Newbie with a question about interactions and headache - need info ASAP!

[seibseib]

Hey there,
I'm new here...and I just received my first bag of Kava from Waka (Wakacon, whatever it's called) and have had 2 cups. I feel nice and relaxed

I just was curious if it would react with any of my current medications - haven't been able to find a clear answer googling around, and I really need to get some good sleep tonight (in a few hours) and would really love to know that nothing is interacting with the Kava and I'll be just fine tomorrow!

Daily meds/vitamins and supps:
-20mg of Lexapro
-10mg of Flexeril/Cyclobenzaprine
-Valerian root (at night)
-Magnesium (at night)
-Diphenhydramine (for allergies which have been insane lately, can be at any time of the day really - I'm so used to it, it doesn't really make me sleepy)
-Melatonin (at night)
-1mg of Xanax (only as needed for anxiety, I bought Kava to hopefully not have to take Xanax as much!)

If there are any known interactions, I'd be super appreciative for any info!

Also...I'm kind of suffering from a headache. Ibuprofen an acetaminophen have never really helped me much (I used to get chronic headaches), so I always take Excedrin Migraine (which has some caffeine in it) - would that have any adverse effects?

***Would really appreciate any info so I can go to sleep later knowing I'm all good and won't have any interactions - thanks so much!!!***

 

[Stan]

ive mixed ssris with kava and didnt experience any problems. i take flexeril on occasion i notice if i take 1.5 tabs ill get dizzy feeling, not sure if that just flex or combination. flex works on gaba like kava does i think. i was taking benadryl and noticed it didnt mix well with the kava. my eyes got alot worse and was pretty miserable. then i ran out of benadryl and just happened to notice my eyes and how i felt was better. flonase helps me the most with allergies. have you taken your excedrin or had some caffeine today? if you havent thatll give ya a wicked headache. ideally its not great to mix all those medicines but from my experience it should be ok. maybe go easy on the kava. good luck.

 

[Stan]

ahh im reading here excedrin has tylenol in it. you dont want to mix tylenol and kava. once or twice wont hurt ya but definitely not good to mix the two.

 

[Kavashua]

I have had unpleasant side effects when I drank kava and taken Diphenhydramine. I don't know if there was any danger to the combo as I'm not a doctor but it was enough to make me avoid ever doing it again. The best way I could describe it was an overwhelming "dopiness" the sedative effects were tripled and I just felt plain stupid

 

[verticity]

Hi, welcome to the Forum.

I'm not a doctor, and not a kava expert, but here is what I know from science stuff I have read about this:

You need to consider 2 things to predict potential interactions: Functionality (if kava and your meds effect the same systems in your body), and metabolic (whether your meds are metabolized the same way as kava).

- Lexapro: Kava is not serotonergic, so I wouldn't it expect it to interfere at a functional level. Lexapro is a P-glycoprotein substrate, whereas kava is a p-glycoprotein inhibitor. What that means, I think, is that combining kava with Lexapro could make it easier for the Lexapro to cross the blood-brain barrier, resulting in increased levels of Lexapro in your brain. If you have adverse side effects from the Lexapro, kava could make the side effects worse. So you should be careful with that combination. Lexapro is metabolized by a liver enzyme called CYP2D6, which is also one of the enzymes involved in kava metabolism. So that could potentially result in increased levels of both Lexapro and kavalactones.

- Flexeril: A muscle relaxant that can cause drowsiness and dizziness as side effects. Combining kava could possibly make these side effects stronger. MAOIs are contraindicated with Flexeril, but the concern seems to be mainly about the risk of serotonin syndrome. There is some evidence that kava can act as a mild MAOI, but it is an MAO-B inhibitor, which means it does not effect serotonin like the antidepressant MAO-A inhibitor drugs do. Flexeril, too, is metabolized by several of the same enzymes that kava is metabolized by, so increased levels of either are possible.

