KRATOM

OTHER NAME(S):

Biak-Biak, Cratom, Gratom, Ithang, Kakuam, Katawn, Kedemba, Ketum, Krathom, Kraton, Kratum, Madat, Maeng Da Leaf, Mambog, Mitragyna speciosa, Mitragynine Extract, Nauclea, Nauclea speciosa, Thang, Thom.<br/><br/>

Overview

Overview Information

Kratom is a tree. The leaves are used as a recreational drug and as medicine.

People use kratom for opiate withdrawal, cough, depression, anxiety, and many others, but there is no scientific evidence to support these uses. Using kratom can also be unsafe.

How does it work?

Kratom contains a chemical called mitragynine. Mitragynine works like opioid drugs such as codeine and morphine to relieve pain.

Uses

Uses & Effectiveness?

Insufficient Evidence for

More evidence is needed to rate the effectiveness of kratom for these uses.

Side Effects

Side Effects & Safety

Kratom is POSSIBLY UNSAFE for most people when taken by mouth.

Kratom can cause many side effects when taken by mouth, including tongue numbness, nausea, vomiting, dry mouth, need to urinate, constipation, aggression, hallucinations, delusions, and thyroid problems. Kratom in large doses may cause trouble breathing, brain swelling, seizure, liver damage, and death.

Kratom can cause dependence when taken regularly. People who use kratom regularly and then stop taking it may experience decreased appetite, diarrhea, muscle pain and spasms, twitches, watery eyes, anxiety, trouble sleeping, anger, hot flashes, and fever.

Special Precautions & Warnings:

Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking kratom if you are pregnant or breast-feeding. Stay on the safe side and avoid use.

Alcoholism: People with alcohol dependence who use kratom appear to have an increased risk of suicide compared to those who use kratom but are not dependent on alcohol.

Mental disorders: In theory, kratom might worsen existing mental disorders. Also, people with mental disorders who use kratom appear to have an increased risk of suicide compared to those who use kratom but do not have a mental disorder.
Interactions

Interactions?

We currently have no information for KRATOM Interactions.

Dosing

Dosing

The appropriate dose of kratom depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for kratom. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

View References

REFERENCES:

