Kava

Kava is suggested for use in treating anxiety disorders, benzodiazepine withdrawal, common cold/upper respiratory tract infections (URIs), depression, epilepsy, headaches/migraines, insomnia, musculoskeletal pain, psychosis, and stress.

• Kava is likely effective for anxiety, and insomnia (short-term).
• Kava is available under the following different brand and other names: ava pepper, awa, intoxicating pepper, kao, kawa, kew, Piper methysticum, sakau, tonga, and yagona

Suggested Dosing

Anxiety disorders

• 70% standardized extract: 100 mg orally three times daily
• Kava-lactones: 60-120 mg/day orally
• Root tea: 1 cup orally one to three times daily; 2-4 g root/150 ml water

Benzodiazepine withdrawal, prevention

• 70% standardized extract
• Initial: 50 mg orally once/day, 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 orally at bedtime

Dosage Considerations – Should be Given as Follows:

• See "Suggested Dosing"

Side effects of kava include:

• Allergic skin reactions
• Dizziness
• Drowsiness
• Enlarged pupils
• Gastrointestinal upset
• Headache
• Hepatitis (acute)
• Liver damage
• Liver failure
• Motor reflex impairment
• Oculomotor equilibrium disturbances
• Parkinsonism
• Visual accommodation disturbances
• Bodyweight decreases (chronic use)
• Facial puffiness (chronic use)
• Blood in the urine (chronic use)
• Kava dermopathy (chronic use)
• Lymphocytopenia (chronic use)
• Movement disorders (chronic use)
• Protein levels decreased (chronic use)
• Pulmonary hypertension (chronic use)
• Rash (chronic use)
• Red blood cell volume increases (chronic use)
• Low blood platelet count (thrombocytopenia) (chronic use)

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Severe Interactions of kava include:
• None
• Serious Interactions of kava include:
  • daclizumab
• Kava has moderate interactions with at least 29 different drugs.
• Mild Interactions of kava include:
  • zidovudine

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

• This medication contains kava. Do not take ava pepper, awa, intoxicating pepper, kao, kawa, kew, Piper methysticum, sakau, tonga, or yagona if you are allergic to kava or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hepatitis: acute, chronic, or any history

Effects of Drug Abuse

• Chronic use of kava may cause side effects including body weight decreases, facial puffiness, blood in the urine (hematuria), kava dermopathy, lymphocytopenia, movement disorders, protein levels decrease, pulmonary hypertension, rash, red blood cell volume increases, and thrombocytopenia.

Short-Term Effects

• See "What Are Side Effects Associated with Using Kava?"

Long-Term Effects

• Chronic use of kava may cause side effects including body weight decreases, facial puffiness, blood in the urine (hematuria), kava dermopathy, lymphocytopenia, movement disorders, protein levels decrease, pulmonary hypertension, rash, red blood cell volume increases, and thrombocytopenia.
• See "What Are Side Effects Associated with Using Kava?"

Cautions

• Depression.
• Risk of liver failure: banned in many countries (UK, Sweden, Netherlands, etc.).

Pregnancy and Lactation

• Kava is unsafe for use during pregnancy or breastfeeding.