat
Hypertension
Anxiety and Irritability
Loss of Appetite
Seizures
Black box warning
Do not drive vehicles or operate machinery
Contraindications/Caution
Contraindications
Hepatic impairment
Children under 18 years of age
Cautions
Potential for dependence and addiction
Lack of regulation
Drug interactions
Pregnancy
Lactation
Personal sensitivity
Comorbidities
Substance use disorders
Mental health conditions
Cardiovascular conditions
Respiratory conditions
Gastrointestinal disorders
Epilepsy
Autoimmune disorders
Pregnancy & breastfeeding:
Pregnancy consideration:
US FDA pregnancy category: Not assigned
Breastfeeding warnings:
Data about the excretion of the drug into breast milk is not known
Pregnancy category:
Pharmacology:
Kratom is a herbal supplement and extracted from leaves of Mitragyna speciosa. This drug produces stimulant effects in low doses and sedative effects in high doses.
Pharmacodynamics:
Mitragynine and 7-hydroxymitragynine, the two active alkaloids in kratom act as partial agonists at mu-opioid receptors in the central nervous system which results in the production of analgesic and sedative effects that are similar to traditional opioids but with a lower level of potency. To this, it also possesses stimulant-like effects via its interactions with adrenergic receptors, especially alpha-2 adrenergic receptors, thereby making an individual more alert, energetic, and focused. It has a significant action on dopaminergic receptors, which is a kind of protein. Though the exact mechanism of action on dopaminergic receptors is not known, it can influence the mood-elevating effects and lead to addiction.
Pharmacokinetics:
Absorption:
The alkaloids present in this drug may be absorbed rapidly through gastrointestinal system.
Distribution:
This is distributed in the body tissues widely and has the potential to cross the BBB (blood-brain barrier) leading to CNS effects.
Metabolism:
It undergoes hepatic metabolism. The primary metabolic pathway involves the action of cytochrome P450 enzymes, particularly CYP3A4 and CYP2D6.
Elimination and excretion:
The drug and its metabolites are eliminated through urine and to a lesser extent in feces. The elimination half-life of kratom alkaloids varies, with mitragynine having a longer half-life compared to 7-hydroxymitragynine.
Administration:
This drug is available in different kinds of oral formulations.
Dried leaves can be chewed directly or brewed into tea. The powder can be mixed with water or other beverages and swallowed.
Patient information leaflet
Generic Name: kratom
Pronounced: KRAY-tum
Why do we use kratom?
Research at present is being examined for its probable healing effects in pain management, anxiety, and depression. Kratom has gained increasing attention for its potential use in the treatment of opioid addiction.
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