Valerian Barbiturates

Valerian Valeriana officinalis Restlessness, sleep disorders Rare if used as directed. May interact with the barbiturates (eg, phenobarbital), the benzodiazepines (eg, diazepam) and the opiates, (eg, morphine). 

Valerian, ginger, goldenseal, and chamomile all interact with sedatives (such as barbiturates and alcohol) to increase sedative effects. 

Valerian Valeriana officinalis) The roots of this plant are dried to produce a potent extract that induces sleepiness and helps treat insomnia. Like lavender, it depresses the activity of the central nervous system in a fashion similar to stronger prescription tranquilizers such as benzodiazepines and barbiturates, but without the dulling or hangover effects the next day or impairing the ability to drive a car. 

Diazepam (Valium, Diastal-) [C-IV] [Anxiolytic, Skeletal Muscle Relaxant, Anticonvufsant, Sedative/Hypnotic/ Benzodiazepine] Uses Anxiety, EtOH withdrawal, muscle spasm, status epilepticus, panic disorders, amnesia, preprocedure sedation Action Benzodiazepine Dose Adults. Status epilepticus 5-10 mg IV/IM Anxiety 2-5 mg IM/IV Preprocedure 5-10 mg IV just prior to procedure Feds. Status epilepticus 0.5-2 mg IV/IM Sedation 0.2-0.5 mg/kg IV (onset w/in 5 IV and 30 min IM duration about 1 h IV and IM) Caution [D, / -] Contra Coma, CNS depression, resp depression, NAG, severe uncontrolled pain, PRG Disp Tabs 2, 5, 10 mg soln 1, 5 mg/mL inj 5 mg/mL rectal gel 2.5, 5, 10, 20 mg/mL SE Sedation, amnesia, bradycardia, BP, rash, i resp rate Interactions T Effects W/ antihistamines, azole antifungals, BBs, CNS depressants, cimetidine, ciprofloxin, clisulfiram, INH, OCP, omeprazole, phenytoin, valproic acid, verapamil, EtOH, kava kava, valerian T effects OF digoxin, diuretics effects w/ barbiturates, carbamazepine,... 

Tea Tree (Melaleuca alternifolia) Uses Rx of superficial wounds (bacterial, viral, fungal, insect bites, minor burns, cold sores, acne Action Broad-spectrum antibiotic activity against E. coli, S. aureus, C. albicans Available forms Topical creams, lotions, oint, oil apply topically PRN Notes/SE Ataxia, contact dermatitis, D, drowsiness, GI mucosal irritation Interactions Effects OF drugs that affect histamine release EMS effects of Benadryl Valerian (Valeriana officinalis) Uses Anxiolytic, antispasmodic, dys-menorrheal, restlessness, sedative Action Inhibits uptake stimulates release of GABA, which T GABA concentration extracellularly causes sedation Available forms Ext 400-900 mg PO 30 min < hs, tea 2-3 g (1 tsp of crude herb) qid, PRN, tine 3-5 mL (1/2-1 tsp) (1 5 ratio) PO qid, PRN Efficacy Probably effective sedative (reduces sleep latency) Notes/SE GI upset, HA, insomnia, N/V, palpitations, restlessness, vision changes Interactions T Effects OF barbiturates, benzodiazepines, opiates, EtOH, catnip, hops, kavakava, passion flower, skullcap effects OF MAOIs, phenytoin, warfarin EMS T Effects of benzodiazepines and opiates abruptly D/C may cause withdrawal symptoms... 

Valerian (Valerian officinalis). No drug interactions have been reported, but animal studies suggest that valerian, used as a sedative and sleep aid, might increase the effects of barbiturates such as pentobarbital, hexo-barbital, and thiopental. 

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 GAB Anergic 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. 

Caution is advised during use of barbiturates, benzodiazepines, and other sedative drugs, as valerian has been speculated to potentiate the effects of some sedatives (Brinker... 

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