{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:09:22Z","timestamp":1780391362177,"version":"3.54.1"},"reference-count":31,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,5,8]]},"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate serum potassium levels and rates of hypokalaemia in patients treated with liquorice-containing Japanese traditional Kampo-medicines Yokukansan (YK) and Yokukansan-ka-chinpihange (YKCH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Patients receiving YK preparations for dementia and other psychiatric disorders in the University of Tsukuba Hospital in Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>389 patients (male\/female: 174\/215, 68.6\u00b116.1 years) were treated with YK preparations for 231 days (range 6\u20132788 days). Patients whose potassium levels were &lt;3.6 mEq\/L before administration of YK preparations, and drug non-compliant patients, were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>The occurrence rate of hypokalaemia and assessment of the risk factors for YK preparation-induced hypokalaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 389 patients treated with YK preparations, 94 (24.2%) developed hypokalaemia (potassium levels &lt;3.6\u2009mEq\/L) 34 days (range 1\u20131600 days) after administration of the preparations. 36 (38.3%) patients had co-administration with lower potassium-inducing drugs (LPIDs; diuretics, glucocorticoids, mineralocorticoids and glycyrrhizin), which was more frequent in the patients without hypokalaemia (17.3%) (p&lt;0.05). A Cox proportional hazard model identified four risk factors for hypokalaemia: YK administration (not YKCH) (HR 3.093, 95% CI 1.408 to 6.798), co-administration of LPIDs (HR 2.743, 95% CI 1.754 to 4.289), hypoalbuminaemia at baseline (HR 2.145, 95% 1.360 to 3.384), and full dosage administration (7.5\u2009g\/day) (HR 1.600, 95% CI 1.005 to 2.549).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Serum potassium monitoring should be done at least monthly in patients with the following risk factors: LPID co-administration, YK administration, hypoalbuminaemia, and full dosage administration.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2016-014218","type":"journal-article","created":{"date-parts":[[2017,6,16]],"date-time":"2017-06-16T00:20:10Z","timestamp":1497572410000},"page":"e014218","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Liquorice-induced hypokalaemia in patients treated with Yokukansan preparations: identification of the risk factors in a retrospective cohort study"],"prefix":"10.1136","volume":"7","author":[{"given":"Saori","family":"Shimada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuaki","family":"Arai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Tamaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Homma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,6,15]]},"reference":[{"key":"2024051611590771000_7.6.e014218.1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n0214"},{"key":"2024051611590771000_7.6.e014218.2","doi-asserted-by":"publisher","DOI":"10.1017\/S146114570800970X"},{"key":"2024051611590771000_7.6.e014218.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2007.12.027"},{"key":"2024051611590771000_7.6.e014218.4","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.pnpbp.2008.12.008","article-title":"Effect of yokukansan on the behavioral and psychological symptoms of dementia in elderly patients with Alzheimer's disease","volume":"33","author":"Monji","year":"2009","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"2024051611590771000_7.6.e014218.5","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.pnpbp.2010.02.013","article-title":"Effects of yokukansan on behavioral and psychological symptoms of dementia in regular treatment for Alzheimer's disease","volume":"34","author":"Okahara","year":"2010","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"2024051611590771000_7.6.e014218.6","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.pnpbp.2010.02.016","article-title":"Treatment of behavioral and psychological symptoms of Alzheimer-type dementia with yokukansan in clinical practice","volume":"34","author":"Hayashi","year":"2010","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"2024051611590771000_7.6.e014218.7","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/j.1479-8301.2012.00413.x","article-title":"Improvement in delusions and hallucinations in patients with dementia with Lewy bodies upon administration of yokukansan, a traditional Japanese medicine","volume":"12","author":"Iwasaki","year":"2012","journal-title":"Psychogeriatrics"},{"key":"2024051611590771000_7.6.e014218.8","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/j.jagp.2011.06.001","article-title":"Yokukansan treatment of chronic renal failure patients receiving hemodialysis, with behavioral and psychological symptoms of dementia: an open-label study","volume":"21","author":"Sumiyoshi","year":"2013","journal-title":"Am J Geriatr Psychiatry"},{"key":"2024051611590771000_7.6.e014218.9","first-page":"535","article-title":"Psychiatric pharmacology: study of the clinical efficacy of yokukansankachimpihange on Alzheimer's disease","volume":"14","author":"Miyazawa","year":"2009","journal-title":"Psychiatry"},{"key":"2024051611590771000_7.6.e014218.10","first-page":"108","article-title":"Effect of yokukansankachimpihange on dementia including the point of view of oriental medicine","volume":"18","author":"Magome","year":"2011","journal-title":"Psychiatry"},{"key":"2024051611590771000_7.6.e014218.11","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1248\/yakushi.15-00232-4","article-title":"[Education program of kampo-medicine for undergraduates in preparation for clinical setting]","volume":"136","author":"Homma","year":"2016","journal-title":"Yakugaku Zasshi"},{"key":"2024051611590771000_7.6.e014218.12","unstructured":"Information of the package insert of YK preparations, Tsumura Kampo Square [Internet]. 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