Drug & supplement interaction

Kava + Spironolactone

Spironolactone brand names: Aldactone, Spiroton, Carospir.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Kava and Spironolactone in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Kava and Spironolactone

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Spironolactone and Kava in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Kava safety at a glance

Kava overall Use caution Kava may help anxiety but has been linked to rare, serious liver injury and is banned or restricted in some countries.
Pregnancy Avoid Kava is not considered safe during pregnancy and should be avoided.
Breastfeeding Possibly Unsafe When used orally. There is concern that the toxic pyrone constituents of kava can pass into breast milk; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Spironolactone and Kava? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Spironolactone

Interactions in our licensed database are recorded against drug classes, not just single drug names. Spironolactone is filed under 4 classifications — including potassium-sparing diuretics, diuretic drugs, antihypertensive drugs. Kava has documented interactions with 12 drug classes — the most serious being cns depressants (major), alcohol (ethanol) (moderate) and cytochrome p450 2c19 (cyp2c19) substrates (moderate) — and none of Spironolactone’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Kava Does Interact With Other Medications

Kava has 248 major, 577 moderate, 341 minor known drug interactions in our database — Spironolactone isn’t one of them. If you take anything else, check it against the full list below.

Major 248 Moderate 577 Minor 341 No known interaction 1,664 (incl. Spironolactone)
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.

What to actually watch for

No Interaction Found — But Data Suggests Kava and Spironolactone May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 3 of them are worth acting on rather than waiting out — marked below.

  • Unsteadiness Worth acting on Additional detail

    Kava

    “Kava has been linked with reports of rhabdomyolysis. A 34-year-old man who consumed kava tea several times a week developed rhabdomyolysis with a peak creatine kinase level of 32,500 units/liter. However, there is speculation that this might have been due to product impurities rather than kava itself.”

    Kava · Natural Medicines adverse-effect record, reported in muscle breakdown.

    3 sources cited
    1. 18212. Bodkin R, Schneider S, Rekkerth D, et al. Rhabdomyolysis associated with kava ingestion. Am J Emerg Med 2012;30:635.el-3. PubMed
    2. 18213. Donadio V, Bonsi P, Zele I, et al. Myoglobinuria after ingestion of extracts of guarana, Ginkgo biloba and kava. Ginkgo biloba and kava. Neurol Sci 2000;21:124. PubMed
    3. 11373. Cairney S, Maruff P, Clough AR, et al. Saccade and cognitive impairment associated with kava intoxication. Hum Psychopharmacol 2003;18:525-33. PubMed

    Spironolactone

    Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›

  • A low platelet count Worth acting on Additional detail

    Kava

    “Long-term use of very large amounts of kava, especially in high doses (400 mg kava pyrones daily), has been associated with overall poor health including symptoms of low body weight, reduced protein levels, puffy face, hematuria, increased red blood cell volume, decreased platelets and lymphocytes, and possibly pulmonary hypertension.”

    Kava · Natural Medicines adverse-effect record, reported in hypertension.

    1 source cited
    1. 6402. Mathews JD, Riley MD, Fejo L, et al. Effects of heavy usage of kava on physical health: Summary of a pilot survey in an aboriginal community. Med J Aust 1988;148:548-55.

    Spironolactone

    Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›

  • An allergic reaction Worth acting on Additional detail

    Kava

    “Orally, kava can cause allergic skin reactions, including sebotropic eruptions, delayed-type hypersensitivity, or urticarial eruption. In one case of kava-associated urticarial eruption, biopsy revealed neutrophilic sebaceous glands with lymphocytic infiltrate. Chronic use of high doses of kava has also been associated with kava dermopathy, which consists of reddened eyes; dry, scaly, flaky skin;”

    Kava · Natural Medicines adverse-effect record, reported in dermatitis.

    6 sources cited
    1. 4032. Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol 2001;16:353-6. PubMed
    2. 11370. Schmidt P, Boehncke WH. Delayed-type hypersensitivity reaction to kava-kava extract. Contact Dermatitis 2000;42:363-4.
    3. 28489. Huynh JC, Asgari MM, Moore MM. Sebotropic eruption associated with use of oral kava kava supplement. Clin Exp Dermatol 2014;39(7):816-8. PubMed
    4. 57277. Grace, R. Kava-induced urticaria. J Am Acad Dermatol 2005;53(5):906. PubMed
    5. 57325. Jappe, U., Franke, I., Reinhold, D., and Gollnick, H. P. Sebotropic drug reaction resulting from kava-kava extract therapy: a new entity? J Am Acad Dermatol. 1998;38(1):104-106. PubMed
    6. 57343. Siegers CP, Honold E, Krall B, and et al. Results of the drug monitoring L 1090 with Laitan capsules. Arztl Forsch 1992;39:7-11.

