Kava

What is the most important information I should know about kava?

Kava has been shown to cause severe liver injury including hepatitis, cirrhosis, and liver failure. Do not take kava if you have liver problems or take medications that can affect the liver. Stop taking kava and seek emergency medical attention if you have liver symptoms such as nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

You should not take kava if you are pregnant. Kava may cause weaken muscle tone in the uterus.

Avoid drinking alcohol while taking kava. Alcohol may increase your risk of liver damage.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by kava. Tell your doctor if you need to use any of these other medicines while you are taking kava.

Kava has not been approved by the FDA to treat any disease, and it should not be substituted for prescription medications.

Kava has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of this product may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. Some marketed herbal supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

What is kava?

Kava is also known as Piper methysticum, awa, kava-kava, kew, tonga, ava, ava pepper, intoxicating pepper, kawa, kava pepper, kava root, rauschpfeffer, sakau, tonga, wurzelstock, and yangona.

Kava has been used to induce and improve sleep, and to decrease anxiety, nervousness, stress, and restlessness.

Kava has not been approved by the FDA to treat any disease, and it should not be substituted for prescription medications.

Kava may also have uses other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking kava?

Before taking kava, talk to your doctor, pharmacist, herbalist, or other healthcare provider. You may not be able to use this product if you have liver or kidney disease, or certain other medical conditions or allergies.

Kava has been shown to cause severe liver injury including hepatitis, cirrhosis, and liver failure. Do not take kava if you have liver problems or take medications that can affect the liver.

Do not take kava without first talking to your doctor if you are depressed or if you are being treated for depression.

Kava may increase drowsiness when taken with substances that cause drowsiness, including antidepressants, alcohol, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Do not take kava without first talking to your doctor if you take any prescription or over-the-counter medicine or herbal/health supplement, that makes you drowsy.

You should not take kava if you are pregnant. Kava may cause weaken muscle tone in the uterus.

Do not take kava without telling your doctor if you are breast-feeding a baby. It is not known whether kava will be harmful to a nursing infant.

How should I take kava?

Kava has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of this product may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. Some marketed herbal supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

If you choose to take kava, use it exactly as directed on the label, or as prescribed by your doctor, pharmacist, or other healthcare provider.

When used to treat insomnia, kava is usually taken one hour before bedtime. When used for other purposes, kava may be taken one to several times a day.

Standardized extracts, tinctures, and solid formulations of herbal/health supplements may provide a more reliable dose of the product.

Kava is available for oral use.

Other formulations of kava may also be available. Do not use different formulations (e.g., tablets, topical formulations, teas, tinctures, and others) of kava at the same time, unless specifically directed to do so by a health care professional. Using different formulations together increases the risk of an overdose of kava.

Kava should not be used for longer than three months without a doctor's supervision. The long-term use of kava has reportedly lead to "kawanism", which is characterized by dry, flaking, discolored skin; reddened eyes; a scaly skin rash; puffy face; muscle weakness; blood abnormalities; and feelings of poor health.

Store kava as directed on the package. In general, kava should be protected from light and moisture and stored in a sealed container.

What happens if I miss a dose?

No information is available regarding a missed dose of kava. Ask your doctor, pharmacist, or healthcare professional for instructions if you miss a dose.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a kava overdose have been reported to include tiredness, sleepiness, and poor coordination.

Kava should not be used for longer than three months without a doctor's supervision. The long-term use of kava has reportedly lead to "kawanism", which is characterized by dry, flaking, discolored skin; reddened eyes; a scaly skin rash; puffy face; muscle weakness; blood abnormalities; and feelings of poor health.

What should I avoid while taking kava?

Do not give any herbal/health supplement to a child without a doctor's advice.

Avoid drinking alcohol while taking kava. Alcohol may increase your risk of liver damage.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by kava. Tell your doctor if you need to use any of these other medicines while you are taking kava.

What are the possible side effects of kava?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking kava and seek emergency medical attention if you have liver symptoms such as nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Other less serious side effects have also been reported. Talk to your doctor, pharmacist, or health care professional if you experience

• morning drowsiness,
• changes in vision, or
• upset stomach.

Kava should not be used for longer than three months without a doctor's supervision. The long-term use of kava has reportedly lead to "kawanism", which is characterized by dry, flaking, discolored skin; reddened eyes; a scaly skin rash; puffy face; muscle weakness; blood abnormalities; and feelings of poor health.

Side effects other than those listed here may also occur. Talk to your doctor, pharmacist, or health care professional about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect kava?

Before taking kava, tell your doctor if you are also using a sedative such as diazepam (Valium) or similar medicines such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), estazolam (ProSom), flurazepam (Dalmane), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), triazolam (Halcion), and others.

There may be other drugs that can interact with kava. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

Your doctor, pharmacist, herbalist, or healthcare provider can provide more information about kava.

Before using any herbal supplement, consult with a licensed healthcare professional or a practitioner trained in the uses of herbal supplements. It is important to keep all of your care providers informed about the treatments and medications you are using. Remember, keep all medicines out of the reach of children, never share your medicines with others, and use this product only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 3.04. Revision date: 08/28/2007.