Interactions

Two alcoholic valerian extracts were found to potentiate pentobarbital sleeping time in mice (37), and Valdispert, an aqueous extract prepared from V. officinalis (L.), increased the thiopental sleeping time in a dose-dependent manner in rats (16). Based on these animal studies, in vitro studies of valerian's effect on GABAnergic transmission, as well as the case series reported by Chan and colleagues, valerian would be expected to have at least an additive effect with barbiturates, alcohol, benzodiazepines, and other CNS depressants.

Valerian may have the potential to increase the level of drugs metabolized by the cytochrome P-450 3A4 (CYP3A4) enzyme. In vitro studies have found that valerian may have an inhibitory effect on CYP3A4. (46,47). A clinical research study suggested that low to moderate doses of valerian did not significantly inhibit CYP3A4, although taking valerian extract 1000 mg/ day increased alprazolam levels by 19% (48). Therefore, it may be wise to use valerian cautiously in patients taking medications that are CYP3A4 substrates such as lovastatin, ketoconazole, itraconazole, fexofenadine, alprazolam, triazolam, and various chemotherapeutic agents.

See also Chapter 5, St. John's Wort, Section 8, Drug Interactions.

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