Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

Zaza Red Ingredients & Drug Interactions

by Zaza

Zaza Red label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Zaza Red 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

The interaction bottom line Most serious interaction: Major

Zaza Red is a dietary supplement by Zaza with 3 active ingredients. Its ingredients are commonly taken for depression (prescription use in some countries), anxiety, mood enhancement.Based on those ingredients, 1,353 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Piper methysticum, Tianeptine, Combretum quadrangulare. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Zaza Red by Zaza

Ask about any prescription or over-the-counter medication and we check it for interactions with Zaza Red by Zaza — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Zaza Red by Zaza

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.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 3 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (700 mg) without saying how much of each component you get.

Zaza Red contains three active ingredients. Tianeptine is a medication with antidepressant-like properties that also produces opioid-like effects at higher doses.

Kava (Piper methysticum) is a plant extract traditionally used to support relaxation. The product also contains Combretum quadrangulare, though we hold no interaction data for this ingredient.

The capsule itself and stearate are inactive ingredients that help form and deliver the product.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Moderate

Some clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Depression — rated "Possibly Effective" (Tianeptine) (Natural Medicines).

Tianeptine carries a "Possibly Effective" rating for depression based on available evidence. Kava is rated "Possibly Ineffective" for generalized anxiety disorder — the condition it's commonly used for — and we don't have enough data to rate it for insomnia.

The evidence for Combretum quadrangulare isn't established in our data.

The evidence, ingredient by ingredient Tianeptine Kava Combretum Micranthum

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Tianeptine sold in supplements carries serious risks of addiction, overdose, and death and is not FDA-approved in the U.S. At prescription doses (25–37.5 mg daily), it's generally well tolerated but can cause constipation, diarrhea, dizziness, drowsiness, headache, insomnia, nausea, and vomiting; rare serious effects include agitation, confusion, coma, high blood pressure, liver damage, and rapid heart rate.

Recreational use has been linked to seizures and toxic brain injury. Kava has been linked to over 100 cases of liver damage, especially with excessive and prolonged use; common side effects include drowsiness, dry mouth, dizziness, and headache.

Neither ingredient should be used during pregnancy or breastfeeding — tianeptine's opioid-like effects and withdrawal potential, plus kava's lack of safety data, make both unsafe.

Side effects, ingredient by ingredient Tianeptine Kava Combretum Micranthum

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 3 of the 3 matched ingredients can interact with medications — Combretum Micranthum, Kava, Tianeptine.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: diabetes medications.
  • For scale: 1,354 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Zaza Red, double-check with your pharmacist if you take monoamine oxidase inhibitors (MAOIs) — the risk is severe. Also verify if you're on any CNS depressants (sedatives, sleep aids, opioids, anti-anxiety medications), aspirin, alcohol, medications metabolized by CYP2C19, CYP2C9, or CYP2E1 enzymes, haloperidol, ropinirole, or drugs that damage the liver.

The product contains ingredients we could not fully check for interactions.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.

This product contains ingredients with serious safety concerns and major drug interactions. Tianeptine is not FDA-approved in the U.S. and carries addiction and overdose risk.

If you take an MAOI antidepressant, any sedative, sleep aid, or opioid, or aspirin regularly, check with your pharmacist before considering this product. Pregnant or nursing?

Talk to your doctor.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2025.

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

At a glance

General information

Key facts about Zaza Red, straight from the product label.

Brand Zaza
Barcode (UPC) 644216357567
Net contents 15 Capsule(s)
Market status On market
Date entered into DSLD Aug 22, 2025
DSLD ID 336531
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years)
From the label
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 Zaza Red by Zaza, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
15
UPC/BARCODE
644216357567
IngredientAmount% DV
Proprietary Blend700 mg--
Tianeptine0 NP--
Piper methysticum0 NP--
Combretum quadrangulare0 NP--

Other ingredients: Vegetable Capsules, Stearate

Tap any ingredient to jump to its full detail below.

Label statements
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

Direction for use

Precautions

Research purposes only

Manufacturers/Re-sellers assume no responsibility for the use or misuse of this product.

Not for sale to minors! 21+ only

Warning Keep out of reach of children

FDA Disclaimer Statement

The Food and Drug Administration has neither reviewed these statements nor approved this product for consumption. It is not known to diagnose, treat, cure or prevent disease.