  • Ancuceanu RV, Dinu M, Anghel AI, et al. Recent prohibition of certain psychoactive ethnobotanicals in Romania. Farmacia 2010;58(2):-121-127.
  • Arndt T, Claussen U, Gussregen B, et al. Kratom alkaloids and O-desmethyltramadol in urine of a "Krypton" herbal mixture consumer. Forensic Sci Int 2011;208(1-3):47-52. View abstract.
  • Babu KM, McCurdy CR, Boyer EW. Opioid receptors and legal highs: Salvia divinorum and Kratom. Clin Toxicol (Phila) 2008;46(2):146-152. View abstract.
  • Backstrom BG, Classon G, Lowenhielm P, Thelander G. [Krypton--new, deadly Internet drug. Since October 2009 have nine young persons died in Sweden]. Lakartidningen 2010;107(50):3196-3197. View abstract.
  • Boyer EW, Babu KM, Adkins JE, McCurdy CR, Halpern JH. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction 2008;103(6):1048-1050. View abstract.
  • Boyer EW, Babu KM, Macalino G. E. Self-treatment of opioid withdrawal with a dietary supplement, Kratom. Am J Addict 2007;16(5):352-356. View abstract.
  • Chan KB, Pakiam C, Rahim RA. Psychoactive plant abuse: the identification of mitragynine in ketum and in ketum preparations. Bull Narc 2005;57(1-2):249-256. View abstract.
  • de Moraes NV, Moretti RA, Furr EB 3rd, McCurdy CR, Lanchote VL. Determination of mitragynine in rat plasma by LC-MS/MS: application to pharmacokinetics. J Chromatogr B Analyt Technol Biomed Life Sci 2009;877(24):2593-7. View abstract.
  • Drug Enforcement Administration. Kratom (Mytragyna speciosa korth). Available at: http://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf.
  • Food and Drug Administration. Import Alert 54-15: DETENTION WITHOUT PHYSICAL EXAMINATION OF DIETARY SUPPLEMENTS AND BULK DIETARY INGREDIENTS THAT ARE OR CONTAIN MITRAGYNA SPECIOSA OR KRATOM. Available at: http://www.accessdata.fda.gov/cms_ia/importalert_1137.html.
  • Janchawee B, Keawpradub N, Chittrakarn S, et al. A high-performance liquid chromatographic method for determination of mitragynine in serum and its application to a pharmacokinetic study in rats. Biomed Chromatogr 2007;21(2):176-83. View abstract.
  • Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119.
  • Kapp FG, Maurer HH, Auwarter V, Winkelmann M, Hermanns-Clausen M. Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa). J Med Toxicol 2011;7(3):227-231. View abstract.
  • Kittirattanapaiboon P, Suttajit S, Junsirimongkol B, Likhitsathian S, Srisurapanont M. Suicide risk among Thai illicit drug users with and without mental/alcohol use disorders. Neuropsychiatr Dis Treat 2014 Mar 13;10:453-8. View abstract.
  • Koch J, Mogensen J, Pedersen S, et al. Fast one-step procedure for the detection of nucleic acids in situ by primer-induced sequence-specific labeling with fluorescein-12-dUTP. Cytogenet Cell Genet 1992;60(1):1-3. View abstract.
  • 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. View abstract.
  • Kronstrand R, Roman M, Thelander G, Eriksson A. Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton. J Anal Toxicol 2011;35(4):242-247. View abstract.
  • McWhirter L, Morris S. A case report of inpatient detoxification after kratom (Mitragyna speciosa) dependence. Eur Addict Res 2010;16(4):229-231. View abstract.
  • Nelsen JL, Lapoint J, Hodgman MJ, Aldous KM. Seizure and coma following Kratom (Mitragynina speciosa Korth) exposure. J Med Toxicol 2010;6(4):424-426. View abstract.
  • Parthasarathy S, Ramanathan S, Ismail S, et al. Determination of mitragynine in plasma with solid-phase extraction and rapid HPLC-UV analysis, and its application to a pharmacokinetic study in rat. Anal Bioanal Chem 2010;397(5):2023-2030. View abstract.
  • Philipp AA, Meyer MR, Wissenbach DK, et al. Monitoring of kratom or Krypton intake in urine using GC-MS in clinical and forensic toxicology. Anal Bioanal Chem 2011;400(1):127-135. View abstract.
  • Philipp AA, Wissenbach DK, Weber AA, et al. Use of liquid chromatography coupled to low- and high-resolution linear ion trap mass spectrometry for studying the metabolism of paynantheine, an alkaloid of the herbal drug Kratom in rat and human urine. Anal Bioanal Chem 2010;396(7):2379-2391. View abstract.
