Ava Pepper

This pantropical genus includes over 1000 species of evergreen, pungent-smelling climbers, shrubs, and small trees. Piper nigrum (pepper) is one of the oldest known spices, and was the main commodity traded along caravan routes of the East. It was the inspiration for early European exploration of sea routes, which created the wealth of cities such as Venice. Pepper has always been one of the most valuable spices: Attila the Hun demanded a huge quantity of it as ransom during the siege of Rome (CE408), and its use as currency gave rise to the term "peppercorn rent". It accounts now for a quarter of the spice trade, India being the main producer. Most peppers are grown for their fruits, which are rich in volatile oil and pungent piperidine alkaloids. Piper guineense (West African, or Ashanti pepper) produces mild-flavored peppercorns, and leaves that are used as a substitute for P. betel in betel quids. Piper methysticum (kava kava) is unusual among peppers in being root crop; the roots may weigh 5.5-7.3kg (12-16lb). It is an important ritual plant in Oceania, used in social and religious gatherings. Research has shown that kava kava is as effective as benzodiazepene in relieving anxiety. Piper auritum (hoja santa) and P. angustifolia (matico) are tropical American species, grown for their leaves. Those of the former resemble spinach, and are used for flavoring in Mexican and Guatemalan cooking; the latter is an astringent, styptic herb with a tea-like aroma, used in S America for wound healing, gastrointestinal complaints, and internal hemorrhage. Pipe auritum is often grown as an ornamental shrub or small tree. The leaves contain large amounts of safrole (as in Sassafras albidum, See, Sassafras), which is carcinogenic; they are traditionally fed to fish in Panama to flavor the flesh. In SE Asia, the leaves of P. sarmentosum (cha phloo) are used as a vegetable and wrapping for savory snacks; similarly P. lalot (lá lót) is used as a pleasant-flavored wrapping in Vietnamese cuisine, and in folk medicine for arthritis and rheumatism. Numerous species other than P. nigrum are grown for their fruits, but only P. longum and P. retrofractum (Javanese long pepper) are sufficiently similar in flavor to use as substitutes. Pink peppercorns come from an unrelated S American tree, Schinus terebinthifolius; they may be mixed with green, black, and white peppercorns for decoration, but they have a resinous flavor so cannot be used as a substitute. Red and chili peppers are the fruits of Capsicum species (See, Bell Pepper).

Kava kava is an herb that comes from the South Pacific, where it has long been used as a tranquilizer. Certain native tribes used an alcoholic drink made from the kava kava root to induce hallucinogenic states during their religious ceremonies. Kava kava contains kavalactones, substances that stimulate and then depress the nervous system, producing a sedative effect that relaxes the skeletal muscles.

Robust, erect, slightly succulent, evergreen shrub with stout rhizomes, fleshy stems, and rounded, heart-shaped leaves, to 15cm (6in) long. Small flowers are produced in spikes 7.5cm (3in) long.


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Common Name:
Ava Pepper
Other Names:
Ava, Intoxicating Pepper, Kava Kava, Kawa, Kew, Tonga
Botanical Name:
Piper methysticum
Genus:
Piper
Family:
Piperaceae
Native Location:
Islands of Oceania
Cultivation:
Rich, well-drained soil in light shade and high humidity (P. longum, P. nigrum). Deep, rich soil, including heavy clay, ample moisture and shade (P. betle, P. cubeba). P. auritum thrives in full sun. Well-drained, stony soil, with ample water and humidity, in sun (P. methysticum). Plants are usually grown on frames. Remove weak of congested stems in late winter or early spring before new growth begins. For optimum fruiting (P. nigrum), cut back young plants to 30cm (12in) several times a year to stimulate growth of shoots, retaining the ten strongest, and tying in at each node. Mature vines are pruned regularly to 4m (12ft). Susceptible to fungal root rot, pepper weevil, and pepper flea beetle.
Propagation:
By seed sown at 20-24°C (66-75°F); by semi-ripe cuttings in summer.
Harvest:
Leaves are picked as required (P. auritum), blanched in the dark, often pressed together, and dried for extracts or to use whole (P. betel). Roots are lifted as required, usually from plants about 2m (6ft) tall, and used fresh, or dried for use in decoctions, liquid extracts, powders, and tablets (P. methysticum). Fruits are picked unripe and distilled for oleo-resin and oil, or dried for use in liquid extracts, powders and tinctures (P. cubeba). Fruit clusters are picked unripe and dried for use whole, ground or in decoctions (P. longum). Fruits of P. nigrum are picked unripe and used fresh, pickled (green peppercorns), and dried (green and black peppercorns); or ripe, and retted for eight days before drying (white peppercorns); black peppercorns are ground or decocted for medicinal use.
