Hawaiian Kava Brew or Chew Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Hawaiian Kava Brew or Chew against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Hawaiian Kava Brew or Chew is a dietary supplement by Maui Medicinal with 1 active ingredient. Its ingredients are commonly taken for anxiety and stress, restlessness, trouble sleeping.Based on those ingredients, 1,166 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are dried Kava. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Hawaiian Kava Brew or Chew by Maui Medicinal
Ask about any prescription or over-the-counter medication and we check it for interactions with Hawaiian Kava Brew or Chew by Maui Medicinal — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Hawaiian Kava Brew or Chew by Maui Medicinal
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
This product contains a single active ingredient: dried kava, the root of a Pacific island plant traditionally used to promote relaxation. There are no other active ingredients.
The product has no inactive fillers or excipients listed.
Does it work?
Not established
The evidence on kava is mixed. For generalized anxiety disorder — one of kava's main uses — the data we hold rates it as possibly ineffective, meaning the studies don't support real benefit.
For insomnia and sexual arousal, we don't have enough reliable evidence to rate it either way. For epilepsy, the evidence is also insufficient.
In short, if you're looking at kava to calm anxiety or sleep better, the research doesn't clearly back that up.
How safe is it?
Well-documented data
Kava is generally well tolerated when taken by mouth, but comes with real cautions. The most serious concern is liver injury: over 100 cases of hepatotoxicity have been reported, though most happened with heavy, long-term use.
In vulnerable people, liver damage can show up in as little as 3–4 weeks. Common side effects include drowsiness, dry mouth, dizziness, upset stomach, headache, memory problems, and tremor — one study found a 3.2-fold higher risk of tremors with regular use.
Rare cases of muscle breakdown (rhabdomyolysis) and involuntary movement disorders have also been reported. Kava is not considered safe in pregnancy and should be avoided.
While breastfeeding, it should also be avoided because we don't have enough safety data and kava may pass into breast milk and affect the infant.
Meds to double-check
Major interaction found
Before taking this kava product, double-check with your pharmacist or doctor if you're on CNS depressants (sedatives, sleep aids, opioids, tranquilizers) — the combination raises the risk of severe drowsiness and slowed reflexes. Also flag any antidepressants, blood pressure meds, blood thinners, heart medications, antipsychotics like haloperidol, or Parkinson's drugs like ropinirole.
Because kava may stress the liver, tell your provider if you take other medications known to affect liver function.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
Kava may appeal to you if you're drawn to traditional remedies for relaxation, but the evidence doesn't clearly show it works for anxiety or sleep, and liver injury is a real if uncommon risk. If you take any prescription medications — especially sedatives, blood thinners, antidepressants, or heart drugs — you need to check them against this product before starting.
Talk with your own doctor or pharmacist about whether kava fits your situation and what safer options might be available.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Aug 24, 2023.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Hawaiian Kava Brew or Chew, straight from the product label.
| Brand | Maui Medicinal |
|---|---|
| Barcode (UPC) | 673125111281 |
| Net contents | 1 Ounce(s); 29 Gram(s) |
| Market status | On market |
| Date entered into DSLD | Aug 24, 2023 |
| DSLD ID | 288641 |
| Product type | Botanical |
| Supplement form | Other (e.g. Tea Bag) |
| Dietary claims / uses | All Other |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Hawaiian Kava Brew or Chew by Maui Medicinal, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| dried Kava | 0 NP | -- |
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
GF Gluten free
Vegan
GMO free
Suggested/Recommended/Usage/Directions
Makes 8 fl oz Suggested Use: Mix cool fresh water with a generous portion of kava in a bowl, strain 10-12 times. Strain off kava debris, serve, drink and enjoy. Chewing Suggestions: Chew like gum. A small pinch is quickly effective.
Precautions
Caution: May cause numbness
Keep out of reach of children
General Statements
808.572.9331 or 800.936.6532
Seals/Symbols
GF Gluten free
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Hawaiian Kava Brew or Chew by Maui Medicinal label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Hawaiian Kava Brew or Chew by Maui Medicinal
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size0.5 Ounce(s) Dosage formOther (e.g. Tea Bag) Servings per container2 Amounts shown are per serving.
Dried Kava
Interacts with1,166 drugs
Kava is a Pacific Island plant traditionally used to promote relaxation and ease anxiety, and some studies suggest it may help mild anxiety. However,...
