Kava is a South Pacific medicinal plant primarily researched for its anxiolytic properties. Extensive meta-analyses and systematic reviews provide strong evidence that Kava extract is effective in treating anxiety and Generalized Anxiety Disorder (GAD).

Evidence by Condition

Anxiety and Generalized Anxiety Disorder (GAD) Strong

Multiple meta-analyses and systematic reviews demonstrate that Kava extract is effective for reducing anxiety symptoms.

Perimenopause Weak

A small randomized controlled trial suggests Kava administration can reduce anxiety in perimenopausal women.

Mood and Motivation Moderate

Some evidence suggests kavalactones may support motivation during intensive training and impact mood disorders.

Effective Doses

Dose ranges not specified in the provided research abstracts.

Key Findings

Meta-analyses and systematic reviews consistently support the use of Kava extract for treating anxiety (PMID: 12535473, PMID: 30396607).
Kava administration has been shown to reduce anxiety specifically in perimenopausal women (PMID: 12590005).
Kavalactones may support motivation to move during intensive training in males (PMID: 39010683).
Research indicates Kava may affect GABA in the dorsal anterior cingulate cortex in patients with GAD (PMID: 37960239).

Limitations

There is a critical need for further research to address concerns regarding long-term safety and potential hepatotoxicity.

Safety & Interactions

There are significant warnings from the CDC regarding potential hepatotoxicity (liver toxicity) associated with Kava use.

AI-generated summary from 19 peer-reviewed studies. Not medical advice. Always consult a healthcare provider.

Drug-Supplement Interactions

ADHD Medications 🔴 Critical

Mechanism: Kava is a strong inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of atomoxetine (adhd-medications), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of atomoxetine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Antiarrhythmics 🔴 Critical

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of amiodarone (antiarrhythmics), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of amiodarone. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Anticonvulsants 🔴 Critical

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of phenytoin (anticonvulsants), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of phenytoin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Antiemetics 🔴 Critical

Mechanism: Kava is a strong inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of ondansetron (antiemetics), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of ondansetron. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Antipsychotics 🔴 Critical

Mechanism: Kava is a strong inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of haloperidol (antipsychotics), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of haloperidol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Antitussives 🔴 Critical

Mechanism: Kava is a strong inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of dextromethorphan (antitussives), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of dextromethorphan. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

GI Prokinetics 🔴 Critical

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of cisapride (gi-prokinetics), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of cisapride. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Immunosuppressants 🔴 Critical

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of cyclosporine (immunosuppressants), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of cyclosporine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Opioids 🔴 Critical

Mechanism: Kava is a strong inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of codeine (opioids), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of codeine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Sedatives 🔴 Critical

Mechanism: Kava potentiates GABA-A receptor activity, additive with benzodiazepines and other CNS depressants.

Effect: Severe CNS depression; excessive sedation; coma risk

Management: Avoid combination. Kava + benzodiazepines has caused semi-comatose states.

Evidence: well-established

Theophylline 🔴 Critical

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of theophylline (theophylline), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of theophylline. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Warfarin 🔴 Critical

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of warfarin (warfarin), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of warfarin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

ARB 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of losartan (arb), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of losartan. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Alcohol 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Ethanol, Ethanol

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Alimemazine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Alimemazine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Analgesics 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP1A2, which decreases metabolism of CYP1A2 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of acetaminophen (analgesics), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of acetaminophen. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Antibiotics 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of sulfamethoxazole (antibiotics), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of sulfamethoxazole. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Antidiabetic Drugs 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of tolbutamide (antidiabetic-drugs), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of tolbutamide. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Antifungals 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of fluconazole (antifungals), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of fluconazole. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Antihistamines 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Promethazine, Promethazine, Promethazine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Antiplatelet Drugs 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C19, which decreases metabolism of CYP2C19 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of clopidogrel (antiplatelet-drugs), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of clopidogrel. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Asparaginase Escherichia coli 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Asparaginase Escherichia coli

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Azatadine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Azatadine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Azelastine (nasal) 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Azelastine (nasal)

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Benzodiazepines 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C19, which decreases metabolism of CYP2C19 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of diazepam (benzodiazepines), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of diazepam. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Beta Blockers 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C19, which decreases metabolism of CYP2C19 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of propranolol (beta-blockers), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of propranolol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Beta-2 Agonists 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of salmeterol (beta2-agonists), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of salmeterol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Brentuximab vedotin 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Brentuximab vedotin

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Brompheniramine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Brompheniramine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

CFTR Modulators 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of ivacaftor (cftr-modulators), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of ivacaftor. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Caffeine 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP1A2, which decreases metabolism of CYP1A2 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of caffeine (caffeine), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of caffeine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Calcium Channel Blockers 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of nifedipine (calcium-channel-blockers), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of nifedipine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Carbinoxamine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Carbinoxamine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Chemotherapy 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of tamoxifen (chemotherapy), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of tamoxifen. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Chlorphenesin 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Chlorphenesin