Height:
3-6m (9-18ft)
Width:
2-5m (6-15ft)
Hardiness:
Min. 15-18°C (59-64°F)
Parts Used:
Rhizome, Roots
Properties:
A bitter, very pungent, warming herb with a lilac aroma. It acts as a diuretic, increases perspiration, relieves pain, relaxes spasms, has relaxant and locally anesthetic effects, and is reputedly aphodisiac.
Medicinal Uses:
Internally for anxiety, tension, insomnia, genito-urinary infections, gall bladder complaints, gonorrhea, arthritis, and rheumatism; externally for joint pains, toothache, and mouth ulcers. Contraindicated during pregnancy and lactation, and in endogenous depression. Excess causes stupor; prolonged use may cause temporary yellowing of skin, hair and nails. May cause drowsiness. Taking in conjunction with alcohol or barbiturates may potentiate inebriation.
To treat nervousness, insomnia, syphilis, gonorrhea, asthma, rheumatism, heartburn, and bloating; to aid in weight loss. Germany's Commission E has approved the use of kava kava to treat nervous anxiety, stress, restlessness, tension, and agitation.
Typical Dose:
A typical dose of kava kava root extract may range from 150 to 300 mg, taken twice daily, with a daily dose of kavalactones ranging from 50 to 240 mg.
Possible Side Effects:
Kava kava's side effects include mild gastrointestinal complaints, minor impairment of motor reflexes, dizziness, headache, and allergic reactions.
Drug Interactions:
Taking kava kava with these drugs may increase the risk of bleeding or bruising:
Abciximab, (ReoPro)
Alteplase, (Activase, Cathflo Activase)
Antithrombin III, (Thrombate III)
Argatroban, (Argatroban)
Aspirin, (Bufferin, Ecotrin)
Aspirin and Dipyridamole, (Aggrenox)
Bivalirudin, (Angiomax)
Clopidogrel, (Plavix)
Dalteparin, (Fragmin)
Danaparoid, (Orgaran)
Dipyridamole, (Novo-Dipiridol, Persantine)
Enoxaparin, (Lovenox)
Eptifibatide, (Integrillin)
Fondaparinux, (Arixtra)
Heparin, (Hepalean, Hep-Lock)
Indobufen, (Ibustrin)
Lepirudin, (Refludan)
Nadroparin, (Fraxiparine)
Reteplase, (Retevase)
Streptokinase, (Streptase)
Tenecteplase, (TNKase)
Ticlopidine, (Alti-Ticlopidine, Ticlid)
Tinzaparin, (Innohep)
Tirofiban, (Aggrastat)
Urokinase, (Abbokinase)
Warfarin, (Coumadin, Jantoven)
Taking kava kava with these drugs may increase sedation and mental depression and/or impairment:
Acetominophen and Codeine, (Capital and Codeine, Tylenol with Codiene)
Alfentanil, (Alfenta)
Alprazolam, (Apo-Alpraz, Xanax)
Amitriptyline, (Elavil, Levate)
Amobarbital, (Amatyl)
Amobarbital and Secobarbital, (Tuinal)
Amoxapine, (Asendin)
Aripiprazole, (Abilify)
Aspirin and Codeine, (Coryphen Codeine)
Belladonna and Opium, (B&O Supprettes)
Bromazepam, (Apo-Bromazepam, Gen-Bromazepam)
Brotizolam, (Lendorm, Sintonal)
Buprenorphine, (Buprenex, Subutex)
Buprenorphine and Naloxone, (Suboxone)
Bupropion, (Wellbutrin, Zyban)
Butabarbital, (Butisol Sodium)
Butalbital, Acetominophen, and Caffeine, (Esgic, Fioricet)
Butalbital, Aspirin and Caffeine, (Fiorinal)
Butorphanal, (Apo-Butorphanol, Stadol)
Carbamazepine, (Carbatrol, Tegretol)
Chloral Hydrate, (Aquachloral Supprettes, Somnote)
Chlordiazepoxide, (Apo-Chlordiazepoxide, Librium)
Chlorpromazine, (Thorazine)
Citalopram, (Celexa)
Clobazam, (Alti-Clobazam, Frisium)
Clomipramine, (Anafranil, Novo-Clopramine)
Clonazepam, (Klonopin, Rivotril)
Clonidine, (Catapres, Duraclon)
