Kava

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

Kava comes from a tall shrub called Piper methysticum that grows in the islands of the Pacific Ocean. This shrub has large, green, heart-shaped leaves. The roots look like bundles of woody, hairy branches. Kava root is the part used medicinally.

Kava has been used to treat:

• anxiety
• colds and respiratory tract infections
• depression
• headaches
• muscle spasms
• seizures
• sleeplessness
• stress
• 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.

Kava is available as 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 health care provider.

Kava may not be safe even with short-term use in normal doses. Some European countries have removed kava from the marketplace due to reports of serious liver damage. The FDA issued an advisory to caution people with liver disease or liver problems to consult a health care provider before taking kava products.

If you take kava, ask your health care 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 health care provider approves.

If you need surgery or dental work, stop taking this remedy at least 24 hours before the procedure.

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

Females of childbearing age: Do not take this remedy if you are pregnant or breast-feeding.

Talk to your health care provider or pharmacist about any natural remedy that you are using or considering. If your provider does not give you specific instructions, 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 health care 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.

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 health care provider if you have any side effects that continue or get worse.

Serious (report these to your health care 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.

When you take this remedy with other medicines, it can change the way this remedy or any of 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 health care provider if you are taking:

• acetaminophen (Tylenol)
• alcohol
• amiodarone (Cordarone)
• antidepressants such as amitriptyline, imipramine (Tofranil), desipramine (Norpramin), fluvoxamine (Luvox), paroxetine (Paxil), and venlafaxine (Effexor)
• antifungal medicines such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• antihistamines such as fexofenadine (Allegra)
• anti-HIV medicines such as saquinavir (Invirase, Fortovase), nelfinavir (Viracept), ritonavir, Norvir), and nevirapine (Viramune)
• anti-psychotic medicines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril), clozapine (Clozaril), haloperidol (Haldol), olanzapine (Zyprexa), clomipramine (Anafranil), and risperidone (Risperdal)
• antiseizure medicines such as carbamazepine (Tegretol), phenobarbital, primidone (Mysoline), phenytoin (Dilantin), and valproic acid (Depakote)
• azathioprine (Imuran)
• beta blockers such as propranolol (Inderal) and metoprolol (Lopressor, Toprol XL)
• calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan)
• cholesterol-lowering medicines such as fenofibrate (Tricor), fluvastatin (Lescol), gemfibrozil (Lopid), atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and rosuvastatin (Crestor)
• cyclobenzaprine (Flexeril)
• cyclophosphamide (Cytoxan)
• dextromethorphan (Robitussin DM)
• diclofenac (Voltaren)
• erythromycin (EES, E-mycin, Ery-Ped)
• estrogen (Premarin, Estrace)
• etoposide (VePesid)
• felbamate (Felbatol)
• herbs with sedative effects such as calendula, catnip, capsicum, Siberian ginseng, German chamomile, comfrey, goldenseal, gotu kola, lemon balm, pennyroyal, sage, sassafras, stinging nettle, and valerian
• immunosuppressants such as azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), mycophenolate mofetil (Cellcept), sirolimus (Rapamune), and tacrolimus (Prograf, Protopic)
• isoniazid
• leflunomide (Arava)
• levodopa (Larodopa, Dopar)
• medicines to treat diabetes such as insulin, glipizide (Glucotrol), glyburide (DiaBeta, Micronase, Glynase), metformin (Glucophage), rosiglitazone (Avandia), acarbose (Precose), and pioglitazone (Actos)
• medicines to treat heartburn and ulcers such as lansoprazole (Prevacid), omeprazole (Prilosec), and pantoprazole (Protonix)
• methotrexate (Rheumatrex)
• mexiletine (Mexitil)
• niacin
• nitrofurantoin (Macrodantin)
• nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Motrin IB, Advil, Nuprin), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), ketoprofen (Orudis, Orudis KT, Oruvail), nabumetone (Relafen), indomethacin (Indocin), ketorolac (Toradol), sulindac (Clinoril), piroxicam (Feldene), diclofenac (Voltaren, Cataflam), and oxaprozin (Daypro)
• ondansetron (Zofran)
• medicines to treat erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
• pentazocine (Talwin)
• pyrazinamide
• rifampin (Rifadin)
• sedatives such as lorazepam (Ativan), alprazolam (Xanax), diazepam (Valium), phenobarbital, secobarbital (Seconal), thiopental (Pentothal), zolpidem (Ambien), zaleplon (Sonata), and triazolam (Halcion)
• tacrine (Cognex)
• tamoxifen
• terbinafine (Lamisil)
• theophylline (Theo-Dur, Theolair, Uniphyl)
• tramadol (Ultram)
• warfarin (Coumadin)
• zolmitriptan (Zomig).

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all health care 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 health care provider or pharmacist for more information.

Keep all medicines out of the reach of children.

Do not share medicines with other people.