The short answer
Review kava before adding it to ziprasidone, especially if you already feel sleepy, dizzy or unsteady. The exact combination’s risk has not been quantified.
What this answer covers
Oral kava supplement with hydrochloride oral capsules or mesylate intramuscular injection, distinguished by route; botanical preparation and medicine route retained.
- Supplement or preparation
- Piper methysticum
- Medication ingredient
- ziprasidone
Why alertness deserves review
Ziprasidone has cognitive or motor impairment precautions. Kava guidance raises alertness concerns, so your symptoms and other medicines matter.
A negative driving result has limits
A small study found no driving impairment with its kava preparation compared with placebo. Oxazepam was a separate comparator, not a combined exposure with this medicine.
Identify the complete product
Bring the amount, preparation and other ingredients to the pharmacist. These sources do not provide a universal safe dose or a protective gap between the supplement and medicine.
Watch for impaired alertness
Ziprasidone can affect alertness and coordination. Avoid driving if affected and contact the prescriber if added sleepiness, confusion or unsteadiness appears after a new product. Severe confusion, fainting or inability to wake needs urgent assessment.
Evidence and practical considerations
Side effects & toxicity
Conditional alertness review based on exact medication effects and supplement precautions; not proven pair-specific CNS depression.
- Exact scope
- Oral kava supplement with hydrochloride oral capsules or mesylate intramuscular injection, distinguished by route; botanical preparation and medicine route retained. with Exact ziprasidone hydrochloride oral capsules or mesylate intramuscular injection, distinguished by route. Exact RxNorm IN115698; hydrochloride oral capsule and mesylate intramuscular formulation distinct. Oral food and antacid findings do not apply to injection absorption.
- Medication form and route
- oral; intramuscular
- Timing or duration
- Source-specific single-dose, repeated-dose and observational exposures distinguished.
What remains uncertain
- No exact-pair co-use trial identified; standalone or other-medicine findings and product differences prevent a uniform risk estimate.
Factors that may matter: preparation and plant part; clinical indication; dose; other medicines; baseline alertness.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed ziprasidone.
Somnolence, QT and electrolyte precautions; low potassium or magnesium requires assessment/correction before proceeding; oral capsules taken with food.
How this applies: Exact RxNorm IN115698; hydrochloride oral capsule and mesylate intramuscular formulation distinct. Oral food and antacid findings do not apply to injection absorption.
No supplement-specific event rate, universal timing rule or untested route/preparation equivalence.
Source 2: official guidance
nccih.nih.gov · Source check Sep 10, 2026
Population: People considering the specified supplement.
Advises against use with sedative substances. Kava may cause dizziness and has been linked to rare severe liver injury, including with different extraction methods.
How this applies: Preparation-specific evidence; exact ziprasidone co-use is not inferred from another medicine or route.
Not a ziprasidone study. Intrinsic liver risk does not establish added ziprasidone hepatotoxicity; preparation and co-exposure vary.
Source 3: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Twenty-two adults in a randomized crossover driving study.
Medicinal-dose kava did not significantly impair driving outcomes; oxazepam impaired some outcomes.
How this applies: Preparation-specific evidence; exact ziprasidone co-use is not inferred from another medicine or route.
Not combined administration or evidence that all kava preparations lack impairment.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Research summary published | |
| Article prepared | |
| Current exact available claims adjudicated using original captures and explicit identity and comparator limits. |
Article revision: 9913037879936b85
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.