Supplement · Considered, not recommended

Kava and medications.

Why it sits outside our recommendations, and what to consider instead.

Kava is not in the Distil recommendation database. We surface it here deliberately, because why a compound is left out is as useful as what we recommend.

Kava is an effective short-term anxiety remedy, and that part is not in dispute. It is excluded for one reason: the liver. Cases of severe liver injury, some requiring a transplant, led the UK to prohibit kava-containing medicines for human consumption, a ban in force since January 2003, and several other countries did the same. The damage was unpredictable, with no clear link to dose or preparation.

It also adds to the sedation of benzodiazepines, alcohol and other depressants. The anxiety benefit is real, but the liver risk and the regulatory status put it outside what we will recommend. The gentler options below carry no comparable liver signal.

What to consider instead. Every option below is in the Distil database, so you can check each against your own medications:

L-Theanine: takes the edge off without sedation
Magnesium Glycinate: calming in the evening, well tolerated
Lemon Balm: a gentle traditional option for nerves and sleep

We still hold the documented interactions for Kava, which is why it stays in the interactions checker even though we do not recommend it. Below are the 4 documented pairs we have explicitly assessed: 4 red. Every call is cited to a clinical reference (PMID) or the British National Formulary.

Documented interactions

Additive CNS depression

Red Alprazolam

Kava and alprazolam both depress the central nervous system through overlapping pathways, and kava is independently linked to liver injury. Combining the two raises the risk of excessive sedation and adds to the liver-injury risk that already exists with kava alone. We treat this as a do-not-combine pair.

PMID 11434754 · PMID 30668342 · BNF: Alprazolam

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Red Diazepam

Kava and diazepam both depress the central nervous system through overlapping pathways, and kava is independently linked to liver injury. Combining the two raises the risk of excessive sedation and adds to the liver-injury risk that already exists with kava alone. We treat this as a do-not-combine pair.

PMID 11434754 · PMID 30668342 · BNF: Diazepam · MHRA:Kava-suspension-2003

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Red Lorazepam

Kava and lorazepam both depress the central nervous system, and kava is independently linked to liver injury. Combining the two raises the risk of excessive sedation. We treat this as a do-not-combine pair.

PMID 11434754 · PMID 30668342 · BNF: Lorazepam · MHRA:Kava-suspension-2003

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Red Temazepam

Kava and temazepam both depress the central nervous system, and kava is independently linked to liver injury. Combining the two raises the risk of excessive sedation, particularly with a hypnotic-strength benzodiazepine like temazepam. We treat this as a do-not-combine pair.

PMID 11434754 · PMID 30668342 · BNF: Temazepam · MHRA:Kava-suspension-2003

Reviewer-flagged: awaiting clinical-reviewer sign-off.

What this page does not say. Leaving a compound out of our recommendations is not a verdict that it is useless for everyone. It is a statement about safety, evidence, or interaction load in the context Distil screens for. Discuss any supplement decision with whoever manages your prescriptions.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology

Your whole stack

Want this checked across everything you take?

This page checks the pairs you enter. The personalised Distil report goes further:

the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
where your current routine may be leaving you short of your goals
the evidence-backed compounds worth adding, and the ones worth dropping

It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.

See a real sample report

Something missing?

If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.

Thanks, that's logged. We go through flagged items every week.

Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.