  • Philipp AA, Wissenbach DK, Weber AA, Zapp J, Maurer HH. Metabolism studies of the Kratom alkaloid speciociliatine, a diastereomer of the main alkaloid mitragynine, in rat and human urine using liquid chromatography-linear ion trap mass spectrometry. Anal Bioanal Chem 2011;399(8):2747-2753. View abstract.
  • Philipp AA, Wissenbach DK, Weber AA, Zapp J, Maurer HH. Metabolism studies of the Kratom alkaloids mitraciliatine and isopaynantheine, diastereomers of the main alkaloids mitragynine and paynantheine, in rat and human urine using liquid chromatography-linear ion trap-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2011;879(15-16):1049-1055. View abstract.
  • Philipp AA, Wissenbach DK, Weber AA, Zapp J, Maurer HH. Phase I and II metabolites of speciogynine, a diastereomer of the main Kratom alkaloid mitragynine, identified in rat and human urine by liquid chromatography coupled to low- and high-resolution linear ion trap mass spectrometry. J Mass Spectrom 2010;45(11):1344-1357. View abstract.
  • Philipp AA, Wissenbach DK, Zoerntlein SW, et al. Studies on the metabolism of mitragynine, the main alkaloid of the herbal drug Kratom, in rat and human urine using liquid chromatography-linear ion trap mass spectrometry. J Mass Spectrom 2009;44(8):1249-1261. View abstract.
  • Phongprueksapattana S, Putalun W, Keawpradub N, Wungsintaweekul J. Mitragyna speciosa: hairy root culture for triterpenoid production and high yield of mitragynine by regenerated plants. Z Naturforsch C 2008 Sep-Oct;63(9-10):691-8. View abstract.
  • Ponglux D, Wongseripipatana S, Takayama H, Kikuchi M, Kurihara M, Kitajima M, Aimi N, Sakai S. A New Indole Alkaloid, 7 alpha-Hydroxy-7H-mitragynine, from Mitragyna speciosa in Thailand. Planta Med 1994 Dec;60(6):580-1. View abstract.
  • Roche KM, Hart K, Sangall B, Lefberg J, Bayer M. "Kratom: A Case of a Legal High". J Clin Toxicol 2008;46(7):598.
  • Rosenbaum CD, Carreiro SP, Babu KM. Here today, gone tomorrow...and back again? A review of herbal marijuana alternatives (K2, Spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and piperazines. J Med Toxicol 2012;8(1):15-32. View abstract.
  • Sheleg SV, Collins GB. A coincidence of addiction to "Kratom" and severe primary hypothyroidism. J Addict Med 2011;5(4):300-301. View abstract.
  • Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend 2014 Jun 1;139:132-7. View abstract.
  • US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
  • Vicknasingam B, Narayanan S, Beng GT, Mansor SM. The informal use of ketum (Mitragyna speciosa) for opioid withdrawal in the northern states of peninsular Malaysia and implications for drug substitution therapy. Int J Drug Policy 2010;21(4):283-288. View abstract.
  • Ward J, Rosenbaum C, Hernon C, McCurdy CR, Boyer EW. Herbal medicines for the management of opioid addiction: safe and effective alternatives to conventional pharmacotherapy? CNS Drugs 2011;25(12):999-1007. View abstract.
  • Ancuceanu RV, Dinu M, Anghel AI, et al. Recent prohibition of certain psychoactive ethnobotanicals in Romania. Farmacia 2010;58(2):-121-127.
  • Anwar M, Law R, Schier J. Notes from the Field: Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers - United States, 2010-2015. MMWR Morb Mortal Wkly Rep. 2016;65(29):748-9. View abstract.
  • Arndt T, Claussen U, Gussregen B, et al. Kratom alkaloids and O-desmethyltramadol in urine of a "Krypton" herbal mixture consumer. Forensic Sci Int 2011;208(1-3):47-52. View abstract.
  • Babu KM, McCurdy CR, Boyer EW. Opioid receptors and legal highs: Salvia divinorum and Kratom. Clin Toxicol (Phila) 2008;46(2):146-152. View abstract.
  • Backstrom BG, Classon G, Lowenhielm P, Thelander G. [Krypton--new, deadly Internet drug. Since October 2009 have nine young persons died in Sweden]. Lakartidningen 2010;107(50):3196-3197. View abstract.
  • Boyer EW, Babu KM, Adkins JE, McCurdy CR, Halpern JH. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction 2008;103(6):1048-1050. View abstract.
