Kava Kava Ingredients & Drug Interactions
by Herbal Terra
What is this page for?
First and foremost: checking Kava 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 Kava is a dietary supplement by Herbal Terra 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 Root Extract, Dry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
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HelloPharmacist Scorecard of Kava Kava by Herbal Terra
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 a single active ingredient: Kava Kava Root Extract (Dry). The liquid also holds alcohol, water, and glycerin as inactive carriers — standard for liquid herbal extracts.
Does it work?
Couldn't assess
The evidence for kava is limited and mixed. For generalized anxiety (the main reason people use it), the data we hold rates it possibly ineffective — meaning the research does not support it working well for that purpose.
For insomnia and sexual function, there isn't enough reliable evidence to rate whether it works or doesn't. The data we have doesn't establish clear effectiveness for the uses kava is commonly marketed for.
How safe is it?
Well-documented data
Kava is generally well tolerated when taken orally, though drowsiness, dry mouth, dizziness, upset stomach, headache, memory problems, and tremor do occur. The serious concern is the liver.
Over 100 cases of liver damage have been reported with kava use, some appearing after as little as 3–4 weeks. Symptoms of liver trouble include yellowed skin and eyes.
Tremors may also occur; one trial found a 3.2-fold higher risk compared to placebo. Kava is not considered safe in pregnancy and should be avoided.
It should also be avoided while breastfeeding because there isn't enough safety data and it may pass to your infant.
Meds to double-check
Major interaction found
Before taking this product, check with your pharmacist if you take CNS depressants (sedatives, sleep aids, opioid painkillers, anti-anxiety drugs) — the combination significantly increases drowsiness and motor impairment. Also ask about medications broken down by CYP2C19, CYP2C9, or CYP2E1 liver enzymes, ropinirole (Requip), haloperidol (Haldol), digoxin (Lanoxin), or any other drug known to stress the liver.
The bottom line
Scorecard at a glanceFully disclosed formula with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Kava carries real risks — liver damage is the big one, and interactions with common medications are numerous. If you take any CNS depressants, medications processed by certain liver enzymes, or drugs that stress the liver, you need to check with your pharmacist first.
Even without medications, the liver risk means you and your doctor should have a direct conversation before you start.
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 Dec 21, 2024.
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, straight from the product label.
| Brand | Herbal Terra |
|---|---|
| Barcode (UPC) | 7238360309348 |
| Net contents | 2 Fluid Ounce(s); 60 mL |
| Market status | On market |
| Date entered into DSLD | Dec 21, 2024 |
| DSLD ID | 325146 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Sugar 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 Kava Kava by Herbal Terra, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Kava Kava Root Extract, Dry | 983 mg | -- |
Other ingredients: Alcohol, Water, Glycerin
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
Shake well before use. Adults take up to 30 drops (1 mL, one full squeeze of the dropper bulb) in 3-4 fl. oz. of juice or water up to 4 times a day.
Precautions
We recommend to seek expert medical advice before taking. May have contraindications and cause adverse reaction.
Consult a physician before giving to children under 18, before using during pregnancy, if nursing, or if you are on any medications.
Consult a physician before giving to children under 18, before using during pregnancy, if nursing, or if you are on any medications. Keep out of the reach of children!
Do not use if you are allergic to any ingredients.
Storage
Store in a cool, dry, dark place.
FDA Disclaimer Statement
This product has not been evaluated by the FDA and is not intended to diagnose, treat, cure or prevent any disease.
Formulation
cGMP Made in compliance with cGMP 21 CFR 111 in an FDA registered and inspected facility.
Sugar free
Expertly extracted 100% natural Premium product
Organic alcohol
No artificial ingredients, color additives, fillers or binders.
Natural Gluten free
Formula
Piper methysticum
Organic alcohol
FDA Statement of Identity
Herbal Supplement
Seals/Symbols
Made in USA
General Statements
Organic raw material.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Kava Kava by Herbal Terra 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 by Herbal Terra
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1 mL Dosage formLiquid Servings per container60 Amounts shown are per serving.
Kava Kava Root Extract, Dry
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 Root Extract, Dry monograph & interactionsOther (inactive) ingredients: Alcohol, Water, Glycerin. These complete the product’s ingredient list but are not active constituents.
