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 ↑ concentrations of the inhibitory CNS transmitter GABA.

Therapeutic effects:

Improved sleep quality.
Decreased anxiety level.

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:

Hypersensitivity to plants in the Valerianaceae family;
Liver disease.

Use Cautiously in:

Alcohol use (may have additive sedative effects);
Surgery (discontinue use ≥2 wk before procedure);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

GI: dry mouth

Neuro: drowsiness, headache

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-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 and then straining. Tincture: 1–3 mL 1–5 times daily. Extract: 400–900 mg up to 2 hr before bedtime or 300–450 mg 3 times daily.

Availability ⬆ ⬇

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

Assessment ⬆ ⬇

Assess degree of anxiety and level of sedation before and periodically throughout therapy.
Assess sleep patterns.
Assess response in older adults because drowsiness and loss of balance may pose a significant risk for injury.

Implementation ⬆ ⬇

PO: Administer 3–5 times daily for anxiety.
Administer 1–2 hr before bedtime when used as a nighttime hypnotic.

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of herb to patient.
Advise patient to consult with health care provider before using any herbal supplement especially when taken concurrently with Rx or OTC medications, or vitamins.
Encourage patient 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 herb is known.
Advise patient to avoid use of alcohol and other medications or herbals that have a sedative effect; may ↑ drowsiness.
Advise patient to discontinue ≥2 wk before surgical procedures.
Advise patient that dependence with withdrawal symptoms may develop with prolonged use.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or breastfeeding before using this herb.

Evaluation/Desired Outcomes ⬆ ⬇

Improved sleep quality.
Decreased anxiety level.

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 ⬆ ⬇