Valerian (Herb/Suppl)

Brand and Other Names:all heal, amantilla, more...baldrian, baldrianwurzel, garden heliotrope, herba benedicta, Valeriana edulis, Valeriana jatamansii, Valeriana officinalis, Valeriana sitchensis, valeriana spp, Valeriana wallichii
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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

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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

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Interactions

Interaction Checker

and Valerian

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (64)

              • 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.

              • 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.

              • 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 (49)

              • 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.

              • 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.

              • 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.

              • 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

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              Adverse Effects

              Frequency Not Defined

              Cardiac disturbances

              Excitability

              Headache

              Hepatotoxicity

              Insomnia

              Morning drowsiness

              Sedation

              Uneasiness

              Withdrawal syndrome (chronic use)

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              Warnings

              Contraindications

              None reported

              Cautions

              Concurrent CNS depressants

              Concurrent CYP 3A4 substrates

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              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.

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              Pharmacology

              Metabolism: N/A

              Excretion: N/A

              Mechanism of Action

              Active constituents: valepotriates

              Inhibits re-uptake of GABA

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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.