    Spironolactone

    Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›

  • Drowsiness / Dizziness / Headache Additional detail

    Kava

    “Orally, kava may cause headache, dizziness, and drowsiness. It might also cause extrapyramidal side effects such as involuntary oral and lingual reflexes, twisting movements of the head and trunk, tremors, and other parkinsonian-like symptoms possibly due to dopamine antagonism.”

    Kava · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 4032. Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol 2001;16:353-6. PubMed
    2. 6402. Mathews JD, Riley MD, Fejo L, et al. Effects of heavy usage of kava on physical health: Summary of a pilot survey in an aboriginal community. Med J Aust 1988;148:548-55.
    3. 11370. Schmidt P, Boehncke WH. Delayed-type hypersensitivity reaction to kava-kava extract. Contact Dermatitis 2000;42:363-4.
    4. 11372. Pittler MH, Ernst E. Kava extract for treating anxiety. Cochrane Database Syst Rev 2003;(1):CD003383.
    5. 11373. Cairney S, Maruff P, Clough AR, et al. Saccade and cognitive impairment associated with kava intoxication. Hum Psychopharmacol 2003;18:525-33. PubMed
    6. 18316. Sarris J, Kavanagh DJ, Byrne G, et al. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum. Psychopharmacology 2009;205:399-407. PubMed

    Spironolactone

    Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›

  • Stomach upset Additional detail

    Kava

    “Orally, kava may cause gastrointestinal upset, nausea, or dry mouth.”

    Kava · Natural Medicines adverse-effect record, reported in dry mouth.

    6 sources cited
    1. 2093. Pittler MH, Ernst E. Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J Clin Psychopharmacol 2000;20:84-9. PubMed
    2. 2094. Volz HP, Kieser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders--a randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry 1997;30:1-5. PubMed
    3. 4032. Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol 2001;16:353-6. PubMed
    4. 11370. Schmidt P, Boehncke WH. Delayed-type hypersensitivity reaction to kava-kava extract. Contact Dermatitis 2000;42:363-4.
    5. 18316. Sarris J, Kavanagh DJ, Byrne G, et al. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum. Psychopharmacology 2009;205:399-407. PubMed
    6. 57228. Scherer, J. Kava-kava extract in anxiety disorders: an outpatient observational study. Adv.Ther. 1998;15(4):261-269.

    Spironolactone

    Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›

  • Tiredness Additional detail

    Kava

    “Since the early 2000's, hepatotoxicity has been a particular concern with kava. Worldwide, there have been at least 100 reported cases of hepatotoxicity following use of kava products. However, some experts question the clinical validity of several of these cases.”

    Kava · Natural Medicines adverse-effect record, reported in anxiety.

    6 sources cited
    1. 7024. Escher M, Desmeules J, Giostra E, Mentha G. Hepatitis associated with Kava, a herbal remedy for anxiety. BMJ 2001;322:139.
    2. 7068. Russmann S, Lauterburg BH, Helbling A. Kava hepatotoxicity [letter]. Ann Intern Med 2001;135:68-9.
    3. 7086. Liver Toxicity With Kava. Pharmacist's Letter/Prescriber's Letter. January 2001.
    4. 7096. Consultation letter MLX 286: Proposals to prohibit the herbal ingredient Kava-Kava (Piper methysticum) in unlicensed medicines. Medicines Control Agency, United Kingdom, July 19, 2002.
    5. 11795. Gow PJ, Connelly NJ, Hill RL, et al. Fatal fulminant hepatic failure induced by a natural therapy containing kava. Med J Aust 2003;178:442-3. PubMed
    6. 17086. Li XZ, Ramzan I. Role of ethanol in kava hepatotoxicity. Phytother Res 2010;24:475-80. PubMed

    Spironolactone

    Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›

  • A skin rash Additional detail

    Kava

    Recorded for Kava in the same Natural Medicines adverse-effect record shown under An allergic reaction above.

    Spironolactone

    Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›

  • Nausea Additional detail

    Kava

    Recorded for Kava in the same Natural Medicines adverse-effect record shown under Stomach upset above.

    Spironolactone

    Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›

Reported for Kava but not commonly for Spironolactone: shortness of breath, memory problems, trouble passing urine and liver problems.

Effects for Spironolactone come from the ADVERSE REACTIONS section of its FDA label; effects for Kava come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Kava in Pregnancy & Breastfeeding

Lactation Possibly Unsafe

When used orally. There is concern that the toxic pyrone constituents of kava can pass into breast milk; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Kava or Spironolactone

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 Spironolactone, 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 Spironolactone

This page covers Kava only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Spironolactone page lists 206 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Lithium (major) and Oleander (major).

By severity: 7 major · 174 moderate · 25 minor.

