Drug & supplement interaction

Kava + Hydroxyzine

Hydroxyzine brand names: Atarax, Vistaril, Ucerax.

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

Kava has a minor interaction with Hydroxyzine. 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 Hydroxyzine

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Hydroxyzine

Hydroxyzine 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

Here's the honest picture with kava and hydroxyzine: the lab-based worry was that kava might slow down the CYP3A4 enzyme, which could let hydroxyzine build up. But better human research doesn't back that up. In a study where healthy people took kava for 28 days, it had no real effect on CYP3A4. So from a metabolism standpoint, this is rated minor and unlikely to cause trouble.

The bigger thing I'd actually flag is overlap in how they make you feel. Both hydroxyzine and kava can be calming and sedating, so together they may leave you extra drowsy, foggy, or dizzy. Kava can also rarely stress the liver, so please run this combo by your pharmacist or doctor before mixing them.

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 Hydroxyzine 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. Hydroxyzine)
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.

From our Q&A

Questions About Kava or Hydroxyzine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Kava or Hydroxyzine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Hydroxyzine

This page covers Kava only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydroxyzine page lists 183 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Henbane (major), Scopolia (major) and St. John's Wort (major).

By severity: 5 major · 135 moderate · 43 minor.

From our pharmacist’s overview on the Hydroxyzine page

“Hydroxyzine (Atarax, Vistaril) is a sedating antihistamine for itching and anxiety, so read this list closely before pairing it with any supplement. Five of the 183 ingredients on file rate major, and those come first: grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Hydroxyzine 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 Hydroxyzine 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 Hydroxyzine 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%

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

29 days ago today
Medication Hydroxyzine
Top 25%

#444 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 Hydroxyzine

What Is Hydroxyzine Used For?

Brand names: Atarax, Vistaril, Ucerax

Hydroxyzine is used to relieve anxiety and tension related to psychoneurosis (anxiety-based mental health conditions) and as a supportive treatment when anxiety is part of another medical condition. Oral forms — including tablets, capsules, and oral solution — are used for anxiety relief and to manage itching (pruritus) caused by allergic conditions such as chronic urticaria (hives), atopic dermatitis, contact dermatitis, and histamine-driven itch. Oral forms are also used as a sedative before and after surgery or general anesthesia.

Hydroxyzine Hydrochloride intramuscular injection is used specifically when a shot is needed — for example, in acute psychiatric or emotional emergencies, acute alcohol withdrawal with anxiety symptoms or delirium tremens, control of nausea and vomiting (except during pregnancy), and as pre- and post-operative or pre- and post-partum supportive medication to reduce narcotic requirements and control nausea.

See full Hydroxyzine 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 Hydroxyzine, 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 Hydroxyzine supplement interactions › Every supplement checked against Hydroxyzine, ranked by severity Hydroxyzine 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 Hydroxyzine Together: Common Questions

Can you take Kava with Hydroxyzine?
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 Hydroxyzine 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 Hydroxyzine and Kava?

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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.