List of Drugs That Could Increase the Chance of Liver Damage When Combined With KratomĪny medication or substance that has known liver-toxic effects will increase the risk of liver damage when combined with kratom. Therefore, if users have any issues with this particular pathway or are using medications that also affect these enzymes, the risk of liver damage is higher. This compound primarily requires the CYP2D6 liver enzyme for metabolism, as well as some help from CYP3A4 and CYP2C9. The most abundant alkaloid in kratom (by far) is called mitragynine. However, people with a genetic defect, preexisting liver damage, sensitivities to kratom, or those who are taking known liver-toxic medications or substances are at the highest risk of experiencing liver damage after using kratom. People with healthy livers are unlikely to have any trouble metabolizing kratom and will therefore not experience any liver injury. What makes kratom different is the sheer volume of alkaloids it provides - which places extra strain on the liver to be able to process all of them effectively. This is the same for just about any medication or supplement. Each of these alkaloids needs to be metabolized by the liver before we can eliminate them from the body (primarily via the kidneys). The active ingredients of kratom are a group of around 12 alkaloids.
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