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Chlorpheniramine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Chlorpheniramine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Clemastine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Clemastine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Clofedanol 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Clofedanol

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Codeine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Codeine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Corticosteroids 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of prednisone (corticosteroids), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of prednisone. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Cyclizine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Cyclizine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Cyproheptadine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Cyproheptadine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Dexbrompheniramine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Dexbrompheniramine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Dextromethorphan 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Dextromethorphan

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Difenoxin 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Difenoxin

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Diphenhydramine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Diphenhydramine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Diphenoxylate 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Diphenoxylate

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Dopamine Agonists 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP1A2, which decreases metabolism of CYP1A2 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of ropinirole (dopamine-agonists), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of ropinirole. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Doxepin (topical) 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Doxepin (topical)

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Doxylamine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Doxylamine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Dronabinol 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Dronabinol

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Hydrocodone 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Hydrocodone

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Leukotriene Antagonists 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of montelukast (leukotriene-antagonists), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of montelukast. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Levodopa 🟡 Moderate

Mechanism: Kava may enhance dopaminergic effects of levodopa, potentially causing dyskinesia.

Effect: Possible worsening of levodopa-induced dyskinesia

Management: Monitor for increased dyskinesia. Avoid combination if possible.

Evidence: possible

MAOI 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP1A2, which decreases metabolism of CYP1A2 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of rasagiline (maoi), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of rasagiline. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Meclizine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Meclizine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Melatonin 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP1A2, which decreases metabolism of CYP1A2 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of melatonin (melatonin), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of melatonin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Mepyramine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Mepyramine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Methdilazine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Methdilazine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Metoclopramide 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Metoclopramide

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Morphine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Morphine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Morphine (liposomal) 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Morphine (liposomal)

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

NSAIDs 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of ibuprofen (nsaids), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of ibuprofen. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Nabilone 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Nabilone

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Naltrexone 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Naltrexone

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Olopatadine (nasal) 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Olopatadine (nasal)

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Opium 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Opium

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Oral Contraceptives 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of ethinylestradiol (oral-contraceptives), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of ethinylestradiol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

PDE5 Inhibitors 🟡 Moderate

Mechanism: Kava is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of sildenafil (pde5-inhibitors), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of sildenafil. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

PPIS 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C19, which decreases metabolism of CYP2C19 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of omeprazole (ppis), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of omeprazole. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Pentoxyverine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Pentoxyverine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Phenindamine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Phenindamine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

SNRI 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C19, which decreases metabolism of CYP2C19 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of venlafaxine (snri), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of venlafaxine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Sibutramine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Sibutramine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Ssri 🟡 Moderate

Mechanism: Kava may have weak MAO-inhibiting properties; combined with SSRIs may increase serotonin levels.

Effect: Possible serotonin syndrome

Management: Avoid combination. Use caution with any serotonergic medication.

Evidence: possible

Statins 🟡 Moderate

Mechanism: Kava is a moderate inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect: Increased plasma levels of fluvastatin (statins), potentially leading to toxicity or enhanced adverse effects.

Management: Monitor for increased adverse effects of fluvastatin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Evidence: cyp-inferred

Thiethylperazine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Thiethylperazine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Tricyclic Antidepressants 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Doxepin

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Trimethobenzamide 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Trimethobenzamide

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Tripelennamine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Tripelennamine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

Triprolidine 🟡 Moderate

Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Triprolidine

Effect: See mechanism description

Management: Consult healthcare provider before combining.

Evidence: ddinter-verified

⚠️ This information is for educational purposes only and does not constitute medical advice. Always consult your healthcare provider before combining supplements with medications.

Claims vs. Evidence

100% Evidence-Backed

0% Unsupported

74% Structure/Function

Claim Type	% of Products	Evidence Required	Status
All Other	99%	Tier D (Unclassified)	✅ Supported
Structure/Function	74%	Tier C (DSHEA Structure/Function (no pre-approval))	✅ Supported
No Claim	1%	Tier D (No claim on label)	✅ Supported

Research by Topic

Kava Anxiety 6 studies

MET Kava for Generalized Anxiety Disorder: A Review of Current E...

SYS The effectiveness and safety of Kava Kava for treating anxie...

RCT Kava for generalised anxiety disorder: A 16-week double-blin...

+3 more

Kava 5 studies

RCT Kava in generalized anxiety disorder: three placebo-controll...

RCT Explanatory attributions of anxiety and recovery in a study ...

RCT Kava-Kava administration reduces anxiety in perimenopausal w...

