Kava Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Kava 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
Kava is a dietary supplement by Herbalist & Alchemist 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 root extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Kava by Herbalist & Alchemist
Ask about any prescription or over-the-counter medication and we check it for interactions with Kava by Herbalist & Alchemist — 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 Kava by Herbalist & Alchemist
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
Full disclosure
This product contains one active ingredient: dried kava root extract. Kava root has been used traditionally for relaxation and social purposes, and modern studies have looked at it for anxiety, sleep, and other uses.
The extract is prepared in a liquid form with ethyl alcohol and distilled water as inactive ingredients.
Does it work?
Not established
The evidence for kava's effectiveness is limited and mixed. For generalized anxiety disorder, the data we hold rates it as possibly ineffective — meaning studies suggest it may not work as well as hoped for this condition.
For insomnia and sexual arousal, there isn't enough reliable evidence to establish whether it works or doesn't. For epilepsy, the evidence is also insufficient to make a claim.
How safe is it?
Well-documented data
Kava is generally well tolerated when taken by mouth, but the adverse effects matter. The most common ones are drowsiness, dry mouth, dizziness, upset stomach, headache, memory problems, and tremors.
Rare but serious effects include liver damage (hepatotoxicity) and muscle breakdown (rhabdomyolysis). Over 100 cases of liver injury have been reported worldwide, sometimes appearing within 3 to 4 weeks of starting kava; symptoms include yellowed skin and eyes.
In one clinical trial, people taking kava had a 3.2-fold higher risk of tremors compared with placebo. Kava is not considered safe during pregnancy and should be avoided.
It should also be avoided while breastfeeding due to lack of safety data and the possibility it could pass to the infant. Because of liver concerns and other risks, kava is banned or restricted in some countries.
Meds to double-check
Major interaction found
Before taking this kava product, double-check your medications with your doctor or pharmacist, especially if you take CNS depressants (sleep aids, sedatives, anxiety medications, some pain relievers). Also flag any medications processed by CYP2C19, CYP2C9, CYP2E1 enzymes, P-glycoprotein substrates like digoxin, haloperidol, or ropinirole.
And mention any drugs that are hard on the liver.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
Kava is an herb with significant interaction risks — especially with sleep aids, sedatives, and medications processed through specific liver enzymes — and a track record of rare but serious liver damage. If you take any prescription medications, you'll want to check them against this product's interaction list before starting, or talk it over with your doctor or pharmacist.
It's not recommended during pregnancy or while breastfeeding.
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 Mar 23, 2018.
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 Kava, straight from the product label.
| Brand | Herbalist & Alchemist |
|---|---|
| Barcode (UPC) | 667056117726 |
| Net contents | 2 fl. Oz.; 60 mL |
| Market status | On market |
| Date entered into DSLD | Mar 23, 2018 |
| DSLD ID | 174382 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Kosher |
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 Kava by Herbalist & Alchemist, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| dried Kava root extract | 2 mL | -- |
Other ingredients: Ethyl Alcohol, distilled Water
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.
Formula
Piper methysticum
OK
General Statements
Promotes relaxation
Botanical preparation ratio 1:4
FDA Statement of Identity
Herbal Supplement
Suggested/Recommended/Usage/Directions
Suggested Use: 30-40 drops (1.5-2 mL) in juice or water. Take 4 times per day. Shake well before using.
Precautions
Contraindications: US FDA advises a potential risk of rare, but severe liver injury may be associated with kava.
Ask a qualified expert before use if you have had liver problems, use alcoholic beverages or take medications.
Stop use and see a doctor if you develop liver problem symptoms.
Not for use by persons under 18 years, or by pregnant or breastfeeding women.
Not for use by persons under 18 years, or by pregnant or breastfeeding women.
Not for use with alcohol. Excessive use, or use with products that cause drowsiness, may impair your ability to operate a vehicle or equipment.
Keep out of children's reach
FDA Disclaimer Statement
This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
General
NO. KVK-2 1740TU
Seals/Symbols
OK
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Kava by Herbalist & Alchemist 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 Kava by Herbalist & Alchemist
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1.5 mL Dosage formLiquid Servings per container30 Amounts shown are per serving.
Dried Kava root extract
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 root extract monograph & interactionsOther (inactive) ingredients: Ethyl Alcohol, Distilled Water. These complete the product’s ingredient list but are not active constituents.