Formulation

Extra strength

General Statements

Quantity per container: 15 capsules

Storage

Storage: Keep in a cool, dry place

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Zaza Red by Zaza label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Zaza Red label

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)
What’s inside

The Ingredients in Zaza Red by Zaza

These are the 3 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container15 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Proprietary Blend

700 mg per serving

Other (inactive) ingredients: Vegetable Capsules, Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Zaza Red by Zaza Drug Interactions

Want to check YOUR meds against Zaza Red?

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 checker
1,353Drugs
256 Major 794 Moderate 303 Minor

Ingredients driving the most interactions

Piper methysticum 1,166
Tianeptine 277
Combretum quadrangulare 265

Individual Drug Interactions

The ingredients in Zaza Red interact with 1,353 drugs. Click any drug to see the details.

3 of the 3 ingredients in Zaza Red interact with drugs. Each result below shows which ingredient is responsible. Piper methysticum Tianeptine Combretum quadrangulare

Each ingredient & the kinds of drugs it affects

For each ingredient in Zaza Red with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Piper methysticum12 drug types · 1,166 drugs

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.

Likelihood Probable Evidence A
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.

Likelihood Possible Evidence A
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Unlikely Evidence B
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.

Likelihood Unlikely Evidence B
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.

Likelihood Unlikely Evidence B
Piper methysticum full monograph & interactions

Tianeptine4 drug types · 277 drugs

Monoamine Oxidase Inhibitors (Maois)

Tianeptine may increase the toxicity of MAOIs.
Concomitant use of tianeptine and non-selective MAOIs might increase the risk of cardiovascular collapse, hypertension, fever, convulsions, and death.

Likelihood Probable Evidence C
Alcohol (Ethanol)

Alcohol increases the clearance and might reduce the levels and clinical effects of tianeptine.
Clinical research shows that alcohol decreases tianeptine absorption rate and lowers tianeptine plasma levels by about 30%. Furthermore, an analysis of alcohol blood levels in 112 patients suggests that alcohol use disorder is associated with a 124% increase in clearance of tianeptine.

Likelihood Probable Evidence B
Aspirin

Chronic use of aspirin might increase the levels and clinical effects of tianeptine.
Aspirin is converted to salicylic acid in the body. In vitro research shows that salicylic acid binds to the same protein sites as tianeptine, displacing protein-bound tianeptine and leading to higher levels of tianeptine in the blood.

Likelihood Possible Evidence D
Cns Depressants

Tianeptine has sedative effects; high doses may have additive effects with other CNS depressants.
Higher doses of tianeptine have opioid like effects and may have additive effects with other sedative drugs. In one case report, a 42-year-old male presented with respiratory depression and aspiration pneumonia due to concomitant use of high-dose tianeptine and alprazolam.

Likelihood Possible Evidence D
Tianeptine full monograph & interactions

Combretum quadrangulare3 drug types · 265 drugs

Antidiabetes Drugs

Theoretically, taking Combretum micranthum leaf with antidiabetes drugs might increase the risk of hypoglycemia.
Some preliminary human and animal research suggests that Combretum micranthum leaf has hypoglycemic effects.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, taking Combretum micranthum leaf with antihypertensive drugs might increase the risk of hypotension.
Clinical research suggests that Combretum micranthum leaf reduces blood pressure.

Likelihood Possible Evidence B
Diuretic Drugs

Theoretically, taking Combretum micranthum leaf with diuretic drugs might increase the risk of hyponatremia.
Combretum micranthum leaf has shown natriuretic effects in preliminary clinical research.

Likelihood Possible Evidence B
Combretum quadrangulare full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Zaza Red, from the product label.

Zaza

See all Zaza products
Name
M&J Distribution
City
Villa Rica
State
GA
ZipCode
30180
Phone Number
1-800-693-7123
Pharmacist Counseling Corner