+2 more

Cochrane Additional Herbs 3 studies

MET Kava extract for treating anxiety

SYS Kava extract for treating anxiety

Dietary Supplement General 2 studies

CLI Investigation of Kava Effects on NNK Metabolism

CLI Effects of Kava on the Body's Elimination of Caffeine and De...

St. John'S Wort 1 studies

SYS Kava and St. John's Wort: current evidence for use in mood a...

Ginkgo 1 studies

MET The risk-benefit profile of commonly used herbal therapies: ...

Ginseng 1 studies

SYS A systematic review of herbal medicinal products for the tre...

Research Evidence (19)

Rct: 8 Systematic Review: 5 Meta Analysis: 4 Clinical Trial: 2

B Kava extract for treating anxiety

Meta Analysis The Cochrane database of systematic reviews 2003 n=345

BACKGROUND: Constraints on resources and time often render treatments for anxiety such as psychological interventions impracticable, while synthetic anxiolytic drugs are effective, but are often burdened with adverse events. Options which are effecti...

PubMed Cochrane

B Kava for Generalized Anxiety Disorder: A Review of Current Evidence

Meta Analysis Journal of alternative and complementary medicine (New York, N.Y.) 2018 n=130

BACKGROUND: Generalized anxiety disorder (GAD) is a chronic and debilitating condition characterized by persistent and overpowering anxiety. Treatment of GAD with antidepressants and benzodiazepines is only moderately effective and not free from side...

PubMed DOI

B Kava extract for treating anxiety

Systematic Review The Cochrane database of systematic reviews 2001

BACKGROUND: Synthetic anxiolytic drugs are effective for anxiety, but they are burdened with adverse events. Constraints on resources and time often render treatments such as psychological interventions impracticable. Thus, an effective and safe oral...

PubMed Cochrane

B Kava extract for treating anxiety

Systematic Review The Cochrane database of systematic reviews 2002

BACKGROUND: Synthetic anxiolytic drugs are effective for anxiety, but are often burdened with adverse events. Constraints on resources and time often render treatments such as psychological interventions impracticable. Thus, an effective and safe ora...

PubMed Cochrane

B The effectiveness and safety of Kava Kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials

Systematic Review Complementary therapies in clinical practice 2018 n=330

BACKGROUND: To determine if Kava Kava is an effective treatment for combating symptoms of anxiety despite warnings of hepatotoxicity from the Centers for Disease Control and Prevention (CDC). METHODS: Databases PubMed, CINAHL, and PsycINFO were utili...

PubMed DOI

C Kava for generalised anxiety disorder: A 16-week double-blind, randomised, placebo-controlled study

Rct The Australian and New Zealand journal of psychiatry 2020 n=171

OBJECTIVE: Previous randomised, double-blind, placebo-controlled studies have shown that Kava (a South Pacific medicinal plant) reduced anxiety during short-term administration. The objective of this randomised, double-blind, placebo-controlled study...

PubMed DOI

C Kava and St. John's Wort: current evidence for use in mood and anxiety disorders

Systematic Review Journal of alternative and complementary medicine (New York, N.Y.) 2009

**Sarris et al., 2009** | J Altern Complement Med | Systematic Review Sarris Jerome, Kavanagh David J. Kava and St. John's Wort: current evidence for use in mood and anxiety disorders. J Altern Complement Med. 2009-Aug;15(8):827-36. doi:10.1089/acm.2...

PubMed DOI

C Neuroimaging Insights: Kava's (Piper methysticum) Effect on Dorsal Anterior Cingulate Cortex GABA in Generalized Anxiety Disorder.

Rct Nutrients

Generalised Anxiety Disorder (GAD) is a prevalent, chronic mental health disorder. The measurement of regional brain gamma-aminobutyric acid (GABA) offers insight into its role in anxiety and is a potential biomarker for treatment response. Research ...

PubMed DOI

C The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava

Meta Analysis Annals of internal medicine 2002

**Ernst et al., 2002** | Ann Intern Med | Meta Analysis Ernst Edzard. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Ann Intern Med. 2002-Jan-01;136(1):42-53 Because us...

PubMed

C Efficacy of kava extract for treating anxiety: systematic review and meta-analysis

Meta Analysis Journal of clinical psychopharmacology 2000

Synthetic anxiolytic drugs are effective for treating anxiety, but they are burdened with adverse effects. Constraints on resources and time often render therapies such as psychologic interventions impracticable. Thus, an effective oral medication wi...

PubMed

C Kava in generalized anxiety disorder: three placebo-controlled trials

Rct International clinical psychopharmacology 2006 n=64

**Connor et al., 2006** | Int Clin Psychopharmacol | Rct Connor Kathryn M, Payne Victoria, Davidson Jonathan R T. Kava in generalized anxiety disorder: three placebo-controlled trials. Int Clin Psychopharmacol. 2006-Sep;21(5):249-53 In this study, we...