- Valerian/Melatonin: As far as I know this acts on serotonin in a way similar to melatonin to make you sleepy. Probably OK with kava, but since kava can also make people sleepy... the result could be that you become even more sleepy... That might be good or bad depending on what you want. If you also add melatonin on top, well, even more sleepiness, but probably safe.

- Magnesium: No idea.

- Diphenhydramine: More additive sleepiness. Like Lexapro, also metabolized by CYP2D6, so combining those two plus kava could result in increased blood levels and side effects.

- Xanax: Again, additive sedative effects. Metabolized by CYP3A4, which is yet another enzyme involved in kava metabolism, so potentially increased levels/side effects.

- Caffeine: Many people have noticed an unpleasant stimulated feeling when combining caffeine with kava, possibly due to increased caffeine levels caused by metabolic interactions.

- Aspirin: Probably OK. This is one of the few medications that is not metabolized by CYP enzymes, so would not interact with kava in that way, but kava is suspected of being a COX inhibitor, like aspirin, so things like blood thinning effect could be increased. On the other hand, kava does help some people with pain, so it could be a beneficial interaction.

- Excedrin/acetaminophen/Tylenol: Never combine acetaminophen (ingredient in Excedrin) with kava. Kava is safe for the liver by itself, but acetaminophen can harm the liver, and combining it with kava could aggravate this effect.

So, you are on quite a few meds, most or all of which could potentially interact with kava. Please get cleared with your doctor before starting on the kava, and unfortunately there is a good possibility that your doctor might recommend that you not use kava.

In the event that your doctor doesn't know anything about kava, please feel free to print this post out and show it to him or her.

 

[Krunkmeup]

Hi, welcome to the Forum.

I'm not a doctor, and not a kava expert, but here is what I know from science stuff I have read about this:

You need to consider 2 things to predict potential interactions: Functionality (if kava and your meds effect the same systems in your body), and metabolic (whether your meds are metabolized the same way as kava).

- Lexapro: Kava is not serotonergic, so I wouldn't it expect it to interfere at a functional level. Lexapro is a P-glycoprotein substrate, whereas kava is a p-glycoprotein inhibitor. What that means, I think, is that combining kava with Lexapro could make it easier for the Lexapro to cross the blood-brain barrier, resulting in increased levels of Lexapro in your brain. If you have adverse side effects from the Lexapro, kava could make the side effects worse. So you should be careful with that combination. Lexapro is metabolized by a liver enzyme called CYP2D6, which is also one of the enzymes involved in kava metabolism. So that could potentially result in increased levels of both Lexapro and kavalactones.

- Flexeril: A muscle relaxant that can cause drowsiness and dizziness as side effects. Combining kava could possibly make these side effects stronger. MAOIs are contraindicated with Flexeril, but the concern seems to be mainly about the risk of serotonin syndrome. There is some evidence that kava can act as a mild MAOI, but it is an MAO-B inhibitor, which means it does not effect serotonin like the antidepressant MAO-A inhibitor drugs do. Flexeril, too, is metabolized by several of the same enzymes that kava is metabolized by, so increased levels of either are possible.

- Valerian/Melatonin: As far as I know this acts on serotonin in a way similar to melatonin to make you sleepy. Probably OK with kava, but since kava can also make people sleepy... the result could be that you become even more sleepy... That might be good or bad depending on what you want. If you also add melatonin on top, well, even more sleepiness, but probably safe.

- Magnesium: No idea.

- Diphenhydramine: More additive sleepiness. Like Lexapro, also metabolized by CYP2D6, so combining those two plus kava could result in increased blood levels and side effects.

- Xanax: Again, additive sedative effects. Metabolized by CYP3A4, which is yet another enzyme involved in kava metabolism, so potentially increased levels/side effects.

- Caffeine: Many people have noticed an unpleasant stimulated feeling when combining caffeine with kava, possibly due to increased caffeine levels caused by metabolic interactions.