Clorazepate, (Tranxene, T-Tab)
Clozapine, (Clozaril, Gen-Clozapine)
Codeine, (Codeine Contin)
Cyclobenzaprine, (Flexeril, Novo-Cycloprine)
Dantrolene, (Dantrium)
Desipramine, (Alti-Desipramine, Norpramin)
Diazepam, (Apo-Diazepam, Valiam)
Dihydrocodeine, Aspirin, and Caffeine, (Synalgos-DC)
Diphenhydramine, (Benedryl Allergy, Nytol)
Doxepin, (Sinequan, Zonalon)
Doxylamine and Pyridoxine, (Dilectin)
Estazolam, (ProSom)
Evorpanol, (Levo-Dromoran)
Fentanyl, (Actiq, Duragesic)
Fexofenadine, (Allegra)
Fluoxetine, (Prozac, Sarafem)
Fluphenazine, (Modecate, Prolixin)
Flurazepam, (Apo-Flurazepam, Dalmane)
Gabapentin, (Neurontin, Nu-Gabapentin)
Hydrocodone and Acetaminophen, (Anexsia, Vicodin)
Hydrocodone and Aspirin, (Damason-P)
Hydrocodone and Ibuprofen, (Vicoprofen)
Hydromorphone, (Dilaudid, PMS-Hydromorphone)
Hydroxyzine, (Atarax, Vistaril)
Imipramine, (Apo-Imipramine, Tofranil)
Levorphanol, (Levo-Dromoran)
Loprazolam, (Dormonoct, Halvane)
Lorazepam, (Ativan, Nu-Loraz)
Loxapine, (Loxitane, Nu-Loxapine)
Meperidine, (Demerol, Meperitab)
Meperidine and Promethazine, (Meperidine and Promethazane)
Mephobarbital, (Mebaral)
Meprobamate, (Miltown, Movo-Mepro)
Mesoridazine, (Serentil)
Methadone, (Dolophine, Methadose)
Methocarbamol, (Robaxin)
Methohexital, (Brevital, Brevital Sodium)
Methotrimeprazine, (Novo-Meprazine, Nozain)
Metoclopramide, (Apo-Metoclop, Reglan)
Midazolam, (Apo-Midazolam, Versed)
Mirtazapine, (Remeron)
Moclobemide, (Apo-Moclobemide, Nu-Moclobemide)
Molidone, (Moban)
Morphine Hydrochloride, (Morphine Hydrochloride)
Morphine Sulfate, (Kadian, MS Contin)
Nalbuphine, (Nubain)
Nefazodone, (Serzone)
Nortriptyline, (Aventyl HCl, Pamelor)
Olanzapine, (Zydis, Zyprexa)
Opium Tincture, (Opium Tincture)
Oxazepam, (Novoxapam, Serax)
Oxcarbazepine, (Tileptal)
Oxycodone, (OxyContin, Roxicodone)
Oxycodone and Acetaminophen, (Endocet, Percocet)
Oxycodone and Aspirin, (Endodan, Percodan)
Oxymorphone, (Numorphan)
Paclitaxel, (Onxol, Taxol)
Paroxetine, (Paxil)
Pentazocine, (Talwin)
Pentobarbital, (Nembutal)
Perphenazine, (Apo-Perphenazine, Trilafon)
Phenobarbital, (Luminal Sodium, PMS-Phenobarbital)
Phenoperidine, (Phenoperidine)
Phenytoin, (Dilantin, Phenytek)
Pizotifen, (Sandomigran)
Pramipexole, (Mirapex)
Prazepam, (Prazepam)
Primidone, (Apo-Primidone, Mysoline)
Prochlorperazine, (Compazine, Compro)
Promethazine, (Phenergan)
Propoxyphene, (Darvon, Darvon-N)
Propoxyphene and Acetominophen, (Darvocet-N 50, Darvocet-N 100)
Propoxyphene, Aspirin, and Caffeine, (Darvon Compound)
Protriptyline, (Vivactil)
Quazepam, (Doral)
Quetiapine, (Seroquel)
Remifentanil, (Ultiva)
Risperidone, (Risperdal)
Ropinirole, (Requip)
S-Citalopram, (Lexapro)
Secobarbital, (Seconal)
Selegiline, (Eldepryl)
Sertraline, (Apo-Sertraline, Zoloft)
Sodium Oxybate, (Xyrem)
Sufentanil, (Sufenta)
Temazepam, (Novo-Temazepam, Restoril)
Tetrazepan, (Mobiforton, Musapam)
Thiethylperazine, (Torecan)
Thiopental, (Pentothal)
Thioridazine, (Mellaril)
Thiothixene, (Navane)
Tiagabine, (Gabitril)
Tizanidine, (Zanaflex)
Tolcapone, (Tasmar)
Tramadol, (Ultram)
Trazodone, (Desyrel, Novo-Trazodone)
Triazolam, (Apo-Triazo, Halcion)
Trifluoperazine, (Novo-Trifluzine, Stelazine)
Trimipramine, (Apo-Trimip, Surmontil)
Venlafaxine, (Effexor)
Vigabatrin, (Sabril)
Zaleplon, (Sonata, Starnoc)
Zolpidem, (Ambien)
Zopiclone, (Alti-Zopiclone, Gen-Zopiclone)
