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Prescription meds and Kava

El Guapo510

Kava Curious
I Know this topic has been raised a billion times but I'm going to revive it for more current input-

Aside from the obvious, Acetaminophen (paracetamol), what other prescription meds are likely going to be problematic mixing with Kava?
 

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
I Know this topic has been raised a billion times but I'm going to revive it for more current input-

Aside from the obvious, Acetaminophen (paracetamol), what other prescription meds are likely going to be problematic mixing with Kava?
Generally with GABAergic medications such as benzos, Lyrica, and any other types of medications that cause sleepiness you'd want to keep an eye out for.

Kava, more specifically kavain, currently is thought of as a general positive allosteric modulator of the GABA-A receptor. What this means is that it causes GABA receptors to increase their response when in the presence of natural GABA. Benzos and other GABAergic meds do this as well, and adding kava on top compounds the sedation.

There is a little evidence that dopaminergic drugs may not play well with kava's dopamine actions such as levodopa in Parkinson's disease patients. It seems kava, more specifically yangonin causes a steep drop in dopamine levels in certain areas of the brain which may interfere with medications looking to increase them. This is about as much as I can say about the pharmacodynamic interactions of kava with other drugs.

In regards to the pharmacokinetic profile, Kava in vitro (or the lab) shows to inhibit several classes of enzymes which are used by the body to break down many types of drugs and chemicals we encounter. Be that as it may, the in vivo (real tests in humans) results show something different. Kava shows in the human body to only affect CYP1A2 and CYP2E1, both of which are quite specific in which drugs they metabolize.

Acetaminophen breaks down into what's known as N-acetyl-p-benzoquinone imine or NAPQI for short. This is known as a liver toxic compound, and can cause severe liver damage [1]. CYP1A2 is the pathway that APAP uses to further metabolize this compound. When CYP1A2 is inhibited APAP will stay in it's NAPQI form for longer, thus leaving higher opportunity to cause cellular damage [2].

There are a limited number of drugs that also use this pathway such as clozapine, Luvox, caffeine, melatonin and antipsychotics such as Haloperidol [3]. They should be used with caution when combining them with kava. They may end up staying in the system longer than anticipated and in certain forms when kava is present.

Basically an easy way of seeing if your drug will interact with kava is by doing the following:

1. Identify the drug (Example: valium)
2. search the drug on https://go.drugbank.com/
3. On the left, click "Pharmacology", and then "Metabolism"

The metabolism screen will show you which enzymes are used in the metabolization of the drug in question. If it involves CYP1A2 or CYP2E1 then they may interact (as in decreases the body's ability to metabolize those drugs) with kava.



[1] Wikimedia Foundation. (2021, April 25). NAPQI. Wikipedia. https://en.wikipedia.org/wiki/NAPQI.

[2] Tonge, R. P., E. J. Kelly, S. A. Bruschi, T. Kalhorn, D. L. Eaton, D. W. Nebert, and S. D. Nelson. 1998. “Role of CYP1A2 in the Hepatotoxicity of Acetaminophen: Investigations Using Cyp1a2 Null Mice.” Toxicology and Applied Pharmacology 153 (1): 102–8. https://doi.org/10.1006/taap.1998.8543

[3] Ghodke-Puranik, Yogita A., and Jatinder K. Lamba. 2017. “Chapter 7 - Pharmacogenomics.” In Innovative Approaches in Drug Discovery, edited by Bhushan Patwardhan and Rathnam Chaguturu, 195–234. Boston: Academic Press. https://doi.org/10.1016/B978-0-12-801814-9.00007-6.
 

El Guapo510

Kava Curious
Wow, Thank you! I take propranolol and I have always wondered. It seems like it is partially metabolized by 1a2 from what I can read about it.
 

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
Wow, Thank you! I take propranolol and I have always wondered. It seems like it is partially metabolized by 1a2 from what I can read about it.
Sure enough. It can probably cause Propranolol to stick around for a bit longer than it usually would. Keep an eye on your blood pressure if you intend to mix the two. Low numbers would be the issue with this combination.

Anything Kava would could possibly effect would be listed as a "Substrate".

Here's a good list: https://en.wikipedia.org/wiki/CYP1A2
 

spoutti

Newbie
Hi everybody,

I just read this new nootropicsdepot's blog https://nootropicsdepot.com/article...=w1fnThZg9c5NTHNTEBj+OjpxdzkQNl9LgdxZ9pnzLRY= talking about the ginkgo biloba ability to antagonize gaba a1 receptor's units. When agonized, the receptor causes relaxation as well as imparing memory.

I couldn't find the specifics about kava and gaba receptors. Because if any on the a1 and a5 receptor's unit, maybe stacking ginkgo biloba could be a good thing?

And its interesting to know kava inhibits the enzyme responsible for melatonin breakdown. It surely has a part in the interaction between kava and sleep.
 
R

Radagaskos

I stumbled upon this post and thought I'd chime in with some information. While Acetaminophen is a common medication that is known to cause issues when mixed with Kava, there are a few other prescription drugs that you should be aware of. However, I'm not a medical professional, so I'd recommend consulting with a doctor or pharmacist before taking Kava with any prescription medication. They will be able to give you a better idea of any potential risks or side effects. On another note, have you heard of CharityRx? It's a platform that helps you find the best prices for your prescription medications. I've personally used it and was able to save quite a bit of money on my meds.
 
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Gabbadict

Kava Curious
Just reading though this thread and I see that paracetamol is an interaction. What if one has a headache or pain which requires the use of an analgesic such as paracetamol? Does one not take this until 24 hours of a kava session or how would it work?

I also take 1mg of clonazapam, have been. For nearly 15 years, I believe it has lost its effectiveness and I take it now just so I don't go through withdrawal. It seems when I was drinking, I could drink so so much and I would to be to out of it. I'm not sure with the kava if it's effects are more intoxicating due to 1mg of clonazapam or because I have been on it for such a long time I've become tolerant and it's not interacting...
 
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