Suggested Dosing
Insomnia
Aqueous Extract: 400-900 mg PO up to 2 hours before bedtime
Ethanolic extract: 600 mg PO HS
Root (fresh or dried): 2-3 g PO qDay-TID
Combinations with hops or lemon balm: 320-500 mg PO HS
No more than 28 days
Suggested Uses
Insomnia/sleep disorders, ADHD, anxiety disorders, depression, epilepsy, infantile convulsions, menopausal symptoms, menstrual cramps, restlessness, tremors
Efficacy
Promotes falling asleep, but does not reduce night awakenings
Does not relieve insomnia as fast as benzodiazepines
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (66)
- alfentanil
valerian and alfentanil both increase sedation. Avoid or Use Alternate Drug.
- alprazolam
valerian and alprazolam both increase sedation. Avoid or Use Alternate Drug.
- amobarbital
valerian increases effects of amobarbital by pharmacodynamic synergism. Avoid or Use Alternate Drug. May enhance CNS depression.
valerian and amobarbital both increase sedation. Avoid or Use Alternate Drug. - atracurium
valerian and atracurium both increase sedation. Avoid or Use Alternate Drug.
- belinostat
valerian will increase the level or effect of belinostat by decreasing metabolism. Avoid or Use Alternate Drug. Strong UGT inhibitors decrease metabolism of belinostat; reduce belinostat starting dose to 750 mg/m2 when coadministered with UGT inhibitors or in patients known to be homozygous for the UGT1A1*28 allele
- buprenorphine
valerian and buprenorphine both increase sedation. Avoid or Use Alternate Drug.
- buprenorphine buccal
valerian and buprenorphine buccal both increase sedation. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
valerian and buprenorphine subdermal implant both increase sedation. Avoid or Use Alternate Drug.
- buprenorphine transdermal
valerian and buprenorphine transdermal both increase sedation. Avoid or Use Alternate Drug.
- butabarbital
valerian increases effects of butabarbital by pharmacodynamic synergism. Avoid or Use Alternate Drug. May enhance CNS depression.
valerian and butabarbital both increase sedation. Avoid or Use Alternate Drug. - butalbital
valerian increases effects of butalbital by pharmacodynamic synergism. Avoid or Use Alternate Drug. May enhance CNS depression.
valerian and butalbital both increase sedation. Avoid or Use Alternate Drug. - butorphanol
valerian and butorphanol both increase sedation. Avoid or Use Alternate Drug.
- chloral hydrate
valerian and chloral hydrate both increase sedation. Avoid or Use Alternate Drug.
- chlordiazepoxide
valerian and chlordiazepoxide both increase sedation. Avoid or Use Alternate Drug.
- cisatracurium
valerian and cisatracurium both increase sedation. Avoid or Use Alternate Drug.
- clonazepam
valerian and clonazepam both increase sedation. Avoid or Use Alternate Drug.
- clorazepate
valerian and clorazepate both increase sedation. Avoid or Use Alternate Drug.
- codeine
valerian and codeine both increase sedation. Avoid or Use Alternate Drug.
- dexmedetomidine
valerian and dexmedetomidine both increase sedation. Avoid or Use Alternate Drug.
- diazepam
valerian and diazepam both increase sedation. Avoid or Use Alternate Drug.
- doxylamine
valerian and doxylamine both increase sedation. Avoid or Use Alternate Drug.
- estazolam
valerian and estazolam both increase sedation. Avoid or Use Alternate Drug.
- eszopiclone
valerian and eszopiclone both increase sedation. Avoid or Use Alternate Drug.
- ethanol
valerian and ethanol both increase sedation. Avoid or Use Alternate Drug.
- fentanyl
valerian and fentanyl both increase sedation. Avoid or Use Alternate Drug.
- fentanyl intranasal
valerian and fentanyl intranasal both increase sedation. Avoid or Use Alternate Drug.
- fentanyl transdermal
valerian and fentanyl transdermal both increase sedation. Avoid or Use Alternate Drug.
- fentanyl transmucosal
valerian and fentanyl transmucosal both increase sedation. Avoid or Use Alternate Drug.
- flurazepam
valerian and flurazepam both increase sedation. Avoid or Use Alternate Drug.