  • Boyer EW, Babu KM, Macalino G. E. Self-treatment of opioid withdrawal with a dietary supplement, Kratom. Am J Addict 2007;16(5):352-356. View abstract.
  • Castillo A, Payne JD, Nugent K. Posterior reversible leukoencephalopathy syndrome after kratom ingestion. Proc (Bayl Univ Med Cent). 2017;30(3):355-357. View abstract.
  • Chan KB, Pakiam C, Rahim RA. Psychoactive plant abuse: the identification of mitragynine in ketum and in ketum preparations. Bull Narc 2005;57(1-2):249-256. View abstract.
  • Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. View abstract.
  • de Moraes NV, Moretti RA, Furr EB 3rd, McCurdy CR, Lanchote VL. Determination of mitragynine in rat plasma by LC-MS/MS: application to pharmacokinetics. J Chromatogr B Analyt Technol Biomed Life Sci 2009;877(24):2593-7. View abstract.
  • Drug Enforcement Administration. Kratom (Mytragyna speciosa korth). Available at: http://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf.
  • FDA Adverse Event Reporting System: Kratom Deaths. February 6, 2018. https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/CDERFOIAElectronicReadingRoom/UCM595575.pdf. Accessed March 6, 2018.
  • Food and Drug Administration. Import Alert 54-15: DETENTION WITHOUT PHYSICAL EXAMINATION OF DIETARY SUPPLEMENTS AND BULK DIETARY INGREDIENTS THAT ARE OR CONTAIN MITRAGYNA SPECIOSA OR KRATOM. Available at: http://www.accessdata.fda.gov/cms_ia/importalert_1137.html.
  • Griffin OH, Webb ME. The Scheduling of Kratom and Selective Use of Data. J Psychoactive Drugs. 2017 Sep 22:1-7. doi: 10.1080/02791072.2017.1371363. View abstract.
  • Guddat S, Görgens C, Steinhart V, Schänzer W, Thevis M. Mitragynine (Kratom) - monitoring in sports drug testing. Drug Test Anal. 2016;8(11-12):1114-1118. View abstract.
  • Janchawee B, Keawpradub N, Chittrakarn S, et al. A high-performance liquid chromatographic method for determination of mitragynine in serum and its application to a pharmacokinetic study in rats. Biomed Chromatogr 2007;21(2):176-83. View abstract.
  • Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119.
  • Kapp FG, Maurer HH, Auwarter V, Winkelmann M, Hermanns-Clausen M. Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa). J Med Toxicol 2011;7(3):227-231. View abstract.
  • Kittirattanapaiboon P, Suttajit S, Junsirimongkol B, Likhitsathian S, Srisurapanont M. Suicide risk among Thai illicit drug users with and without mental/alcohol use disorders. Neuropsychiatr Dis Treat 2014 Mar 13;10:453-8. View abstract.
  • Koch J, Mogensen J, Pedersen S, et al. Fast one-step procedure for the detection of nucleic acids in situ by primer-induced sequence-specific labeling with fluorescein-12-dUTP. Cytogenet Cell Genet 1992;60(1):1-3. View abstract.
  • 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. View abstract.
  • Kronstrand R, Roman M, Thelander G, Eriksson A. Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton. J Anal Toxicol 2011;35(4):242-247. View abstract.
  • Kruegel AC, Grundmann O. The medicinal chemistry and neuropharmacology of kratom: A preliminary discussion of a promising medicinal plant and analysis of its potential for abuse.Neuropharmacology. 2017. pii: S0028-3908(17)30393-3. View abstract.
  • Lydecker AG, Sharma A, McCurdy CR, Avery BA, Babu KM, Boyer EW. Suspected Adulteration of Commercial Kratom Products with 7-Hydroxymitragynine. J Med Toxicol. 2016;12(4):341-349. View abstract.
  • McWhirter L, Morris S. A case report of inpatient detoxification after kratom (Mitragyna speciosa) dependence. Eur Addict Res 2010;16(4):229-231. View abstract.
  • Multistate Outbreak of Salmonella Infections Linked to Kratom. Centers for Disease Control and Prevention: 2018 Outbreaks. March 15, 2018. https://www.cdc.gov/salmonella/kratom-02-18/index.html. Accessed March 16, 2018
  • Nelsen JL, Lapoint J, Hodgman MJ, Aldous KM. Seizure and coma following Kratom (Mitragynina speciosa Korth) exposure. J Med Toxicol 2010;6(4):424-426. View abstract.
