Is Kava Safe with Tramadol?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Do not use kava with tramadol. Seek emergency care immediately if you experience muscle twitching, agitation, fever, rapid heart rate, confusion, or seizures.
Why this interaction occurs
Tramadol lowers the seizure threshold and has serotonergic activity. Kava (Piper methysticum) inhibits CYP2D6 and CYP3A4 enzymes responsible for tramadol metabolism, potentially raising plasma tramadol levels. Additionally, kava's CNS effects combined with tramadol's serotonergic properties may increase seizure risk and symptoms resembling serotonin syndrome.
Evidence
Evidence level: moderate.
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 219,122 reports mentioning Tramadol. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the Tramadol + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All Kava interactions → · All Tramadol interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.