- gabapentin
valerian and gabapentin both increase sedation. Avoid or Use Alternate Drug.
- hydromorphone
valerian and hydromorphone both increase sedation. Avoid or Use Alternate Drug.
- levorphanol
valerian and levorphanol both increase sedation. Avoid or Use Alternate Drug.
- lorazepam
valerian and lorazepam both increase sedation. Avoid or Use Alternate Drug.
- meperidine
valerian and meperidine both increase sedation. Avoid or Use Alternate Drug.
- methadone
valerian and methadone both increase sedation. Avoid or Use Alternate Drug.
- metoclopramide intranasal
valerian, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- midazolam
valerian and midazolam both increase sedation. Avoid or Use Alternate Drug.
- morphine
valerian and morphine both increase sedation. Avoid or Use Alternate Drug.
- nalbuphine
valerian and nalbuphine both increase sedation. Avoid or Use Alternate Drug.
- olopatadine intranasal
valerian and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- oxazepam
valerian and oxazepam both increase sedation. Avoid or Use Alternate Drug.
- oxycodone
valerian and oxycodone both increase sedation. Avoid or Use Alternate Drug.
- oxymorphone
valerian and oxymorphone both increase sedation. Avoid or Use Alternate Drug.
- pancuronium
valerian and pancuronium both increase sedation. Avoid or Use Alternate Drug.
- pentazocine
valerian and pentazocine both increase sedation. Avoid or Use Alternate Drug.
- pentobarbital
valerian increases effects of pentobarbital by pharmacodynamic synergism. Avoid or Use Alternate Drug. May enhance CNS depression.
valerian and pentobarbital both increase sedation. Avoid or Use Alternate Drug. - pexidartinib
valerian will increase the level or effect of pexidartinib by Other (see comment). Avoid or Use Alternate Drug. Pexdartinib is a UGTA4 substrate. Reduce pexdartinib dose if concomitant use of UGT inhibitors cannot be avoided (refer to drug monograph dosage modifications). After discontinuing the CYP3A4 inhibitor for 3 elimination half-lives, may resume previous pexidartinib dose.
- phenobarbital
valerian increases effects of phenobarbital by pharmacodynamic synergism. Avoid or Use Alternate Drug. May enhance CNS depression.
- quazepam
valerian and quazepam both increase sedation. Avoid or Use Alternate Drug.
- ramelteon
valerian and ramelteon both increase sedation. Avoid or Use Alternate Drug.
- remifentanil
valerian and remifentanil both increase sedation. Avoid or Use Alternate Drug.
- rocuronium
valerian and rocuronium both increase sedation. Avoid or Use Alternate Drug.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b and valerian both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- secobarbital
valerian increases effects of secobarbital by pharmacodynamic synergism. Avoid or Use Alternate Drug. May enhance CNS depression.
valerian and secobarbital both increase sedation. Avoid or Use Alternate Drug. - succinylcholine
valerian and succinylcholine both increase sedation. Avoid or Use Alternate Drug.
- sufentanil
valerian and sufentanil both increase sedation. Avoid or Use Alternate Drug.
- sufentanil SL
valerian and sufentanil SL both increase sedation. Avoid or Use Alternate Drug.
- suvorexant
valerian and suvorexant both increase sedation. Avoid or Use Alternate Drug.
- tapentadol
valerian and tapentadol both increase sedation. Avoid or Use Alternate Drug.
- tasimelteon
valerian and tasimelteon both increase sedation. Avoid or Use Alternate Drug.
- temazepam
valerian and temazepam both increase sedation. Avoid or Use Alternate Drug.
- tramadol
valerian and tramadol both increase sedation. Avoid or Use Alternate Drug.
- triazolam
valerian and triazolam both increase sedation. Avoid or Use Alternate Drug.
- vecuronium
valerian and vecuronium both increase sedation. Avoid or Use Alternate Drug.
- zaleplon
valerian and zaleplon both increase sedation. Avoid or Use Alternate Drug.
- zolpidem
valerian and zolpidem both increase sedation. Avoid or Use Alternate Drug.
Monitor Closely (52)
- amitriptyline
valerian and amitriptyline both increase sedation. Use Caution/Monitor.
- amoxapine
valerian and amoxapine both increase sedation. Use Caution/Monitor.