Zaza Red by Zaza: Common Questions

Does Zaza Red by Zaza interact with any medications?
Yes. Based on its ingredients, Zaza Red has a known interaction with 1,353 medications, including 256 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Zaza Red contains 3 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
What is tianeptine and why is it in a supplement?
Tianeptine is a medication used for depression in some countries, but it's not FDA-approved in the U.S. When sold as a supplement, it's not regulated the same way prescriptions are, and it carries serious risks of addiction and overdose. That's a major red flag.
Can I take this while pregnant or breastfeeding?
No. The safety data advises against both tianeptine and kava during pregnancy and breastfeeding. Tianeptine has opioid-like effects and withdrawal risks that are unsafe, and kava lacks safety data for these stages. Talk to your doctor about what's right for you.
What are the common side effects?
At prescription doses, tianeptine commonly causes constipation, diarrhea, dizziness, drowsiness, headache, insomnia, nausea, and vomiting. Kava commonly causes drowsiness, dry mouth, dizziness, and headache. Both can cause more serious effects with higher doses or longer use.
Does kava actually work for anxiety?
Kava is rated "Possibly Ineffective" for generalized anxiety disorder — the main reason people use it. The evidence doesn't support it working for that purpose.
Why is there a warning about liver damage?
Kava has been linked to over 100 reported cases of liver injury, especially with excessive or prolonged use. There's also concern that using it alongside other drugs that can damage the liver raises the risk further. This is one reason it's banned or restricted in some countries.
Is this product FDA-approved?
No. Tianeptine in supplements is not FDA-approved in the U.S., and this product is sold as a dietary supplement, not a medication. That means it's not held to the same safety and efficacy standards as prescription drugs.

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

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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.

Zaza Red label
Go deeper

The Full Monographs Behind Zaza Red’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Tianeptine

Interacts with 277 drugs

Tianeptine is a prescription antidepressant in some countries, but it is NOT approved by the FDA in the United States and is illegally sold in dietary supplements and 'gas station' products....

Read the full Tianeptine monograph → Herb & supplement monograph

Kava

Interacts with 1,166 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 has been linked to rare but serious...

Read the full Kava monograph → Herb & supplement monograph

Combretum Micranthum

Interacts with 265 drugs

Combretum micranthum (kinkeliba) is a West African shrub whose leaves are brewed into a traditional tea for digestion, liver complaints, and fever. Solid human studies are lacking, so its be...

Read the full Combretum Micranthum monograph →
Sources

Sources & How We Checked

Zaza Red'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.

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 93 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.

Tianeptine 18 references
  1. Bence C, Bonord A, Rebillard C, et al. Neonatal Abstinence Syndrome Following Tianeptine Dependence During Pregnancy. Pediatrics. 2016;137(1). PubMed
  2. El Zahran T, Schier J, Glidden E, et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System - United States, 2000-2017. MMWR Morb Mortal Wkly Rep. 2018;67(30):815-818. PubMed
  3. Goodnough R, Li K, Fouladkou F, et al. Notes from the Field: Toxic Leukoencephalopathy Associated with Tianeptine Misuse - California, 2017. MMWR Morb Mortal Wkly Rep. 2018;67(27):769-770.
  4. Grasela TH, Fiedler-Kelly JB, Salvadori C, Marey C, Jochemsen R. Development of a population pharmacokinetic database for tianeptine. Eur J Clin Pharmacol. 1993;45(2):173-9. PubMed
  5. Guelfi JD, Dulcire C, Le Moine P, Tafani A. Clinical safety and efficacy of tianeptine in 1,858 depressed patients treated in general practice. Neuropsychobiology. 1992;25(3):140-8. PubMed
  6. Lauhan R, Hsu A, Alam A, Beizai K. Tianeptine Abuse and Dependence: Case Report and Literature Review. Psychosomatics. 2018;59(6):547-553. PubMed
  7. Le Bricquir Y, Larrey D, Blanc P, Pageaux GP, Michel H. Tianeptine--an instance of drug-induced hepatotoxicity predicted by prospective experimental studies. J Hepatol. 1994;21(5):771-3. PubMed
  8. Lucaj S, Leo RJ. Tianeptine Sodium: A Nootropic With Potentially Lethal Consequences. Prim Care Companion CNS Disord. 2018;20(4).
  9. Salvadori C, Ward C, Defrance R, Hopkins R. The pharmacokinetics of the antidepressant tianeptine and its main metabolite in healthy humans--influence of alcohol co-administration. Fundam Clin Pharmacol. 1990;4(1):115-25. PubMed
  10. Samuels BA, Nautiyal KM, Kruegel AC, et al. The Behavioral Effects of the Antidepressant Tianeptine Require the Mu-Opioid Receptor. Neuropsychopharmacology. 2017;42(10):2052-2063. PubMed
  11. Voican CS, Corruble E, Naveau S, Perlemuter G. Antidepressant-induced liver injury: a review for clinicians. Am J Psychiatry. 2014;171(4):404-15. PubMed
  12. Zini R, Morin D, Salvadori C, Tillement JP. The influence of various drugs on the binding of tianeptine to human plasma proteins. Int J Clin Pharmacol Ther Toxicol. 1991;29(2):64-6.
  13. Summary of Product Characteristics Stablo: Tianeptine. 2008. Available at: https://www.servier.com.ve/sites/default/files/spc-pil/spc-stablon.pdf
  14. Rushton W, Whitworth B, Brown J, Kurz M, Rivera J. Characteristics of tianeptine effects reported to a poison control center: a growing threat to public health. J. Clin Toxicol (Phila). 2021;59(2):152-7. PubMed
  15. García-Alberca JM, Gris E, de la Guía P, Mendoza S. Effects of Tianeptine Treatment on Depression and Cognitive Function in Patients with Alzheimer's Disease: A 12-Month Retrospective Observational Study. J Alzheimers Dis 2022;88(2):707-720. PubMed
  16. AQuadir M, Rine NI, Badeti J, et al. Tianeptine Exposures Reported to United States Poison Centers, 2015-2023. J Med Toxicol 2025;21(1):30-41. PubMed
  17. Hershey HL, Onyango EM, Durst K, Korona-Bailey J, Mukhopadhyay S. Tianeptine-involved emergency department visits, fatal overdoses, and substance seizures in Tennessee, 2021-2023. Drug Alcohol Depend Rep 2024;12:100272. PubMed
  18. Ikeri K, Anderson A, Eyal F, Whitehurst R. Neonatal Opioid Withdrawal Syndrome Following Prenatal Use of Supplements Containing Tianeptine. Pediatrics 2024;153(2):e2023062382. PubMed