  • Parthasarathy S, Ramanathan S, Ismail S, et al. Determination of mitragynine in plasma with solid-phase extraction and rapid HPLC-UV analysis, and its application to a pharmacokinetic study in rat. Anal Bioanal Chem 2010;397(5):2023-2030. View abstract.
  • Philipp AA, Meyer MR, Wissenbach DK, et al. Monitoring of kratom or Krypton intake in urine using GC-MS in clinical and forensic toxicology. Anal Bioanal Chem 2011;400(1):127-135. View abstract.
  • Philipp AA, Wissenbach DK, Weber AA, et al. Use of liquid chromatography coupled to low- and high-resolution linear ion trap mass spectrometry for studying the metabolism of paynantheine, an alkaloid of the herbal drug Kratom in rat and human urine. Anal Bioanal Chem 2010;396(7):2379-2391. View abstract.
  • Philipp AA, Wissenbach DK, Weber AA, Zapp J, Maurer HH. Metabolism studies of the Kratom alkaloid speciociliatine, a diastereomer of the main alkaloid mitragynine, in rat and human urine using liquid chromatography-linear ion trap mass spectrometry. Anal Bioanal Chem 2011;399(8):2747-2753. View abstract.
  • Philipp AA, Wissenbach DK, Weber AA, Zapp J, Maurer HH. Metabolism studies of the Kratom alkaloids mitraciliatine and isopaynantheine, diastereomers of the main alkaloids mitragynine and paynantheine, in rat and human urine using liquid chromatography-linear ion trap-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2011;879(15-16):1049-1055. View abstract.
  • Philipp AA, Wissenbach DK, Weber AA, Zapp J, Maurer HH. Phase I and II metabolites of speciogynine, a diastereomer of the main Kratom alkaloid mitragynine, identified in rat and human urine by liquid chromatography coupled to low- and high-resolution linear ion trap mass spectrometry. J Mass Spectrom 2010;45(11):1344-1357. View abstract.
  • Philipp AA, Wissenbach DK, Zoerntlein SW, et al. Studies on the metabolism of mitragynine, the main alkaloid of the herbal drug Kratom, in rat and human urine using liquid chromatography-linear ion trap mass spectrometry. J Mass Spectrom 2009;44(8):1249-1261. View abstract.
  • Phongprueksapattana S, Putalun W, Keawpradub N, Wungsintaweekul J. Mitragyna speciosa: hairy root culture for triterpenoid production and high yield of mitragynine by regenerated plants. Z Naturforsch C 2008 Sep-Oct;63(9-10):691-8. View abstract.
  • Ponglux D, Wongseripipatana S, Takayama H, Kikuchi M, Kurihara M, Kitajima M, Aimi N, Sakai S. A New Indole Alkaloid, 7 alpha-Hydroxy-7H-mitragynine, from Mitragyna speciosa in Thailand. Planta Med 1994 Dec;60(6):580-1. View abstract.
  • Roche KM, Hart K, Sangall B, Lefberg J, Bayer M. "Kratom: A Case of a Legal High". J Clin Toxicol 2008;46(7):598.
  • Rosenbaum CD, Carreiro SP, Babu KM. Here today, gone tomorrow...and back again? A review of herbal marijuana alternatives (K2, Spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and piperazines. J Med Toxicol 2012;8(1):15-32. View abstract.
  • Sheleg SV, Collins GB. A coincidence of addiction to "Kratom" and severe primary hypothyroidism. J Addict Med 2011;5(4):300-301. View abstract.
  • Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend 2014 Jun 1;139:132-7. View abstract.
  • Trakulsrichai S, Sathirakul K, Auparakkitanon S, et al. Pharmacokinetics of mitragynine in man. Drug Des Devel Ther. 2015;9:2421-9. View abstract.
  • US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
  • Vicknasingam B, Narayanan S, Beng GT, Mansor SM. The informal use of ketum (Mitragyna speciosa) for opioid withdrawal in the northern states of peninsular Malaysia and implications for drug substitution therapy. Int J Drug Policy 2010;21(4):283-288. View abstract.
  • Ward J, Rosenbaum C, Hernon C, McCurdy CR, Boyer EW. Herbal medicines for the management of opioid addiction: safe and effective alternatives to conventional pharmacotherapy? CNS Drugs 2011;25(12):999-1007. View abstract.
  • White CM. Pharmacologic and clinical assessment of kratom. Am J Health Syst Pharm. 2017. pii: ajhp161035. View abstract.

More Resources for KRATOM

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

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