Suggested Dosing
Anxiety disorders
70% standardized extract: 100 mg PO TID
Kava-lactones: 60-120 mg/day PO
Root tea: 1 cup PO qD-TID; 2-4 g root/150 ml water
Benzodiazepine withdrawal, prevention
70% stdzd extract
- Initial: 50 mg PO qD, THEN
- Titrate up over 1 week while tapering benzodiazepine over 2 weeks
- No more than 300 mg/day titrated over 1 week
Insomnia
Kava-lactones: 180-210 mg PO qHS
Suggested Uses
Anxiety disorders, benzodiazepine withdrawal, common cold/URIs, depression, epilepsy, headaches/migraines, insomnia, musculoskeletal pain, psychosis, stress
Efficacy
Likely effective for anxiety, insomnia (short-term)
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (26)
- amobarbital
kava increases effects of amobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- azelastine
kava increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- brompheniramine
kava increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- butabarbital
kava increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- butalbital
kava increases effects of butalbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- carbinoxamine
kava increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- chloral hydrate
kava increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- chlorpheniramine
kava increases effects of chlorpheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- cinnarizine
kava increases effects of cinnarizine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- clemastine
kava increases effects of clemastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- clonazepam
kava and clonazepam both increase sedation. Use Caution/Monitor.
- cyclizine
kava increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- cyproheptadine
kava increases effects of cyproheptadine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- dexchlorpheniramine
kava increases effects of dexchlorpheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- dexmedetomidine
kava increases effects of dexmedetomidine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- dimenhydrinate
kava increases effects of dimenhydrinate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- diphenhydramine
kava increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- doxylamine
kava increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- hydroxyzine
kava increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- pentobarbital
kava increases effects of pentobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- phenobarbital
kava increases effects of phenobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- primidone
kava increases effects of primidone by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- promethazine
kava increases effects of promethazine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- secobarbital
kava increases effects of secobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- triclofos
kava increases effects of triclofos by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- triprolidine
kava increases effects of triprolidine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
Minor (1)
- zidovudine
kava increases toxicity of zidovudine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hepatoxicity.
Adverse Effects
Frequency Not Defined
Allergic skin reactions
Dizziness
Drowsiness
Enlarged pupils
Gastrointestinal upset
Headache
Hepatitis (acute)
Hepatotoxicity
Liver failure
Motor reflex impairment
Oculomotor equilibrium disturbances
Parkinsonism
Visual accommodation disturbances
Body weight decreases (chronic use)
Facial puffiness (chronic use)
Hematuria (chronic use)
Kava dermopathy (chronic use)
Lymphocytopenia (chronic use)
Movement disorders (chronic use)
Protein levels decrease (chronic use)
Pulmonary hypertension (chronic use)
Rash (chronic use)
Red blood cell volume increases (chronic use)
Thrombocytopenia (chronic use)
Warnings
Contraindications
Hepatitis, acute or hx
Cautions
Depression
Risk of liver failure: banned in many countries (UK, Sweden, Netherlands etc)
Pregnancy & Lactation
Pregnancy Category: unsafe
Lactation: unsafe
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
Kavalactones act on limbic system
No evidence of binding to GABA or opioid receptors