- Aspirin: Probably OK. This is one of the few medications that is not metabolized by CYP enzymes, so would not interact with kava in that way, but kava is suspected of being a COX inhibitor, like aspirin, so things like blood thinning effect could be increased. On the other hand, kava does help some people with pain, so it could be a beneficial interaction.

- Excedrin/acetaminophen/Tylenol: Never combine acetaminophen (ingredient in Excedrin) with kava. Kava is safe for the liver by itself, but acetaminophen can harm the liver, and combining it with kava could aggravate this effect.

So, you are on quite a few meds, most or all of which could potentially interact with kava. Please get cleared with your doctor before starting on the kava, and unfortunately there is a good possibility that your doctor might recommend that you not use kava.

In the event that your doctor doesn't know anything about kava, please feel free to print this post out and show it to him or her.

Wow versisity you certainly know your stuff!
I too am on a few medications, I was wondering if you know of any possible interaction of these with kava? The main one I am worried about is quetiapine as it has effects on dopamine.
Quetiapine, clomipramine, propanolol and Escitalopram.
Thanks in advance. (Escitalopram is an ssri so I'm guessing safe, clomipramine is a tricycle so slightly different)

 

[verticity]

Wow versisity you certainly know your stuff!
I too am on a few medications, I was wondering if you know of any possible interaction of these with kava? The main one I am worried about is quetiapine as it has effects on dopamine.
Quetiapine, clomipramine, propanolol and Escitalopram.
Thanks in advance. (Escitalopram is an ssri so I'm guessing safe, clomipramine is a tricycle so slightly different)

I would be very cautious about the clomipramine. As you are probably aware, the effects of an overdose of tricyclics are potentially life-threatening. Clomipramine is metabolized by CYP2D6:

"Its use is also advised against in those concurrently on CYP2D6 inhibitors due the potential for increased plasma levels of clomipramine and the resulting potential for CNS and cardiotoxicity."

There is evidence from in vitro studies that kava could be a CYP2D6 inhibitor (although one study in vivo contradicts that). But considering the possible serious adverse effects of elevated clomipramine levels it would be advisable at the very least to consult with your doctor about this, and if you do end up using kava to get your blood level of clomipramine tested to make sure it stays within the therapeutic range.

Another concern with clomipramine is that it is a norepinephrine re-uptake inhibitor, and so is kava, so the kava could cause increased side effects from an additive effect there, such as anxiety.

The propranolol also has some common metabolizing enzymes (also including CYP2D6), and excessively high levels of that can also be dangerous, so you would definitely need to keep a close eye on your blood pressure to make sure it doesn't get too low.

The quetiapine and escitalopram might also have metabolic interactions (the great majority of drugs have that potential since kava is metabolized by a broad spectrum of CYP450 isoenzymes), but the main concern with quetiapine is probably just that because it counteracts the effect of dopamine, it could blunt some of the "good feeling" that you get from the dopamine enhancing effect of kava.

And please remember: I'm not a doctor; I am some guy on the internet. I am wearing pajamas right now. Seriously. Please talk to your own doctor.

 

[Krunkmeup]

I would be very cautious about the clomipramine. As you are probably aware, the effects of an overdose of tricyclics are potentially life-threatening. Clomipramine is metabolized by CYP2D6:

"Its use is also advised against in those concurrently on CYP2D6 inhibitors due the potential for increased plasma levels of clomipramine and the resulting potential for CNS and cardiotoxicity."

There is evidence from in vitro studies that kava could be a CYP2D6 inhibitor (although one study in vivo contradicts that). But considering the possible serious adverse effects of elevated clomipramine levels it would be advisable at the very least to consult with your doctor about this, and if you do end up using kava to get your blood level of clomipramine tested to make sure it stays within the therapeutic range. (

Another concern with clomipramine is that it is a norepinephrine re-uptake inhibitor, and so is kava, so the kava could cause increased side effects from an additive effect there, such as anxiety.

The propranolol also has some common metabolizing enzymes (also including CYP2D6), and excessively high levels of that can also be dangerous, so you would devinitely need to keep a close eye on your blood pressure to make sure it doesn't get too low.