Dried Kava monograph & interactionsHawaiian Kava Brew or Chew by Maui Medicinal Drug Interactions
HelloPharmacist Interaction Report
Hawaiian Kava Brew or Chew by Maui Medicinal, made from dried kava, has documented interactions with a substantial number of medications.
The most serious concern is with CNS depressants (sedatives, sleep aids, pain relievers that contain opioids, and tranquilizers) — combining them with kava can add up to dangerously high drowsiness and impaired motor reflexes.
Read the full breakdown — every affected drug type, severity by severity
Kava also interacts with several other medication types at moderate severity. It may raise levels of drugs metabolized through CYP2C19, CYP2C9, and CYP2E1 enzymes, which includes many common antidepressants, blood pressure medications, and blood thinners.
There's a theoretical risk with P-glycoprotein substrates (certain heart and cancer drugs), though one clinical study of the heart drug digoxin showed no interaction. Two specific medications — haloperidol (an antipsychotic) and ropinirole (a Parkinson's drug) — have case reports of serious side effects when combined with kava, likely from enzyme inhibition.
There is also a moderate-severity concern with hepatotoxic drugs (medications that can stress the liver). Kava itself has been linked to over 100 cases of liver injury, mostly with heavy or long-term use; combining it with other liver-stressing drugs may raise that risk further.
Altogether, these interactions span 1,167 individual medications. Use the medication checker on this page to look up your exact prescriptions before starting kava, and talk with your own doctor or pharmacist about whether it's right for you.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Hawaiian Kava Brew or Chew?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Hawaiian Kava Brew or Chew interact with 1,166 drugs. Click any drug to see the details.
1 of the 1 ingredient in Hawaiian Kava Brew or Chew interact with drugs. Each result below shows which ingredient is responsible. dried Kava
AcepromazineAtravet
How Acepromazine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava + Acepromazine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +4 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +3 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaHepatotoxic Drugs, Cytochrome P450 2e1 (cyp2e1) Substrates +3 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Dried Kava + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCns Depressants, Hepatotoxic Drugs +4 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2e1 (cyp2e1) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +4 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +3 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +3 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCns Depressants, Cytochrome P450 2e1 (cyp2e1) Substrates +3 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +3 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +3 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaHepatotoxic Drugs, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Dried Kava + Acetaminophen, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCns Depressants, Hepatotoxic Drugs +2 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava + Acetaminophen, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava + Acetaminophen, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaHepatotoxic Drugs, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Dried Kava + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava + Acetaminophen, Hydrocodone interactionAcetaminophen, MeperidineDemerol APAP
How Acetaminophen, Meperidine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants +3 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Meperidine interactionAcetaminophen, OxycodonePercocet, Roxicet, Tylox, Xartemis XR
How Acetaminophen, Oxycodone interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaHepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +3 Major
Interaction Summary
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Read the full Dried Kava + Acetaminophen, Oxycodone interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +2 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Pentazocine interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates +3 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Dried Kava + Acetaminophen, Propoxyphene interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava + Acetazolamide interactionAlfentanilAlfenta
How Alfentanil interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava + Alfentanil interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Major
Interaction Summary
It is unclear if kava inhibits CYP3AA; research is conflicting.
Read the full Dried Kava + Alprazolam interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAminoglutethimideCytadren
How Aminoglutethimide interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava + Aminoglutethimide interactionAminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Hawaiian Kava Brew or Chew — through 1 ingredient. Tap an ingredient for the detail:
Dried KavaCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava + Aminophylline, Amobarbital, Ephedrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Hawaiian Kava Brew or Chew with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
dried Kava
Cns Depressants
Combining kava with CNS depressants can have additive sedative effects.
Kava has CNS depressant effects. Concomitant use of kava with other CNS depressants can increase the risk of drowsiness and motor reflex depression. Clinical practice guidelines from a joint taskforce of the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) recommend that CNS depressants, including alcohol and benzodiazepines, not be used with kava.
Alcohol (Ethanol)
Combining kava with alcohol may increase the risk of sedation and/or hepatotoxicity.
