Diazepam Nasal Spray and Kava: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Kava
No brand names on recordDiazepam Nasal Spray
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased central nervous system depression
Interaction Deep Dive
Concomitant use of kava and a benzodiazepine may result in enhanced central nervous system depression. A case report describes a patient experiencing a semicomatose state likely due to concomitant use of kava and alprazolam2. In vitro data suggests this is most likely attributed to an increase in GABA binding sites in selected areas of the brain 3.
Why it happens (mechanism)
Additive effects on GABA receptor binding
Literature reports
1 report — tap to read
a) A 54-year-old man was hospitalized in a lethargic and disoriented state attributed to concomitant administration of kava with alprazolam for 3 days. The doses of neither medication were provided. The patient was also taking cimetidine and terazosin, which can cause confusion and sedation but was apparently not experienced previously in this patient. Blood alcohol level was negative 1.
Common questions
Can I take Diazepam Nasal Spray and Kava together?
Increased central nervous system depression Always confirm with your pharmacist or prescriber before making any change.
How serious is the Diazepam Nasal Spray and Kava interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Diazepam Nasal Spray or Kava need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (3)
- Almeida JC & Grimsley EW: Coma from the health food store: interaction between kava and alprazolam. Ann Intern Med 1996; 125:940-941. PubMed
- Almeida JC & Grimsley EW: Coma from the health food store: interaction between kava and alprazolam (letter). Ann Intern Med 1996; 125:940-941. DOI
- Jussofie, SA, & Hiemke C: Kavapyrone enriched extract from Piper methysticum as modulator of the GABA binding site in different regions of rat brain. Psychopharmacology (Berl) 1994; 116:469-474.
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