valerian

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Insomnia
Anxiety

Action ⬆ ⬇

May increase concentrations of the inhibitory CNS transmitter GABA.

Therapeutic effects:

Improvement in sleep quality.

Pharmacokinetics ⬆ ⬇

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	30–60 min	2 hr	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Pregnancy and lactation.

Use Cautiously in:

Alcohol use (may have additive sedative effects);
Surgery (discontinue use 2 wk prior to elective procedures);
Children (do not use longer than 8 wk).

Adv. Reactions/Side Effects ⬆ ⬇

CNS: drowsiness, headache

GI: dry mouth

Misc: Benzodiazepine-like withdrawal symptoms with discontinuation after long-term use

Interactions ⬆ ⬇

Natural-Drug Products:

Additive CNS depression with alcohol, antihistamines, anesthetic agents, sedative hypnotics, and other CNS depressants.
Alcohol-containing preparations may interact with disulfiram and metronidazole.

Natural-Natural Products:

Additive sedative effects can occur when used with herbal supplements with sedative properties such as kava, l-tryptophan, melatonin, SAMe, and St. John's wort.

Route/Dosage ⬆ ⬇

PO (Adults ): Tea: 1 cup tea 1–5 times daily. Tea is made by steeping 2–3 g root in 150 mL boiling water for 5–10 min then straining. Tincture: 1–3 mL 1–5 times daily. Extract: 400–900 mg up to 2 hr before bedtime or 300–450 mg divided tid.

Availability ⬆ ⬇

Capsules: ^OTC
Extract: ^OTC
Tea: ^OTC
Tincture: ^OTC

Assessment ⬆ ⬇

Assess degree of anxiety and level of sedation prior to and periodically throughout therapy.
Assess sleep patterns.
Assess response in the elderly population where drowsiness and loss of balance may pose a significant risk for injury.

Implementation ⬆ ⬇

Take 1–2 hr before bedtime if used for nighttime hypnotic.
Administer orally three to five times daily to control anxiety.

Patient/Family Teaching ⬆ ⬇

Encourage patients to avoid stimulants such as caffeine and to provide an environment that promotes restful sleep.
May cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to drug is known.
Caution patient to avoid use of alcohol and other medications or herbals that have a sedative effect; may increase drowsiness.
Advise patients to discontinue 2 wk prior to elective surgical procedures.
Inform patients that dependence with withdrawal symptoms may develop with prolonged use.
Rep: Advise females of reproductive potential to avoid valerian if pregnancy is planned or suspected or breast feeding.

Evaluation/Desired Outcomes ⬆ ⬇

Decreased anxiety level.
Improvement in sleep with a feeling of restfulness without drowsiness upon awakening.

US Brand Names ⬆

Amantilla, All-Heal, Baldrian, Baldrianwurzel, Belgium Valerian, Common Valerian, Fragrant Valerian, Garden Heliotrope, Garden Valerian, Indian Valerian, Mexican Valerian, Pacific Valerian, Tagara, Valeriana, Valeriana officinalis, Valerianae radix, Valeriana rhizome, Valeriane

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