Kava-Kava 425 mg Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Kava-Kava 425 mg 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-Kava 425 mg is a dietary supplement by Sunshine Naturals 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 Kava Kava. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Kava-Kava 425 mg by Sunshine Naturals
Ask about any prescription or over-the-counter medication and we check it for interactions with Kava-Kava 425 mg by Sunshine Naturals — 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-Kava 425 mg by Sunshine Naturals
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: kava kava at 425 mg per capsule. The capsules also contain inactive ingredients — microcrystalline cellulose (a binder), magnesium stearate (a flow agent), and gelatin (the capsule material itself).
Does it work?
Not established
The evidence we hold rates kava as possibly ineffective for generalized anxiety disorder, even though it's often marketed for anxiety. For insomnia and sexual arousal, the evidence isn't established enough to rate.
In short, the data doesn't clearly show this works for the conditions people typically buy it for.
How safe is it?
Well-documented data
Kava is generally well tolerated in the short term, but the most common side effects include drowsiness, dry mouth, dizziness, stomach upset, headache, memory problems, and tremor. The bigger concern is liver injury — over 100 cases of serious liver damage have been reported worldwide with kava use, especially after weeks of regular use.
Symptoms can show up in as little as 3 to 4 weeks and include yellowed skin and darkened urine. Kava is not considered safe in pregnancy and should be avoided.
It should also be avoided while breastfeeding due to lack of safety data and the possibility it could pass into breast milk.
Meds to double-check
Major interaction found
Before taking this product, double-check with your pharmacist or doctor if you take any CNS depressants (sedatives, sleep aids, anti-anxiety drugs, opioids, or certain pain relievers). Also confirm with them if you take drugs metabolized by the liver's CYP2C19, CYP2C9, CYP2E1, or P-glycoprotein pathways, hepatotoxic medications, haloperidol, or ropinirole — kava can affect how your body processes these and raise their levels.
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-Kava 425 mg carries real risks: serious interactions with many common medications, documented cases of liver injury, and evidence that it doesn't actually work well for anxiety. If you're considering it, talk with your doctor or pharmacist first — they can review your specific medications and weigh whether the risks fit your situation.
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 Jul 21, 2022.
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-Kava 425 mg, straight from the product label.
| Brand | Sunshine Naturals |
|---|---|
| Barcode (UPC) | 789939100707 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jul 21, 2022 |
| DSLD ID | 271276 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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-Kava 425 mg by Sunshine Naturals, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Kava Kava | 425 mg | -- |
Other ingredients: Microcrystalline Cellulose, Magnesium Stearate, Gelatin
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.
Suggested/Recommended/Usage/Directions
Directions: Take 1 or 2 capsules a day with meals.
Precautions
Excessive consumption may cause dizziness.
Keep out of the reach of children.
Do not use if safety seal is broken or missing.
Formula
The historical use of Kava in Polynesia confirms to be beneficial to help nervous tension, stress and agitation.
(Piper Methysticum)
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Storage
Store in a cool dry place.
FDA Statement of Identity
Herbal Supplement
Formulation
A natural help for anxiety
Proudly Made in the USA.
Seals/Symbols
Proudly Made in the USA.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Kava-Kava 425 mg by Sunshine Naturals 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-Kava 425 mg by Sunshine Naturals
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.
Kava 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,...
Kava Kava monograph & interactionsOther (inactive) ingredients: Microcrystalline Cellulose, Magnesium Stearate, Gelatin. These complete the product’s ingredient list but are not active constituents.
Kava-Kava 425 mg by Sunshine Naturals Drug Interactions
HelloPharmacist Interaction Report
Kava-Kava 425 mg by Sunshine Naturals has documented interactions through its kava kava ingredient with a range of medications.
The most serious concern is with CNS depressants (sedatives, sleep aids, anxiety medications, pain relievers with sedative effects) — combining kava with these can add up and leave you drowsy and impaired. Kava can slow how your liver breaks down several types of medications, potentially raising their levels in your bloodstream.
This includes drugs metabolized by CYP2C19, CYP2C9, CYP2E1, and P-glycoprotein pathways — categories that span many common prescriptions. There's also a theoretical risk if you take hepatotoxic drugs (medicines known to stress the liver) alongside kava, since kava itself has been linked to liver injury in rare cases.
Two specific medications carry documented case reports of problems: haloperidol (an antipsychotic) and ropinirole (a Parkinson's medication). Altogether, these interactions span 1,167 individual medications.
Before you start this product, search your exact prescriptions in the tool on this page — and talk with your pharmacist or doctor about whether kava is right for you.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Kava-Kava 425 mg?
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-Kava 425 mg interact with 1,166 drugs. Click any drug to see the details.
1 of the 1 ingredient in Kava-Kava 425 mg interact with drugs. Each result below shows which ingredient is responsible. Kava Kava
AcepromazineAtravet
How Acepromazine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava + Acepromazine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +3 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Kava 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 Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCns Depressants, Hepatotoxic Drugs +4 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Kava Kava + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 2e1 (cyp2e1) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +3 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCns Depressants, Cytochrome P450 2e1 (cyp2e1) Substrates +3 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCns Depressants, Hepatotoxic Drugs +2 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava + Acetaminophen, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava + Acetaminophen, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava + Acetaminophen, Hydrocodone interactionAcetaminophen, MeperidineDemerol APAP
How Acetaminophen, Meperidine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants +3 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Kava Kava + Acetaminophen, Meperidine interactionAcetaminophen, OxycodonePercocet, Roxicet, Tylox, Xartemis XR
How Acetaminophen, Oxycodone interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Oxycodone interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +2 Major
Interaction Summary
It is unclear if kava inhibits CYP1A2; research is conflicting.
Read the full Kava Kava + Acetaminophen, Pentazocine interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava 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 Kava Kava + Acetaminophen, Propoxyphene interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava + Acetazolamide interactionAlfentanilAlfenta
How Alfentanil interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava + Alfentanil interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Major
Interaction Summary
It is unclear if kava inhibits CYP3AA; research is conflicting.
Read the full Kava Kava + Alprazolam interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAminoglutethimideCytadren
How Aminoglutethimide interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava + Aminoglutethimide interactionAminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Kava-Kava 425 mg — through 1 ingredient. Tap an ingredient for the detail:
Kava KavaCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava + Aminophylline, Amobarbital, Ephedrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Kava-Kava 425 mg 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.
Kava 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 Kava-Kava 425 mg, from the product label.
Sunshine Naturals
See all Sunshine Naturals products- Name
- American Naturavit Inc.
- City
- Miami
- State
- FL
- ZipCode
- 33166
- Phone Number
- 305-593-5417
- Web Address
- www.sunshinenaturals.com
Kava-Kava 425 mg by Sunshine Naturals: Common Questions
Does Kava-Kava 425 mg by Sunshine Naturals interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Does kava actually work for anxiety?
What are the most common side effects?
Can I take this while pregnant or breastfeeding?
Why is there concern about liver damage?
How much kava is in each capsule?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Kava-Kava 425 mg 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 Kava-Kava 425 mg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Kava-Kava 425 mg'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.
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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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- 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
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- 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
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- 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
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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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