Therapeutic advances in drug safety · 2026
Adverse drug reactions associated with glycyrrhiza-containing Chinese patent medicines: a literature-based analysis of individual case reports and clinical trials.
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Yu Ziyi, Wu Danwei, Xie Yitong, Mao Lu, Jiang Ziwei, Zhen Jiancun, Zhang Wei
Аннотация
BACKGROUND: Licorice, a commonly used traditional Chinese medicine in clinical practice, and pharmaceuticals with glycyrrhiza or glycyrrhiza extract as the main component play an important role in the treatment of hepatic and biliary system diseases and other conditions. Its dual identities as a traditional Chinese material medica and a natural phytocomponent have led to the underestimation of its latent adverse drug reactions (ADRs) in clinical and research.
OBJECTIVE: This study adopted a retrospective literature analysis method and stratified subgroups based on the inherent attribute differences of different study types, aiming to explore the characteristic differences in ADRs induced by glycyrrhiza-containing Chinese patent medicines under different study designs and considering the individual differences among patients.
DESIGN: A retrospective literature analysis was conducted in this study.
METHODS: This study adopted a retrospective study design. We searched PubMed, Web of Science, Scopus, Google Scholar, CNKI, Wanfang, and VIP Database from index inception to August 2025. Data on patient demographics, ADRs details, medication regimens, and outcomes were extracted and analyzed via SPSS 23.0.
RESULTS: A total of 120 articles were included (110 case reports, 10 clinical trials: 2 case series, 8 RCTs). Patient-related high-risk factors included males aged >60 years, hepatic insufficiency, or drug allergy history. Drug-related risk factors included off-label dosage, specific administration routes, and concomitant use with thiazide diuretics, drugs that induce arrhythmias or electrolyte disturbances, as well as agents with high plasma protein binding rates. All these factors were associated with the incidence and severity of ADRs. Most symptoms were alleviated following timely drug withdrawal and targeted treatment.
CONCLUSION: ADRs induced by Glycyrrhiza-containing Chinese patent medicines involve multiple organ systems. Early detection and prompt drug withdrawal are crucial for symptom alleviation. In clinical practice, such preparations should be administered in conjunction with patients' individual characteristics to ensure rational drug use.
OBJECTIVE: This study adopted a retrospective literature analysis method and stratified subgroups based on the inherent attribute differences of different study types, aiming to explore the characteristic differences in ADRs induced by glycyrrhiza-containing Chinese patent medicines under different study designs and considering the individual differences among patients.
DESIGN: A retrospective literature analysis was conducted in this study.
METHODS: This study adopted a retrospective study design. We searched PubMed, Web of Science, Scopus, Google Scholar, CNKI, Wanfang, and VIP Database from index inception to August 2025. Data on patient demographics, ADRs details, medication regimens, and outcomes were extracted and analyzed via SPSS 23.0.
RESULTS: A total of 120 articles were included (110 case reports, 10 clinical trials: 2 case series, 8 RCTs). Patient-related high-risk factors included males aged >60 years, hepatic insufficiency, or drug allergy history. Drug-related risk factors included off-label dosage, specific administration routes, and concomitant use with thiazide diuretics, drugs that induce arrhythmias or electrolyte disturbances, as well as agents with high plasma protein binding rates. All these factors were associated with the incidence and severity of ADRs. Most symptoms were alleviated following timely drug withdrawal and targeted treatment.
CONCLUSION: ADRs induced by Glycyrrhiza-containing Chinese patent medicines involve multiple organ systems. Early detection and prompt drug withdrawal are crucial for symptom alleviation. In clinical practice, such preparations should be administered in conjunction with patients' individual characteristics to ensure rational drug use.