The quetiapine and escitalopram might also have metabolic interactions (the great majority of drugs have that potential since kava is metabolized by a broad spectrum of CYP450 isoenzymes), but the main concern with quetiapine is probably just that because it counteracts the effect of dopamine, it could blunt some of the "good feeling" that you get from the dopamine enhancing effect of kava.

And please remember: I'm not a doctor; I am some guy on the internet. I am wearing pajamas right now. Seriously. Please talk to your own doctor.

Hi verticity thankyou very much for your detailed reply. That was my thinking about the quetiapine that it could block the kava working so well.
I didn't think the clomipramine would be an issue so thanks for raising that, I will look into it. I am on half the about I used to be on which is a good thing.
Cheers Matt.

 

[verticity]

Hi verticity thankyou very much for your detailed reply. That was my thinking about the quetiapine that it could block the kava working so well.
I didn't think the clomipramine would be an issue so thanks for raising that, I will look into it. I am on half the about I used to be on which is a good thing.
Cheers Matt.

Yeah, with clomipramine, in a addition to the issue of toxicity, probably the more likely issue is that tricyclics have a therapeutic "window": If the blood level is to low, or too high, they are less effective. It should be a simple matter to get a test to make sure it is at the right level. A long time ago I used to take nortriptyline, and I remember getting tested to adjust the dose--I think it's a standard thing.

 

[Krunkmeup]

Yeah, with clomipramine, in a addition to the issue of toxicity, probably the more likely issue is that tricyclics have a therapeutic "window": If the blood level is to low, or too high, they are less effective. It should be a simple matter to get a test to make sure it is at the right level. A long time ago I used to take nortriptyline, and I remember getting tested to adjust the dose--I think it's a standard thing.

I am currently in the process of reducing the clomipramine and quetiapine so I guess the less I take the better to avoid the levels getting too high?

 

[SelfBiasResistor]

Hey there,
I'm new here...and I just received my first bag of Kava from Waka (Wakacon, whatever it's called) and have had 2 cups. I feel nice and relaxed

I just was curious if it would react with any of my current medications - haven't been able to find a clear answer googling around, and I really need to get some good sleep tonight (in a few hours) and would really love to know that nothing is interacting with the Kava and I'll be just fine tomorrow!

Daily meds/vitamins and supps:
-20mg of Lexapro
-10mg of Flexeril/Cyclobenzaprine
-Valerian root (at night)
-Magnesium (at night)
-Diphenhydramine (for allergies which have been insane lately, can be at any time of the day really - I'm so used to it, it doesn't really make me sleepy)
-Melatonin (at night)
-1mg of Xanax (only as needed for anxiety, I bought Kava to hopefully not have to take Xanax as much!)

If there are any known interactions, I'd be super appreciative for any info!

Also...I'm kind of suffering from a headache. Ibuprofen an acetaminophen have never really helped me much (I used to get chronic headaches), so I always take Excedrin Migraine (which has some caffeine in it) - would that have any adverse effects?

***Would really appreciate any info so I can go to sleep later knowing I'm all good and won't have any interactions - thanks so much!!!***

I use magnesium with kava every night and have not noticed any difference. I could not imagine using kava and diphenhydramine or flexeril anywhere near each other. Sounds like it would be a very bad experience. If you need to use xanax (benzos) while on kava, the dose should be 25-50% of a normal dose at most unless the goal is to sleep. Kava seems to strengthen the sedating effects of a benzo even more than alcohol, without the blackout, at least.

 

[Edward]

@seibseib I can't help with interactions but if you're getting headachy then it could well be down to dehydration. It's easy to underestimate just how much extra water you're going to need to drink to stay hydrated when you're drinking kava. Try and be well hydrated going into a session, not quite as critical after in that case. Also caffeine at any time will compound the problem. This is just something that stands out to me from your first post.

 

[Odourman]

I take antihistamines everyday in the summer, a small dose. It's a must. It makes you a bit sluggish.