Kava kava, also called simply kava, is an herbal remedy mainly used for relieving anxiety. Derived from dried roots of the plant Piper methysticum, kava also may be helpful with stress, insomnia and unpleasant effects of menopause. Kava interacts with numerous drugs and herbs, and also can cause severe side effects. The University of Maryland Medical Center recommends taking a two-week break from this herb if you use it for three months straight, and also taking kava only under a doctor's supervision.
Primary Benefit
Several high-quality studies have shown kava to be effective at treating anxiety, according to the NIH. Unlike many herbal remedies that take time to work, kava often appears effective within one or two doses. Kava may be as effective as benzodiazepine drugs such as diazepam, known as Valium, and buspirone, known as Buspar, but it does not seem to have similar sedating properties.
Increased Drug Effects
Kava inhibits several types of liver enzymes, and since many medications are broken down by liver enzymes, kava interacts with a large number of medications, explains eMedTV. Kava activity can lead to an increase in blood levels of these drugs, thus increasing the risk of side effects, which can be dangerous.
Liver Concerns
The U.S. Food and Drug Administration issued a consumer advisory in 2002 about the potential for products containing kava to cause liver damage. Although the incidence is rare relative to the number of people who have used kava, multiple cases of hepatitis, cirrhosis and liver failure have been linked to kava use, according to the University of Maryland Medical Center. Some countries have banned the sale of kava because of these reports. People may be at greater risk for liver problems while taking kava if they also take medications that have negative effects on the liver, such as acetaminophen, or is they drink large amounts of alcohol.
Increased Sedative Effects
Kava can increase the sedative effects of any medications and herbs that have this effect, as noted by the NIH. This can lead to excessive drowsiness. Examples of these drugs include sleep aids, opioid pain relievers such as oxycodone and propoxyphene, and medications prescribed for treating depression and anxiety, such as fluoxetine, sertraline, buspirone and opipramol. Kava also may increase the sedating effects of alcohol.
Brain-Affecting Drugs
Kava may have similar chemical properties as monoamine oxidase inhibitor antidepressants, so it may increase the effects of these drugs, according to the NIH. Examples of MAOIs include isocarboxazid and phenelzine. Kava also might increase the effects of herbal remedies that act like MAOI drugs, such as evening primrose oil. Kava may increase side effects associated with phenothiazine drugs commonly used for treating schizophrenia, including chlorpromazine, known as Thorazine. Kava may reduce the effectiveness of levodopa, a medication that increases levels of dopamine in the brain and is used to treat Parkinson's disease. It also may worsen neurologic side effects of drugs that block dopamine, such as haloperidol, known as Haldol.
Additional Interactions
Kava may cause the effects of anesthesia to last longer, so anyone planning to have surgery may need to discontinue using this herb at least two weeks before the procedure. Although research with humans is lacking, laboratory results indicate that kava may increase the risk of abnormal bleeding, according to the NIH. This is primarily a problem for people who take medications or supplements with blood-thinning effects, such as aspirin, ibuprofen, warfarin, heparin, clopidogrel and Ginkgo biloba. Additionally, kava has diuretic properties, which could result in excessive urination when taken with diuretic substances. These include drugs used to reduce fluid retention and some blood pressure medications. Excessive urination can lead to dehydration and electrolyte depletion.
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