Kava KA-va

What are other names for this remedy?

Type of medicine: natural remedy

Scientific and common names: Piper methysticum, kava, kawa, awa, kew, tonga, ava pepper, ava root, gea, gi, intoxicating long pepper, kao, kavain, kawa pepper

What is kava?

Kava comes from a tall shrub that grows in the islands of the Pacific Ocean. The root is the part used medicinally.

What is it used for?

This remedy has been used to treat several conditions. Studies in humans or animals have not proved that this remedy is safe or effective for all uses. Before using this remedy for a serious condition, you should talk with your healthcare provider. There may be other uses that are not listed below.

Kava has been used to treat:

• anxiety
• canker sores
• colds and respiratory tract infections
• depression
• headaches
• menstrual cramps
• muscle spasms
• seizures
• sleeplessness
• stress
• toothache
• urinary tract infections
• withdrawal symptoms from certain tranquilizers and sleeping pills

The US Food and Drug Administration (FDA) does not approve uses for natural remedies. The FDA does not inspect or regulate natural remedies the way they do prescription medicines.

How is it taken?

Kava comes in the form of a dried extract, tablets, capsules, or in liquid drops. A drink can be made from the roots of the plant by simmering them in water.

Follow the directions printed on the product label or given by your healthcare provider.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

Kava may not be safe even when used for a short time and in normal doses. Some European countries do not allow kava to be sold due to reports of serious liver damage. The FDA advises people with liver disease or liver problems to talk with a healthcare provider before taking kava products.

If you take kava, ask your healthcare provider to check your liver function regularly.

Do not use kava if you have:

• depression
• liver disease such as hepatitis
• Parkinson's disease

This remedy increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Do not drive or operate heavy machinery unless you are fully alert and can see clearly.

Talk to your healthcare provider or pharmacist about any natural remedy that you are using or thinking about using. If your provider does not tell you how to take it, follow the directions that come with the package. Do not take more or take it longer than recommended. Ask about anything you do not understand. Remember:

• Natural remedies are not always safe.
• You should not take them if you are pregnant or breast-feeding without your healthcare provider's approval. They should not be taken by infants, children, or older adults without your provider's approval.
• They affect your body and may interact with prescription medicines that you take.
• Natural remedies are not standardized and may have different strengths and effects. They may be contaminated.

What are the possible side effects?

Along with its desirable effects, this remedy may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the remedy. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Yellow eyes and skin, severe tiredness, dark urine, nausea, vomiting, stomach pain, loss of appetite, abnormal muscle movements.

Other: Headache, drowsiness, dizziness, scaly skin rash, trouble seeing or hearing, shakiness, hair loss, dry mouth.

What products might interact with this remedy?

When you take this remedy with other medicines, it can change the way the remedy or the medicines work. Vitamins and certain foods may also interact. Using these products together might cause harmful side effects. Before taking this remedy, talk to your healthcare provider if you are taking:

• acetaminophen (Tylenol)
• alcohol
• amiodarone (Cordarone)
• antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• antidepressants such as amitriptyline, bupropion (Wellbutrin), doxepin, duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox CR), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), paroxetine (Paxil), sertraline (Zoloft), trazodone, and venlafaxine (Effexor)
• antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• anti-HIV medicines such as nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), and saquinavir (Invirase)
• antipsychotic medicines such as chlorpromazine, haloperidol (Haldol), olanzapine (Zyprexa), prochlorperazine (Compro), risperidone (Risperdal), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• antiseizure medicines such as carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), primidone (Mysoline), and valproic acid (Depakote)
• azathioprine (Imuran)
• beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal LA), and sotalol (Betapace)
• birth control pills, rings, patches, and implants and hormones such as conjugated estrogens (Premarin), estradiol (Estrace), medroxyprogesterone (Provera), and norethindrone (Aygestin, Camila, Jolivette, Micronor)
• calcium channel blockers such as diltiazem (Cardizem, felodipine, isradipine (DynaCirc CR), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera-HS, Isoptin SR, Verelan, Tiazac)
• cholesterol-lowering medicines such as atorvastatin (Lipitor), fenofibrate (TriCor), fluvastatin (Lescol), gemfibrozil (Lopid), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor)
• cyclobenzaprine (Flexeril)
• cyclophosphamide (Cytoxan)
• dextromethorphan (Robitussin DM)
• diabetes medicines such as glipizide (Glucotrol, Glucotrol XL), glyburide (DiaBeta, Glynase PresTab), insulin, metformin (Glucophage), pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia)
• diclofenac (Voltaren)
• erythromycin (EES, E-mycin, Ery-Ped)
• etoposide (VePesid)
• felbamate (Felbatol)
• fexofenadine (Allegra)
• immunosuppressants such as azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), mycophenolate mofetil (CellCept), sirolimus (Rapamune), and tacrolimus (Prograf, Protopic)
• isoniazid
• leflunomide (Arava)
• levodopa/carbidopa (Sinemet)
• medicines to treat erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
• medicines to treat heartburn and ulcers such as lansoprazole (Prevacid), omeprazole (Prilosec), and pantoprazole (Protonix)
• methotrexate (Rheumatrex)
• mexiletine (Mexitil)
• natural remedies such as calendula, catnip, capsicum, chaparral, comfrey, DHEA, Siberian ginseng, German chamomile, goldenseal, gotu kola, lemon balm, pennyroyal, red yeast, sage, sassafras, stinging nettle, St. John’s wort, and valerian
• niacin
• nitrofurantoin (Macrodantin)
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• ondansetron (Zofran)
• pentazocine (Talwin)
• pyrazinamide
• rifampin (Rifadin)
• sleeping pills such as amobarbital (Amytal), butabarbital (Butisol), flurazepam, phenobarbital, temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien)
• tacrine (Cognex)
• tamoxifen
• terbinafine (Lamisil)
• theophylline (Theo-Dur, Theolair, Uniphyl)
• tramadol (Ultram)
• warfarin (Coumadin)
• zolmitriptan (Zomig)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes select information only. The information was obtained from scientific journals, study reports, and other documents. The author and publisher make no warranty, expressed or implied, as to the information. The advisory may not include all side effects associated with a remedy or interactions with other medicines. Nothing herein shall constitute a recommendation for the use of any remedy. Ask your healthcare provider or pharmacist for more information.

Keep all medicines out of the reach of children.

Do not share medicines with other people.