Kava by Herbalist & Alchemist Drug Interactions
HelloPharmacist Interaction Report
Kava by Herbalist & Alchemist carries significant interaction risks you need to know about.
Its single active ingredient, dried kava root extract, interacts with a major class of medications and several others. The most serious concern is with CNS depressants — drugs that slow the central nervous system, like sleep aids, sedatives, anti-anxiety medications, and some pain relievers.
Combining kava with these can add up to dangerous levels of drowsiness and impaired motor reflexes.
Read the full breakdown — every affected drug type, severity by severity
Kava also affects how your body metabolizes several drug classes. It can theoretically raise levels of medications processed through CYP2C19, CYP2C9, and CYP2E1 enzymes, which includes many common prescriptions.
There's also conflicting evidence about whether it affects P-glycoprotein substrates like digoxin. Additionally, kava poses a moderate interaction risk with haloperidol and ropinirole, with case reports of heart rhythm changes and hallucinations respectively.
One more important point: kava has been linked to over 100 cases of liver damage, especially with long-term use. Using it alongside medications that are themselves hard on the liver adds to that concern.
Altogether, these interactions span 1,167 individual medications. Before you start kava, run it through the medication checker on this page or talk with your doctor or pharmacist about your full medication list.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Kava?
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 Kava interact with 1,166 drugs. Click any drug to see the details.
1 of the 1 ingredient in Kava interact with drugs. Each result below shows which ingredient is responsible. dried Kava root extract
AcepromazineAtravet
How Acepromazine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava Root Extract + Acepromazine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractHepatotoxic 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 Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + 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 Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCns Depressants, Hepatotoxic Drugs +4 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava Root Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCns 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 Root Extract + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava Root Extract + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractHepatotoxic 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 Root Extract + Acetaminophen, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCns Depressants, Hepatotoxic Drugs +2 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava Root Extract + Acetaminophen, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava Root Extract + Acetaminophen, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractHepatotoxic 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 Root Extract + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Dried Kava Root Extract + Acetaminophen, Hydrocodone interactionAcetaminophen, MeperidineDemerol APAP
How Acetaminophen, Meperidine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Meperidine interactionAcetaminophen, OxycodonePercocet, Roxicet, Tylox, Xartemis XR
How Acetaminophen, Oxycodone interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractHepatotoxic 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 Root Extract + Acetaminophen, Oxycodone interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Pentazocine interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome 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 Root Extract + Acetaminophen, Propoxyphene interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava Root Extract + Acetazolamide interactionAlfentanilAlfenta
How Alfentanil interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava Root Extract + Alfentanil interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Major
Interaction Summary
It is unclear if kava inhibits CYP3AA; research is conflicting.
Read the full Dried Kava Root Extract + Alprazolam interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava Root Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAminoglutethimideCytadren
How Aminoglutethimide interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava Root Extract + Aminoglutethimide interactionAminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Kava — through 1 ingredient. Tap an ingredient for the detail:
Dried Kava Root ExtractCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Dried Kava Root Extract + Aminophylline, Amobarbital, Ephedrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Kava 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 root extract
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 Kava, from the product label.
Herbalist & Alchemist
See all Herbalist & Alchemist products- Name
- Herbalist & Alchemist, Inc.
- City
- Washington
- State
- NJ
- ZipCode
- 07882
- Phone Number
- 800-611-8235
- Web Address
- www.herbalist-alchemist.com
Kava by Herbalist & Alchemist: Common Questions
Does Kava by Herbalist & Alchemist interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Does kava actually help with anxiety?
What are the most common side effects I might notice?
Is kava safe to take long-term?
Can I take kava while pregnant or breastfeeding?
Why does this product interact with so many medications?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Kava is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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 Kava’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Kava'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
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- 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.
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- 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.
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- 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
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- 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.
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- 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
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- 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
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- Chanwai, L. G. Kava toxicity. Emergency Medicine 2002;12:142-145.
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- Teschke R. Kava hepatotoxicity: pathogenetic aspects and prospective considerations. Liver Int 2010;30(9):1270-9. PubMed
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- 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
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- 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.
© 2021 Therapeutic Research Center, LLC