Drug & supplement interaction

Kava + Darunavir, Cobicistat

Darunavir, Cobicistat brand name: Prezcobix.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Kava has a minor interaction with Darunavir, Cobicistat. It is unclear if kava inhibits CYP3AA; research is conflicting.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Kava and Darunavir, Cobicistat

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Darunavir, Cobicistat

Darunavir, Cobicistat falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Kava interacts with.

It is unclear if kava inhibits CYP3AA; research is conflicting.
Although in vitro research suggests that kava inhibits CYP3A4, more robust clinical evidence shows that kava has no effect on CYP3A4. In a clinical study in healthy volunteers, taking kava 1000 mg twice daily (containing a daily dose of 138 mg kavalactones) for 28 days had no effect on CYP3A4 activity.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Your Prezcobix combo (darunavir plus cobicistat) leans on the liver enzyme CYP3A4. In theory, if kava slowed that enzyme down, your darunavir levels could climb a bit, which might mean more nausea, diarrhea, or headache. But here's the reassuring part: while early lab (test tube) studies hinted kava might block CYP3A4, a better human study found it actually had no real effect on this enzyme. So this interaction is rated minor and unlikely.

My bigger concern is something else entirely. Kava has been tied to rare but serious liver injury, and HIV medications can also stress the liver. Stacking the two isn't something I'd take lightly. Please loop in your pharmacist or doctor before adding kava.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mathews JM, Etheridge AS, Black SR. Inhibition of human cytochrome P450 activities by kava extract and kavalactones. Drug Metab Dispos 2002;30:1153-7. PubMed
  2. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  3. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
  4. Asher GN, Corbett AH, Hawke RL. Common Herbal Dietary Supplement-Drug Interactions. Am Fam Physician. 2017;96(2):101-107.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Kava Also Interacts With Other Medications

Kava has 248 major, 577 moderate, 340 minor known drug interactions in our database — the Darunavir, Cobicistat one above is one of them. If you take anything else, check it against the full list below.

Major 248 Moderate 577 Minor 340 No known interaction 1,665 (incl. Darunavir, Cobicistat)
Taking anything else?

Check Another of Your Medications Against Kava

Covers the 2,830 medications we’ve checked against Kava. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Darunavir, Cobicistat

This page covers Kava only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Darunavir, Cobicistat page lists 145 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 102 moderate · 40 minor.

From our pharmacist’s overview on the Darunavir, Cobicistat page

“Prezcobix (darunavir with cobicistat) treats HIV, and it only works if it holds a steady blood level, so this list of 145 supplements deserves real care. Three carry a major rating and matter most: St.”

Reviewed by 2 · Jul 18, 2026

Open the Darunavir, Cobicistat interaction page

One more smart check

Taking Kava as Part of a Dietary Supplement Product? Check It for Interactions

We hold 403 real supplement products containing Kava, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Kava. Your product may carry other ingredients that interact with Darunavir, Cobicistat too, on top of Kava — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Kava and Darunavir, Cobicistat Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Kava
Top 25%

#289 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Darunavir, Cobicistat
Top half

#871 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Kava

What is Kava?

Kava
  • Anxiety and stress
  • Restlessness
  • Trouble sleeping
  • Relaxation in social or cultural settings
  • Menopausal symptoms

Kava is a Pacific Island plant traditionally used to promote relaxation and ease anxiety, and some studies suggest it may help mild anxiety. However, kava has been linked to rare but serious liver damage, so it should be used with caution, avoided by people with liver problems, and only used after talking with your pharmacist or doctor.

Read the full Kava monograph & all interactions
Medication

About Darunavir and Cobicistat

What Is Darunavir and Cobicistat Used For?

Brand name: Prezcobix

Prezcobix and Prezcobix Ped are used to treat HIV-1 (human immunodeficiency virus type 1) infection. They are always used together with other antiretroviral (anti-HIV) medicines — never alone. Both products are approved for people who are new to HIV treatment (treatment-naïve) and for those who have taken HIV medicines before (treatment-experienced), as long as certain darunavir resistance mutations are not present.

Prezcobix tablets are approved for adults and pediatric patients weighing at least 40 kg. Prezcobix Ped tablets for oral suspension extend coverage to pediatric patients 3 years of age and older weighing at least 15 kg.

See full Darunavir and Cobicistat drug information
Keep checking

Other Drugs & Kava

Browse every other medication we’ve checked against Kava — both the ones with a known interaction and the ones without. Select any drug for the full detail.

248Major
577Moderate
340Minor
1,664No known interaction
248 Major 577 Moderate 340 Minor 1,664 No interaction
Major

248 interactions

Showing 60 of 248 major interactions — see all 248 on the Kava page.

Moderate

577 interactions

Showing 60 of 577 moderate interactions — see all 577 on the Kava page.

Minor

340 interactions

Showing 60 of 340 minor interactions — see all 340 on the Kava page.

No interaction 1,664 drugs checked — show the list

We also checked Kava against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,664 medications checked with no known interaction — see the full Kava list.

See the full Kava interactions page
See every supplement checked against Darunavir, Cobicistat, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Kava monograph › Uses, safety, and every drug interaction in one place Darunavir, Cobicistat supplement interactions › Every supplement checked against Darunavir, Cobicistat, ranked by severity Darunavir and Cobicistat drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Kava and Darunavir, Cobicistat Together: Common Questions

Can you take Kava with Darunavir, Cobicistat?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Kava and Darunavir, Cobicistat interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Darunavir, Cobicistat and Kava?

Our pharmacists answer your medication & supplement questions — free.

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.