PubMed

C Kavalactones support motivation to move during intensive training in males preparing for military special operations forces.

Rct Journal of the International Society of Sports Nutrition

BACKGROUND: Military special operators, elite athletes, and others requiring uninterrupted optimal performance currently lack options for sleep and mood support without performance-inhibiting effects. Kavalactones, derived from the root of the kava p...

PubMed DOI

C Explanatory attributions of anxiety and recovery in a study of kava

Rct Journal of alternative and complementary medicine (New York, N.Y.) 2004

**Abraham et al., 2004** | J Altern Complement Med | Rct Abraham Kurian C, Connor Kathryn M, Davidson Jonathan R T. Explanatory attributions of anxiety and recovery in a study of kava. J Altern Complement Med. 2004-Jun;10(3):556-9 OBJECTIVE: A need e...

PubMed

C Investigation of Kava Effects on NNK Metabolism

Clinical Trial ClinicalTrials.gov 2015

**NCT ID**: NCT02500472 **Phase**: NA **Status**: COMPLETED **Enrollment**: 24 **Completion**: 2018-03

ClinicalTrials.gov

D Kava-Kava administration reduces anxiety in perimenopausal women

Rct Maturitas 2003 n=34

**Cagnacci et al., 2003** | Maturitas | Rct Cagnacci Angelo, Arangino Serenella, ... Volpe Annibale. Kava-Kava administration reduces anxiety in perimenopausal women. Maturitas. 2003-Feb-25;44(2):103-9 OBJECTIVE: Disturbances of mood, such as anxiety...

PubMed

D Kava treatment in patients with anxiety

Rct Phytotherapy research : PTR 2004 n=50

**Geier et al., 2004** | Phytother Res | Rct Geier F P, Konstantinowicz T. Kava treatment in patients with anxiety. Phytother Res. 2004-Apr;18(4):297-300 In several clinical trials, mainly conducted with a dose of 300 mg kava extract per day, kava ha...

PubMed

D A systematic review of herbal medicinal products for the treatment of menopausal symptoms

Systematic Review Menopause (New York, N.Y.) 2003 n=4

**Huntley et al., 2003** | Menopause | Systematic Review Huntley Alyson L, Ernst Edzard. A systematic review of herbal medicinal products for the treatment of menopausal symptoms. Menopause. 2003;10(5):465-76 OBJECTIVE: Many women have turned to comp...

PubMed

D Efficacy of kava-kava in the treatment of non-psychotic anxiety, following pretreatment with benzodiazepines

Rct Psychopharmacology 2001

**Malsch et al., 2001** | Psychopharmacology (Berl) | Rct Malsch U, Kieser M. Efficacy of kava-kava in the treatment of non-psychotic anxiety, following pretreatment with benzodiazepines. Psychopharmacology (Berl). 2001-Sep;157(3):277-83 A 5-week ran...

PubMed

D Effects of Kava on the Body's Elimination of Caffeine and Dextromethorphan

Clinical Trial ClinicalTrials.gov 2001

**NCT ID**: NCT00009542 **Phase**: PHASE4 **Status**: COMPLETED **Enrollment**: 20 **Completion**: 2001-04

ClinicalTrials.gov

Related Supplements

St Johns Wort 2 shared sources Ginseng 2 shared sources Saw Palmetto 1 shared sources Ginkgo 1 shared sources Electrolytes 1 shared sources Echinacea 1 shared sources Calcium 1 shared sources Caffeine 1 shared sources

Frequently Asked Questions

What is Kava and what is it used for?

Kava is a medicinal plant native to the South Pacific. It is primarily researched for its anxiolytic properties, which refers to its potential to help reduce anxiety.

Does Kava work for anxiety and GAD?

Yes, there is strong evidence from multiple meta-analyses and systematic reviews that Kava extract is effective in treating anxiety and Generalized Anxiety Disorder (GAD).

Can Kava help with perimenopause symptoms?

There is weak evidence suggesting that Kava may help reduce anxiety specifically in perimenopausal women. However, more research is needed to confirm these findings.

Does Kava help with mood and motivation?

There is moderate evidence suggesting that kavalactones in Kava may support motivation during intensive training and may impact mood disorders.

Is Kava safe to take?

There are significant safety concerns regarding Kava, including warnings from the CDC about potential liver toxicity (hepatotoxicity). Because of these risks, individuals should consult a doctor before use, especially those with liver health concerns.

What is the recommended dose of Kava?

The current research does not specify an effective or recommended dose range for Kava. You should always consult a healthcare professional to determine an appropriate dosage for your needs.

Are there any known drug interactions with Kava?

There are currently no documented drug interactions for Kava. However, you should always speak with your doctor before adding a new supplement to your routine to ensure it is safe for you.

Answers generated from research evidence. Not medical advice.