Kava has CNS depressant effects. Concomitant use of kava with other CNS depressants can increase the risk of drowsiness and motor reflex depression. Additionally, kava has been associated with over 100 cases of hepatotoxicity. There is some concern that kava can adversely affect the liver, especially when used in combination with hepatotoxic drugs. Clinical practice guidelines from a joint taskforce of the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) recommend that alcohol not be used with kava.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, kava might increase levels of CYP2C19 substrates.
In vitro research shows that kava significantly inhibits CYP2C19 enzymes. This effect has not yet been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, kava might increase levels of CYP2C9 substrates.
In vitro research shows that kava significantly inhibits CYP2C9 enzymes. This effect has not yet been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Kava might increase levels of CYP2E1 substrates.
In a clinical study in healthy volunteers, taking kava 1000 mg twice daily (containing a daily dose of 138 mg kavalactones) for 28 days inhibited the metabolism of CYP2E1 substrates.
Haloperidol (Haldol)
Combining kava and haloperidol might increase the risk of cardiovascular adverse effects and hypoxia.
Atrial flutter and hypoxia has been reported for a patient who received intramuscular injections of haloperidol and lorazepam after using kava orally. The side effects were attributed to kava-induced inhibition of CYP2D6, but might also have been related to additive adverse effects with the concomitant use of haloperidol, lorazepam, and kava.
Hepatotoxic Drugs
Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.
Kava has been linked with over 100 cases of hepatotoxicity. Most cases occur with excessive and prolonged use. There is some concern that kava can adversely affect the liver, especially when used in combination with hepatotoxic drugs.
P-Glycoprotein Substrates
It is unclear if kava inhibits P-glycoprotein (P-gp); research is conflicting.
In vitro research shows that kava can inhibit P-gp efflux. However, a clinical study in healthy volunteers shows that taking kava standardized to provide 225 mg kavalactones daily for 14 days does not affect the pharmacokinetics of digoxin, a P-gp substrate. It is possible that the use of other P-gp substrates or higher doses of kava might still inhibit P-gp.
Ropinirole (Requip)
Taking kava with ropinirole might increase the risk for dopaminergic toxicity.
A case of visual hallucinations and paranoid delusions has been reported for a patient who used kava in combination with ropinirole. The adverse effects were attributed to kava-induced inhibition of CYP1A2, which may have reduced the metabolism of ropinirole, resulting in excessive dopaminergic stimulation.
Cytochrome P450 1A2 (Cyp1A2) Substrates
It is unclear if kava inhibits CYP1A2; research is conflicting.
Although in vitro research and a case report suggest that kava inhibits CYP1A2, more robust clinical evidence shows that kava has no effect on CYP1A2. 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 CYP1A2 activity.
Cytochrome P450 2D6 (Cyp2D6) Substrates
It is unclear if kava inhibits CYP1A2; research is conflicting.
In vitro research shows that kava extract significantly inhibits CYP2D6. However, clinical research shows that kava does not affect the metabolism of CYP2D6 substrates in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
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.
Brand information
Manufacturer and brand details for Hawaiian Kava Brew or Chew, from the product label.
Maui Medicinal
See all Maui Medicinal products- Name
- Maui Medicinal
- Street Address
- 20 Kekaulike Ave.
- City
- Kula
- State
- HI
- ZipCode
- 96768
- Phone Number
- 800.936.6532
- Web Address
- mauimedicinal.com
Hawaiian Kava Brew or Chew by Maui Medicinal: Common Questions
Does Hawaiian Kava Brew or Chew by Maui Medicinal interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take this while pregnant?
Is it safe to use while breastfeeding?
What side effects should I watch for?
Does it actually help anxiety or sleep?
Why is kava restricted in some countries?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Hawaiian Kava Brew or Chew is safe with your meds?
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Hawaiian Kava Brew or Chew’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Hawaiian Kava Brew or Chew's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 71 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Kava 71 references
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Strahl S, Ehret V, Dahm HH, Maier KP. [Necrotizing hepatitis after taking herbal medication]. Dtsch Med Wochenschr 1998;123:1410-4.
- Spillane PK, et al. Neurological manifestations of kava intoxication. Med J Aust 1997;167:172-3. PubMed
- Swensen JN. Man convicted of driving under the influence of kava. Salt Lake City, UT: Deseret News, 1996.
- Pittler MH, Ernst E. Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J Clin Psychopharmacol 2000;20:84-9. PubMed
- 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
- 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
- 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.
- Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol 2001;16:353-6. PubMed
- Schelosky L, Raffaup C, Jendroska K, Poewe W. Kava and dopamine antagonism. J Neurol Neurosurg Psychiatry 1995;58:639-40. PubMed
- Norton SA, Ruze P. Kava dermopathy. J Am Acad Dermatol 1994;31:89-97.
- Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 2nd ed. Edinburgh:Churchill Livingstone, 1999.
- 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.
- Escher M, Desmeules J, Giostra E, Mentha G. Hepatitis associated with Kava, a herbal remedy for anxiety. BMJ 2001;322:139.
- Russmann S, Lauterburg BH, Helbling A. Kava hepatotoxicity [letter]. Ann Intern Med 2001;135:68-9.
- Liver Toxicity With Kava. Pharmacist's Letter/Prescriber's Letter. January 2001.
- 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.
- Meseguer E, Taboada R, Sanchez V, et al. Life-threatening parkinsonism induced by kava-kava. Mov Disord 2002;17:195-6. PubMed
- Ruze P. Kava-induced dermopathy: a niacin deficiency? Lancet 1990;335:1442-5. PubMed
- Singh YN. Kava: an overview. J Ethnopharmacol 1992;37:13-45.
- Bilia AR, Gallori S, Vincieri FF. Kava-kava and anxiety: growing knowledge about the efficacy and safety. Life Sci 2002;70:2581-97. PubMed
- Wooltorton E. Herbal kava: reports of liver toxicity. CMAJ 2002;166:777.
- 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
- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
- Teschke R, Gaus W, Loew D. Kava extracts: safety and risks including rare hepatotoxicity. Phytomedicine 2003;10:440-6. PubMed
- Schmidt P, Boehncke WH. Delayed-type hypersensitivity reaction to kava-kava extract. Contact Dermatitis 2000;42:363-4.
- Schulze J, Raasch W, Siegers CP. Toxicity of kava pyrones, drug safety and precautions--a case study. Phytomedicine 2003;10:68-73.. PubMed
- Pittler MH, Ernst E. Kava extract for treating anxiety. Cochrane Database Syst Rev 2003;(1):CD003383.
- Cairney S, Maruff P, Clough AR, et al. Saccade and cognitive impairment associated with kava intoxication. Hum Psychopharmacol 2003;18:525-33. PubMed
- Moulds RF, Malani J. Kava: herbal panacea or liver poison? Med J Aust 2003;178:451-3. PubMed
- 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
- 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
- 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
- Weiss J, Sauer A, Frank A, Unger M. Extracts and kavalactones of Piper methysticum G. Forst (kava-kava) inhibit P-glycoprotein in vitro. Drug Metab Dispos 2005;33:1580-3. PubMed
- Gurley BJ, Swain A, Barone GW, et al. Effect of goldenseal (Hydrastis canadensis) and kava kava (Piper methysticum) supplementation on digoxin pharmacokinetics in humans. Drug Metab Dispos 2007;35:240-5. PubMed
- Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
- Li XZ, Ramzan I. Role of ethanol in kava hepatotoxicity. Phytother Res 2010;24:475-80. PubMed
- Bodkin R, Schneider S, Rekkerth D, et al. Rhabdomyolysis associated with kava ingestion. Am J Emerg Med 2012;30:635.el-3. PubMed
- 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
- 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
- Hannam S, Murray M, Romani L, Tuicakau M, J Whitfeld M. Kava dermopathy in Fiji: an acquired ichthyosis? Int J Dermatol 2014;53(12):1490-4. PubMed
- 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
- Teschke R, Sarris J, Schweitzer I. Kava hepatotoxicity in traditional and modern use: the presumed Pacific kava paradox hypothesis revisited. Br J Clin Pharmacol 2012;73(2):170-4. PubMed
- Scherer, J. Kava-kava extract in anxiety disorders: an outpatient observational study. Adv.Ther. 1998;15(4):261-269.
