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What are the known things that kava interacts with ?

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Plantacious

Kava Enthusiast
Not necessarily looking for a scientifically report full of evidence, although that would be great.
But even if it's just one person reporting one bad experience, what substances (whether natural or medication) have been known or even suspected, to have negative interactions with kava ?
 
The Kap'n

The Kap'n

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Krunkie McKrunkface

Krunkie McKrunkface

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Kapmcrunk said:
http://kavaforums.com/forum/brdc-do...e-cautious-of-or-avoid-while-drinking-kava.7/

Hopefully this helps you find what you're looking for :)
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there are other things, too, that while not particularly negative or contraindicated, one should be aware of, to know what to expect and to adjust accordingly.

e.g. kava and caffeinated beverages, kava will potentiate the caffeine so you probably need to drink less caffeine, although the caffeine does not potentiate the kava

kava and alcohol, kava will potentiate the alcohol, so drink less than usual or better, none at all

if you take medical mj for a medical condition: they both potentiate each other, so if consuming both at the same time, reduce normal dosage for each.

kava and water: kava dehydrates so increase water consumption above usual levels.

If anyone can add to this I would find that useful.
 
verticity

verticity

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Kapmcrunk said:
http://kavaforums.com/forum/brdc-do...e-cautious-of-or-avoid-while-drinking-kava.7/

Hopefully this helps you find what you're looking for :)
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That is a nice summary. Like it says, there are a wide array of things that can potentially interact with kava. And you should be aware of all these, but really in my mind the most important contraindication is the CYP 2E1 medications. Studies in test tubes have shown that kava can inhibit many liver enzymes, but as far as I know 2E1 is the only one that has actually been shown experimentally to be inhibited by kava in living humans. And the two big things you definitely need to avoid in that category are: alcohol and acetaminophen (Tylenol/Paracetamol). In addition to the in vivo study of the CYP2E1 isoform, there have also been case reports of bad interactions with alcohol, and additional experimental evidence that liver damage caused by acetaminophen can be exacerbated by combining it with kava. I would actually change the label on that one from "Interaction Rating: Moderate Be cautious with this combination." to "Potentially Severe" or something. So that is the short answer. For the long answer, read that whole post. It also should be noted that the lists of medications in that post are not exhaustive. The fact that a specific medication is not listed there does not necessarily mean it has no interactions.
 
verticity

verticity

I'm interested in things
Plantacious said:
Thanks. I didn't see anti-depressants on that list. But theoretically it seems like they could interact.
Does anybody know about anti-depressants ?
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Most antidepressants do have the potential to interact with kava, because they are generally metabolized by some of the same liver enzymes. On the other hand, there have been anecdotal reports from people here who have not had any problem with the combination. Of course the fact that some people have not had problems does not mean that problems can't happen.

There are several old-style tricyclic antidepressants on that list: desipramine, imipramine, amitryptiline. Also Prozac is listed as an example of a drug that is metabolized by CYP 2D6.

In general, if you want to check a specific medication that isn't on the list already, do a Google search for:

1) "[medication name] metabolism"
and also
2) "[medication name] mechanism of action"

or check the Wikipedia page for the medication.

For example, if you want to check on the new antidepressant "Fetzima", google (while reflecting upon the fact that someone was paid cash money to come up with the name of that drug) :

"Fetzima mechanism of action"

which will inform you this is a norepinephrine and serotonin reuptake inhibitor (SNRI). Since kava has been shown to possibly also be a mild norepinephrine reuptake inhibitor, there is a potential for increased side effects when combined with kava.

Next, search for:

"Fetzima metabolism"

and you can find out that this medication is metabolized by the enzyme called CYP 3A4. Check that against the list in the above post ( http://kavaforums.com/forum/brdc-do...e-cautious-of-or-avoid-while-drinking-kava.7/ ), and you can see that that is in fact one of the enzymes involved in kava metabolism. So in addition to the overlap in function (norepinephrine reuptake), there is also a potential for metabolic interaction, meaning combining kava with this med could cause the levels of both the medication and kavalactones to be increased.
 
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Plantacious

Kava Enthusiast
chandra said:
I took antidepressants and kava together for awhile. Only side effect I noticed was being able to come off of the anti depressants.
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If you don't mind answering this, could you tell me what type of antidepressant they were ?
Not really the brand name, but the classification - like SSRI, SNRI, MAOI, Tetracyclic, Atypical, etc.
Also, the brand name would be appreciated as well, if you don't mind stating it, or if you're not sure of the classification I mentioned above.
 
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