Kava Kava by Herbal Terra Drug Interactions
HelloPharmacist Interaction Report
Herbal Terra's Kava Kava is a single-ingredient liquid extract that interacts with a significant number of medications.
The most serious concern is with CNS depressants (sedatives, sleep aids, pain relievers, anxiety medications) — kava adds to their drowsiness and motor impairment, and this combination carries Major severity.
Read the full breakdown — every affected drug type, severity by severity
Kava also has documented Moderate interactions with several other drug categories. It may raise levels of medications broken down by liver enzymes CYP2C19, CYP2C9, and CYP2E1 — potentially making those drugs stronger.
There's also a reported case of visual hallucinations when kava was combined with ropinirole (a Parkinson's drug), and a case of heart rhythm problems and low oxygen when kava was used with haloperidol (an antipsychotic). Additionally, because kava itself can stress the liver, combining it with other drugs known to harm the liver carries Moderate risk.
The interaction data on P-glycoprotein substrates (a group of medications including digoxin) is conflicting; in one small study kava didn't affect digoxin, but other evidence suggests a potential risk.
Although kava is the only active ingredient here, it affects many individual medications. Altogether, these interactions span 1,146 individual medications.
Use the medication checker on this page to look up your exact prescriptions and over-the-counter drugs before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Kava 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 Kava interact with 1,166 drugs. Click any drug to see the details.
1 of the 1 ingredient in Kava Kava interact with drugs. Each result below shows which ingredient is responsible. Kava Kava Root Extract, Dry
AcepromazineAtravet
How Acepromazine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava Root Extract, Dry + Acepromazine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryHepatotoxic 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 Root Extract, Dry + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + 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 — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCns Depressants, Hepatotoxic Drugs +4 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava Root Extract, Dry + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates, Hepatotoxic Drugs +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava Root Extract, Dry + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCns 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 Root Extract, Dry + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava Root Extract, Dry + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryHepatotoxic 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 Root Extract, Dry + Acetaminophen, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCns Depressants, Hepatotoxic Drugs +2 Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava Root Extract, Dry + Acetaminophen, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava Root Extract, Dry + Acetaminophen, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryHepatotoxic 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 Root Extract, Dry + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +4 Major
Interaction Summary
Kava might increase levels of CYP2E1 substrates.
Read the full Kava Kava Root Extract, Dry + Acetaminophen, Hydrocodone interactionAcetaminophen, MeperidineDemerol APAP
How Acetaminophen, Meperidine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Meperidine interactionAcetaminophen, OxycodonePercocet, Roxicet, Tylox, Xartemis XR
How Acetaminophen, Oxycodone interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryHepatotoxic 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 Root Extract, Dry + Acetaminophen, Oxycodone interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Pentazocine interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome 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 Root Extract, Dry + Acetaminophen, Propoxyphene interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava Root Extract, Dry + Acetazolamide interactionAlfentanilAlfenta
How Alfentanil interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava Root Extract, Dry + Alfentanil interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants Major
Interaction Summary
It is unclear if kava inhibits CYP3AA; research is conflicting.
Read the full Kava Kava Root Extract, Dry + Alprazolam interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava Root Extract, Dry + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAminoglutethimideCytadren
How Aminoglutethimide interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava Root Extract, Dry + Aminoglutethimide interactionAminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Kava Kava — through 1 ingredient. Tap an ingredient for the detail:
Kava Kava Root Extract, DryCns Depressants Major
Interaction Summary
Combining kava with CNS depressants can have additive sedative effects.
Read the full Kava Kava Root Extract, Dry + Aminophylline, Amobarbital, Ephedrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Kava 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.
Kava Kava Root Extract, Dry
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, from the product label.
Herbal Terra
See all Herbal Terra products- Name
- Herbal Terra LLC
- Phone Number
- +18083857868
- Web Address
- herbalterra.com
Kava Kava by Herbal Terra: Common Questions
Does Kava Kava by Herbal Terra 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 side effects?
Is kava safe to take during pregnancy or while breastfeeding?
Why does this interact with so many medications?
What's in the liquid besides the kava?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Kava 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 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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- 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
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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