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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:

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

Last reviewed 15 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.

Additive CNS depression

Red Does interact with 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.

Evidence: Based on an established mechanism, with no direct study of this exact combination yet.

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

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

Red Does interact with 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.

Evidence: Based on an established mechanism, with no direct study of this exact combination yet.

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

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

Red Does interact with 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.

Evidence: Based on an established mechanism, with no direct study of this exact combination yet.

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

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

Red Does interact with 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.

Evidence: Based on an established mechanism, with no direct study of this exact combination yet.

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 or pharmacist, 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
The full report

A full supplement review, built around you, not a generic stack.

The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.

  • what your diet already covers, so you are not adding a capsule for something food is already handling
  • which evidence-graded compounds are worth considering for your goals, and which were considered but left out
  • what to keep, change or stop from what you already take, plus the order to introduce anything new
  • how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment

The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.

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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.