From our pharmacist’s overview on the Spironolactone page

“Potassium is the supplement I check first for anyone on spironolactone (Aldactone, Carospir), because this water pill works by holding potassium in the body, and supplementing more on top of that can push blood levels too high. It is one of 206 supplement and herbal ingredients with documented interactions here, and the list warrants g…”

Reviewed by 2 · Jul 18, 2026

Open the Spironolactone 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. Even though Kava itself has no known interaction with Spironolactone, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Kava and Spironolactone 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 Spironolactone
Top 25%

#286 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Kava reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Kava and Spironolactone records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Piper methysticum · Piperaceae · Roots and rhizomes · Capsules, tablets, liquid extracts, tinctures, teas, and traditional water-based root drinks

An interaction check asks whether these two react with each other — it does not ask whether Kava is a good idea for someone in your situation. Here is what our Kava record says about it on its own.

Kava: dosing

There is no single established or standardized dose for kava, and products vary widely in how much kavalactone they contain. Because of this and the risk of liver harm, it is best not to guess at a dose on your own.If you and your healthcare provider decide kava is appropriate, follow the directions on the product label and use the lowest effective amount for the shortest time. Many experts advise limiting how long you use kava.

From our Kava monograph — the full record covers uses, side effects and every documented interaction.

Read the full Kava monograph & all interactions
Medication

About Spironolactone

What Is Spironolactone Used For?

Brand names: Aldactone, Spiroton, Carospir

Spironolactone tablets (including Aldactone) are used to treat moderate-to-severe heart failure, high blood pressure, and fluid retention (edema) caused by liver cirrhosis or nephrotic syndrome. They are also used to diagnose and manage primary hyperaldosteronism — a condition where the adrenal glands produce too much of the hormone aldosterone.

Spironolactone oral suspension shares several of these uses — heart failure, high blood pressure, and edema from liver cirrhosis — but is not the same as Aldactone and is not therapeutically interchangeable with it. Your prescriber will choose the right form for your situation.

See full Spironolactone 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
341Minor
1,663No known interaction
248 Major 577 Moderate 341 Minor 1,663 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

341 interactions

Showing 60 of 341 minor interactions — see all 341 on the Kava page.

No interaction 1,663 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 1,663 medications checked with no known interaction — see the full Kava list.

See the full Kava interactions page
See every supplement checked against Spironolactone, ranked by severity
Evidence & sources

Kava References

The 71 references that drive our Kava monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Strahl S, Ehret V, Dahm HH, Maier KP. [Necrotizing hepatitis after taking herbal medication]. Dtsch Med Wochenschr 1998;123:1410-4.
  3. Spillane PK, et al. Neurological manifestations of kava intoxication. Med J Aust 1997;167:172-3. PubMed
  4. Swensen JN. Man convicted of driving under the influence of kava. Salt Lake City, UT: Deseret News, 1996.
  5. Pittler MH, Ernst E. Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J Clin Psychopharmacol 2000;20:84-9. PubMed
  6. Volz HP, Kieser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders--a randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry 1997;30:1-5. PubMed
  7. Heinze HJ, Munthe TF, Steitz J, Matzke M. Pharmacopsychological effects of oxazepam and kava-extract in a visual search paradigm assessed with event-related potentials. Pharmacopsychiatry 1994;27:224-30. PubMed
  8. Munte TF, Heinze HJ, Matzke M, Steitz J. Effects of oxazepam and an extract of kava roots (Piper methysticum) on event-related potentials in a word recognition task. Neuropsychobiology 1993;27:46-53.
  9. Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol 2001;16:353-6. PubMed
  10. Schelosky L, Raffaup C, Jendroska K, Poewe W. Kava and dopamine antagonism. J Neurol Neurosurg Psychiatry 1995;58:639-40. PubMed
  11. Norton SA, Ruze P. Kava dermopathy. J Am Acad Dermatol 1994;31:89-97.
  12. Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 2nd ed. Edinburgh:Churchill Livingstone, 1999.
  13. Mathews JD, Riley MD, Fejo L, et al. Effects of heavy usage of kava on physical health: Summary of a pilot survey in an aboriginal community. Med J Aust 1988;148:548-55.
  14. Escher M, Desmeules J, Giostra E, Mentha G. Hepatitis associated with Kava, a herbal remedy for anxiety. BMJ 2001;322:139.
  15. Russmann S, Lauterburg BH, Helbling A. Kava hepatotoxicity [letter]. Ann Intern Med 2001;135:68-9.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Kava and Spironolactone Together: Common Questions

Is it safe to take Kava with Spironolactone?
We do not list a known interaction between Kava and Spironolactone. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Kava and Spironolactone have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Kava and Spironolactone combination checked?
Interactions in our licensed database are recorded against drug classes. Spironolactone is filed under 4 classifications, and Kava has documented interactions with 12 drug classes — none of Spironolactone's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Kava interact with any other medications?
Yes. Kava has 1,166 documented drug interactions in our database — Spironolactone is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Spironolactone interact with any supplements?
Yes. Spironolactone has documented interactions with 206 supplements in our database — Kava is not one of them. The Spironolactone interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Kava monograph Uses, safety profile, and every drug interaction in one place Spironolactone drug information The full plain-English guide to this medication Spironolactone supplement interactions Every supplement checked against Spironolactone, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 71 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Spironolactone 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.