- Humberston, C. L., Akhtar, J., and Krenzelok, E. P. Acute hepatitis induced by kava kava. J Toxicol.Clin Toxicol. 2003;41(2):109-113. PubMed
- Schmidt, M. Are kavalactones the hepatotoxic principle of kava extracts? The pitfalls of the glutathione theory. J Altern Complement Med 2003;9(2):183-187. PubMed
- Stickel, F., Baumuller, H. M., Seitz, K., Vasilakis, D., Seitz, G., Seitz, H. K., and Schuppan, D. Hepatitis induced by Kava (Piper methysticum rhizoma). J Hepatol. 2003;39(1):62-67. PubMed
- Grace, R. Kava-induced urticaria. J Am Acad Dermatol 2005;53(5):906. PubMed
- Christl, S. U., Seifert, A., and Seeler, D. Toxic hepatitis after consumption of traditional kava preparation. J.Travel.Med. 2009;16(1):55-56. PubMed
- Teschke, R., Genthner, A., and Wolff, A. Kava hepatotoxicity: comparison of aqueous, ethanolic, acetonic kava extracts and kava-herbs mixtures. J.Ethnopharmacol. 6-25-2009;123(3):378-384. PubMed
- 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
- Gessner B and Cnota P. Extract of the kava-kava rhizome in comparison with diazepam and placebo. Z Phytother 1994;15(1):30-37.
- Johnson D, Frauendorf A, Stecker K, and et al. Neurophysiological active profile and tolerance of kava extract WS 1490, A pilot study with randomized evaluation. TW Neurolgie Psychiatrie 1991;5(6):349-354.
- Keller F and Klohs M. A review of the chemistry and pharmacology of the constituents of Piper methysticum. Lloydia 1963;26:1-15.
- 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.
- Chanwai, L. G. Kava toxicity. Emergency Medicine 2002;12:142-145.
- Leung, N. Acute urinary retention secondary to kava ingestion. Emerg Med Australas 2004;16(1):94. PubMed
- Teschke R. Kava hepatotoxicity: pathogenetic aspects and prospective considerations. Liver Int 2010;30(9):1270-9. PubMed
- Toohey TP, Lu BY, Wada C. Toxic effects of psychotropics related to possible p450 enzyme inhibition by kava:report of 2 cases. Prim Care Companion CNS Disord 2013;15(5). PubMed
- Ostermayer D. News: Kava, Popular as Alcohol Alternative, May Cause Toxicity. Emerg Med News. 2016;38(1B).
- Kuchta K, Schmidt M, Nahrstedt A. German Kava Ban Lifted by Court: The Alleged Hepatotoxicity of Kava (Piper methysticum) as a Case of Ill-Defined Herbal Drug Identity, Lacking Quality Control, and Misguided Regulatory Politics. Planta Med. 2015;81(18):16 PubMed
- Schmidt M. German Court Ruling Reverses Kava Ban; German Regulatory Authority Appeals Decision. HerbalEGram. 2014;11(7).
- Wainiqolo I, Kool B, Nosa V, Ameratunga S. Is driving under the influence of kava associated with motor vehicle crashes? A systematic review of the epidemiological literature. Aust N Z J Public Health 2015;39(5):495-9. PubMed
- Wainiqolo I, Kafoa B, Kool B, et al. Driving following kava use and road traffic injuries: a population-based case-control study in Fiji (TRIP 14). PLoS One 2016;11(3):e0149719. PubMed
- Asher GN, Corbett AH, Hawke RL. Common Herbal Dietary Supplement-Drug Interactions. Am Fam Physician. 2017;96(2):101-107.
- Sarris J, Byrne GJ, Bousman CA, et al. Kava for generalised anxiety disorder: A 16-week double-blind, randomised, placebo-controlled study. Aust N Z J Psychiatry. 2020 Mar;54(3):288-297. PubMed
- Aporosa AS, Atkins M, Brunton R. Kava drinking in traditional settings: towards understanding effects on cognitive function. Hum Psychopharmacol. 2020;35(2):e2725. PubMed
- Sarris J, Ravindran A, Yatham LN, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety T
- Aporosa S', Ballard H, Pandey R, McCarthy MJ. The impact of traditional kava (Piper methysticum) use on cognition: Implications for driver fitness. J Ethnopharmacol 2022;291:115080. PubMed
- Savage K, Sarris J, Hughes M, et al. Neuroimaging insights: Kava's (Piper methysticum) effect on dorsal anterior cingulate cortex GABA in generalized anxiety disorder. Nutrients 2023;15(21):4586. PubMed
- du Plessis Nisbet J, Xie D, Thompson R, Wark K, Lamrock E, Scurry J. Kava-induced dermatitis: A detailed histopathological analysis. Australas J Dermatol 2024. PubMed
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.
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