- azelastine
valerian increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- brexanolone
brexanolone, valerian. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brompheniramine
valerian increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- carbinoxamine
valerian increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- cenobamate
cenobamate, valerian. Either increases effects of the other by sedation. Use Caution/Monitor.
- chloral hydrate
valerian increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- chlorpheniramine
valerian increases effects of chlorpheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- cinnarizine
valerian increases effects of cinnarizine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- citalopram
valerian and citalopram both increase sedation. Use Caution/Monitor.
- clemastine
valerian increases effects of clemastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- clomipramine
valerian and clomipramine both increase sedation. Use Caution/Monitor.
- cyclizine
valerian increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- cyproheptadine
valerian increases effects of cyproheptadine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- daridorexant
valerian and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- desipramine
valerian and desipramine both increase sedation. Use Caution/Monitor.
- desvenlafaxine
valerian and desvenlafaxine both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
valerian increases effects of dexchlorpheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- dexmedetomidine
valerian increases effects of dexmedetomidine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- difelikefalin
difelikefalin and valerian both increase sedation. Use Caution/Monitor.
- dimenhydrinate
valerian increases effects of dimenhydrinate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- diphenhydramine
valerian increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- doxepin
valerian and doxepin both increase sedation. Use Caution/Monitor.
- doxylamine
valerian increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- duloxetine
valerian and duloxetine both increase sedation. Use Caution/Monitor.
- escitalopram
valerian and escitalopram both increase sedation. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, valerian. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- fluoxetine
valerian and fluoxetine both increase sedation. Use Caution/Monitor.
- fluvoxamine
fluvoxamine and valerian both increase sedation. Use Caution/Monitor.
- ganaxolone
valerian and ganaxolone both increase sedation. Use Caution/Monitor.
- hydroxyzine
valerian increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- imipramine
valerian and imipramine both increase sedation. Use Caution/Monitor.
- isocarboxazid
valerian and isocarboxazid both increase sedation. Use Caution/Monitor.
- lasmiditan
lasmiditan, valerian. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant will increase the level or effect of valerian by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- levomilnacipran
valerian and levomilnacipran both increase sedation. Use Caution/Monitor.
- lithium
valerian and lithium both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, valerian. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- milnacipran
valerian and milnacipran both increase sedation. Use Caution/Monitor.
- nortriptyline
valerian and nortriptyline both increase sedation. Use Caution/Monitor.
- paroxetine
valerian and paroxetine both increase sedation. Use Caution/Monitor.
- phenelzine
valerian and phenelzine both increase sedation. Use Caution/Monitor.
- primidone
valerian increases effects of primidone by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- promethazine
valerian increases effects of promethazine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- protriptyline
valerian and protriptyline both increase sedation. Use Caution/Monitor.
- sertraline
valerian and sertraline both increase sedation. Use Caution/Monitor.
- tranylcypromine
valerian and tranylcypromine both increase sedation. Use Caution/Monitor.
- triclofos
valerian increases effects of triclofos by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- trimipramine
valerian and trimipramine both increase sedation. Use Caution/Monitor.
- triprolidine
valerian increases effects of triprolidine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- venlafaxine
valerian and venlafaxine both increase sedation. Use Caution/Monitor.
Minor (2)
- irinotecan
valerian will increase the level or effect of irinotecan by decreasing metabolism. Minor/Significance Unknown. UGT1A1 inhibitors decrease irinotecan metabolism
- irinotecan liposomal
valerian will increase the level or effect of irinotecan liposomal by decreasing metabolism. Minor/Significance Unknown. UGT1A1 inhibitors decrease irinotecan metabolism
Adverse Effects
Frequency Not Defined
Cardiac disturbances
Excitability
Headache
Hepatotoxicity
Insomnia
Morning drowsiness
Sedation
Uneasiness
Withdrawal syndrome (chronic use)
Warnings
Contraindications
None reported
Cautions
Concurrent CNS depressants
Concurrent CYP 3A4 substrates
Pregnancy & Lactation
Pregnancy Category: avoid use
Lactation: avoid use
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Metabolism: N/A
Excretion: N/A
Mechanism of Action
Active constituents: valepotriates
Inhibits re-uptake of GABA