# Kava

Source: https://onco.cc/technologies/kava-kava/  
OnCo record `kava-kava` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Kava is a Pacific root drink taken to ease anxiety and sleep. Some trials found a short-term effect on anxiety and others did not, and kava has caused liver injury, including liver failure needing a transplant. Several governments have withdrawn or warned against it, and it adds to sedatives and should be stopped before surgery.

## Summary

Kava (Piper methysticum) is a social drink in the Pacific islands and a supplement for anxiety, stress and insomnia. Memorial Sloan Kettering's About Herbs summary cites moderate short-term benefit for generalised anxiety disorder in some analyses, while a double-blind placebo-controlled trial and an internet-based study found no benefit over placebo. Because of hepatotoxicity, the Canadian, French and British governments withdrew or warned against kava products and the US FDA has advised consumers of the risk of liver injury; MSK records acute liver failure leading to transplant in a patient who had used kava for almost two months without excess dosage, with low-quality products, overdose, prolonged use and co-medication identified as factors in other cases. Kava may enhance sedation with benzodiazepines, barbiturates and other sedatives, can impair driving, should be stopped before surgery because of interaction with anaesthetics, and increased paracetamol liver-cell toxicity in vitro. One constituent stimulated melanoma cells in the laboratory.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-11-04
- Tags: complementary; supportive-care; evidence:harm
- Principle: Kavalactones act on GABA-A receptors and sodium and calcium channels, producing sedation and muscle relaxation; their metabolites are implicated in liver injury.
- Strengths: Some trials show short-term reduction in anxiety
- Limitations: Liver failure, including transplant; Withdrawn or warned against by several governments; Additive sedation; stop before surgery

## Sources

- MSK About Herbs: Kava (page last updated 9 February 2022): https://www.mskcc.org/cancer-care/integrative-medicine/herbs/kava

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- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- bottlenecks: [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)

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