See these in context on the Tianeptine monograph →

Kava 71 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Strahl S, Ehret V, Dahm HH, Maier KP. [Necrotizing hepatitis after taking herbal medication]. Dtsch Med Wochenschr 1998;123:1410-4.
  3. Spillane PK, et al. Neurological manifestations of kava intoxication. Med J Aust 1997;167:172-3. PubMed
  4. Swensen JN. Man convicted of driving under the influence of kava. Salt Lake City, UT: Deseret News, 1996.
  5. Pittler MH, Ernst E. Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J Clin Psychopharmacol 2000;20:84-9. PubMed
  6. Volz HP, Kieser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders--a randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry 1997;30:1-5. PubMed
  7. Heinze HJ, Munthe TF, Steitz J, Matzke M. Pharmacopsychological effects of oxazepam and kava-extract in a visual search paradigm assessed with event-related potentials. Pharmacopsychiatry 1994;27:224-30. PubMed
  8. Munte TF, Heinze HJ, Matzke M, Steitz J. Effects of oxazepam and an extract of kava roots (Piper methysticum) on event-related potentials in a word recognition task. Neuropsychobiology 1993;27:46-53.
  9. Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol 2001;16:353-6. PubMed
  10. Schelosky L, Raffaup C, Jendroska K, Poewe W. Kava and dopamine antagonism. J Neurol Neurosurg Psychiatry 1995;58:639-40. PubMed
  11. Norton SA, Ruze P. Kava dermopathy. J Am Acad Dermatol 1994;31:89-97.
  12. Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 2nd ed. Edinburgh:Churchill Livingstone, 1999.
  13. Mathews JD, Riley MD, Fejo L, et al. Effects of heavy usage of kava on physical health: Summary of a pilot survey in an aboriginal community. Med J Aust 1988;148:548-55.
  14. Escher M, Desmeules J, Giostra E, Mentha G. Hepatitis associated with Kava, a herbal remedy for anxiety. BMJ 2001;322:139.
  15. Russmann S, Lauterburg BH, Helbling A. Kava hepatotoxicity [letter]. Ann Intern Med 2001;135:68-9.
  16. Liver Toxicity With Kava. Pharmacist's Letter/Prescriber's Letter. January 2001.
  17. 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.
  18. Meseguer E, Taboada R, Sanchez V, et al. Life-threatening parkinsonism induced by kava-kava. Mov Disord 2002;17:195-6. PubMed
  19. Ruze P. Kava-induced dermopathy: a niacin deficiency? Lancet 1990;335:1442-5. PubMed
  20. Singh YN. Kava: an overview. J Ethnopharmacol 1992;37:13-45.
  21. Bilia AR, Gallori S, Vincieri FF. Kava-kava and anxiety: growing knowledge about the efficacy and safety. Life Sci 2002;70:2581-97. PubMed
  22. Wooltorton E. Herbal kava: reports of liver toxicity. CMAJ 2002;166:777.
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See these in context on the Kava monograph →

Combretum Micranthum 4 references
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See these in context on the Combretum Micranthum monograph →

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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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