Taking kava kava with these drugs may decrease the effectiveness of the drug:
Amantadine, (Endantadine, Symmetrel)
Bromocriptine, (Apo-Bromocriptine, Parlodel)
Carbidopa, (Lodosyn)
Chlorpromazine, (Largactil, Thorazine)
Fluphenazine, (Modecate, Prolixin)
Levodopa, (Dopar, Larodopa)
Levodopa-Carbidopa, (Nu-Levocarb, Sinemet)
Mesoridazine, (Serentil)
Methylphenidate, (Concerta, Ritalin)
Modafinil, (Alertec, Provigil)
Pergolide, (Permax)
Perphenazine, (Apo-Perphenazine, Trilafon)
Pramipexole, (Mirapex)
Prochlorperazine, (Compazine, Compro)
Promethazine, (Phenergan)
Ropinirole, (Requip)
Thiethylperazine, (Torecan)
Thioridazine, (Mellaril)
Thiothixene, (Navane)
Trifluoperazine, (Novo-Trifluzine, Stelazine)
Taking kava kava with these drugs may cause or increase liver damage:
Atorvastatin, (Lipitor)
Meloxicam, (MOBIC, Mobicox)
Methotrexate, (Rheumatrex, Trexall)
Methyldopa, (Apo-Methyldopa, Nu-Medopa)
Naproxen, (Aleve, Naprosyn)
Nevirapine, (Viramune)
Nitrofurantoin, (Furadantin, Macrobid)
Ofloxacin, (Floxin, Ocuflox)
Ondasetron, (Zofran)
Paclitaxel, (Onxol, Taxol)
Taking kava kava with these drugs may cause or increase serotonin syndrome, symptoms of which include agitation, rapid heart rate, flushing, heavy sweating, and possibly even death:
Desipramine, (Alti-Desipramine, Norpramin)
Doxepin, (Sinequan, Zolanon)
Fluvoxamine, (Alti-Fluvoxamine, Luvox)
Imipramine, (Apo-Imipramine, Tofranil)
Nortriptyline, (Aventyl HCl, Pamelor)
Pramipexole, (Mirapex)
Protriptyline, (Vivactil)
Trazadone, (Desyrel, Novo-Trazodone)
Trimipramine, (Apo-Trimip, Surmontil)
Venlafaxine, (Effexor)
Taking kava kava with these drugs may increase the risk of monoamine oxidase inhibitor (MAOI) toxicity (symptoms of which include anxiety, insomnia, restlessness, dizziness, and sweating):
Iproniazid, (Marsilid)
Moclobemide, (Alti-Moclobemide, Nu-Moclobemide)
Phenelzine, (Nardil)
Selegiline, (Eldepryl)
Tranylcypromine, (Parnate)
Taking kava kava with these drugs may increase the adverse effects of the drug:
Allopurinol, (Aloprim, Zyloprim)
Fluphenazine, (Modecate, Prolixin)
Risperidone, (Risperdal)
Lab Test Alterations:
  • May cause liver damage.
  • May increase values on liver function tests including aspartic acid transaminase (AST), alanine aminotransferase (ALT), total bilirubin, and conjugated bilirubin.
Disease Effects:
May worsen hepatitis in certain people.
Food Interactions:
  • Absorption of kava kava increases when taken with food.
  • Increased risk of drowsiness, impaired motor skills, and liver damage when combined with alcohol.
Supplement Interactions:
  • May enhance therapeutic and adverse effects of herbs and supplements that have sedative properties, such as 5-HTP, St. John's Wort, and Valerian.
  • May increase the risk of liver damage when combined with herbs and supplements that can cause hepatotoxicity (destructive effects on the liver), such as Bishop's Weed, Borage, Chaparral, Uva Ursi, and others.
Culinary Uses:
Chewed, fermented roots are the basis of ritual Polynesian drink that has a calming effect, but promotes mental awareness.
Bibliography:
Encyclopedia of Herbs by Deni BrownCopyright © 1995, 2001 Dorling Kindersley Limited. pp. 319-321
The Essential Herb-Drug-Vitamin Interaction Guide by Geo. T. Grossberg,MD and Barry Fox,PhD Copyright©2007 Barry Fox,PhD. pp. 291-295