kava (generic name)

an herbal product - treats Insomnia, Anxiety, Parkinson's disease, and Stress
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Interactions with Drugs

Based on multiple human reports of liver toxicity, including hepatitis, cirrhosis, and liver failure, a theoretical increased risk of liver damage may occur if kava is taken with drugs that may injure the liver such as alcohol or acetaminophen (Tylenol®). Chronic use of kava may lead to kidney damage. Agents broken down by the kidneys should be used cautiously with kava due to increased risk of kidney damage.

In theory, kava may increase the effects of alcohol or other drugs that cause sedation (drowsiness). In theory, kava may interfere with the effects of dopamine or drugs that are similar to dopamine and may worsen the neurologic side effects of drugs that block dopamine such as haloperidol (Haldol®).

Kava may have chemical properties similar to monoamine oxidase inhibitors (MAO-I). In theory, kava may add to the effects of MAO-I antidepressants, such as isocarboxazid (Marplan®), phenelzine (Nardil®), or tranylcypromine (Parnate®). Due to this possible effect, kava may also cause the effects of anesthesia to last longer and some practitioners recommend stopping kava two to three weeks before surgery.

Laboratory tests suggest that kava may increase the risk of bleeding through effects on blood platelets. However, human evidence is lacking in this area. People using aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) and heparin, or anti-platelet drugs such as clopidogrel (Plavix®) should be aware of possible interactions.

Since kava has diuretic properties, it may have additive effects when taken with diuretic drugs such as furosemide or with ACE-inhibitors such as benazepril or captopril. Avoid in Parkinson's disease or in patients with a history of medication-induced extrapyramidal effects because kava may cause additive effects. Kava may cause excessive drowsiness when taken with SSRI antidepressant drugs such as fluoxetine or sertraline. Buspirone and opipramol may have additive effects when taken with kava.

Early evidence shows that kava may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be altered in the blood, which may cause different effects or potentially serious adverse reactions.

Kava may have additive sedative effects when taken concomitantly with the opioid analgesics oxycodone and propoxyphene.

Kava may also interact with anti-cancer drugs or hormonal drugs, such as birth control pills.

Interactions with Herbs and Dietary Supplements

Based on multiple human reports of liver toxicity, including hepatitis, cirrhosis, and liver failure, a theoretical increased risk of liver damage may occur if kava is taken with herbs or supplements that may damage the liver.

Kava may increase the amount of sedation (drowsiness) caused by some herbs or supplements, such as valerian. Caution is advised while driving or operating machinery.

In theory, kava may add to the effects of herbs and supplements that act like monoamine oxidase inhibitor (MAO-I) drugs, such as evening primrose oil. It may also add to the effects of herbs that have activity similar to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

Based on laboratory tests, it is suggested that kava may increase the risk of bleeding through effects on blood platelets. However, human evidence is lacking in this area. People using other herbs or supplements that may increase the risk of bleeding should speak with a healthcare professional before starting kava.

Since kava has diuretic properties, it may have additive effects when taken with diuretic herbs or supplements like horsetail or licorice.

Use cautiously with herbs or supplements that are broken down by the kidneys because kidney damage may occur.

Preliminary evidence shows that kava may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may be too high in the blood.

Kava may interact with herbs and supplements with anti-cancer or hormonal activity; use cautiously.

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