Background

Kratom (Mitragyna speciosa) is a tree native to Southeast Asia. The leaves contain a chemical called mitragynine, which works like opioids such as morphine.

Kratom has pain-relieving effects like opioid drugs. It also has many of the same serious safety concerns as other opioids.

People commonly use kratom for withdrawal from heroin, morphine, and other opioid drugs, as well as cough, depression, anxiety, and many other conditions, but there is no good scientific evidence to support these uses. Using kratom can also be unsafe.

Kratom is banned in some states and countries due to serious safety concerns. The US FDA has warned consumers to avoid using products containing kratom.

Safety Safety definitions

When taken by mouth: Kratom is possibly unsafe for most people. Large doses of kratom can cause many serious side effects, including nausea, aggression, hallucinations, trouble breathing, liver damage, and death. Long-term use has been linked with dependence and withdrawal symptoms similar to other opioids.

When applied to the skin: There isn't enough reliable information to know if kratom is safe or what the side effects might be.

Special Precautions & Warnings:

Pregnancy: Kratom is possibly unsafe when taken by mouth during pregnancy. Babies exposed to kratom during pregnancy have experienced withdrawal symptoms after birth. These babies required special treatment for addiction.

Breast-feeding: There isn't enough reliable information to know if kratom is safe to use when breast-feeding. Stay on the safe side and avoid use.

Alcohol use disorder: People with alcohol dependence who use kratom appear to have an increased risk of suicide.

Epilepsy: People with epilepsy who use kratom might have an increased risk of seizures.

Heart conditions: Kratom might worsen existing heart conditions. It might increase the risk of a very fast heartbeat.

Mental disorders: Kratom might worsen existing mental disorders. People with mental disorders who use kratom appear to have an increased risk of suicide.

Effectiveness

Dosing & administration

There isn't enough reliable information to know what an appropriate dose of kratom might be. Kratom contains chemicals that act like opioid drugs and may be unsafe. Any use runs the risk of dependence and overdose.

Interactions with pharmaceuticals

Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Kratom might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)

Interaction Rating=Minor Be watchful with this combination.

Some medications are changed and broken down by the liver. Kratom might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Kratom might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) inhibitors)

Interaction Rating=Moderate Be cautious with this combination.

Kratom is changed and broken down by the liver. Some drugs decrease how quickly the liver changes and breaks down kratom. This could change the effects and side effects of kratom.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Kratom might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Modafinil (Provigil)

Interaction Rating=Moderate Be cautious with this combination.

Taking kratom along with modafinil might increase the risk for seizures. Until more is known, avoid kratom if you are taking modafinil.

Naltrexone (Vivitrol)

Interaction Rating=Moderate Be cautious with this combination.

Taking kratom along with naltrexone might lead to withdrawal. Stop taking kratom before starting naltrexone.

Quetiapine (Seroquel)

Interaction Rating=Moderate Be cautious with this combination.

Kratom might slow down how quickly the body breaks down quetiapine. This could increase the effects and side effects of quetiapine. Until more is known, avoid kratom if you are taking quetiapine.

Sedative medications (CNS depressants)

Interaction Rating=Moderate Be cautious with this combination.

Kratom might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking kratom with sedative medications might cause breathing problems and/or too much sleepiness.

Serotonergic drugs

Interaction Rating=Moderate Be cautious with this combination.

Kratom might increase a brain chemical called serotonin. Some medications also have this effect. Taking kratom along with these medications might increase serotonin too much. This might cause serious side effects including heart problems, seizures, and vomiting.

Venlafaxine (Effexor)

Interaction Rating=Moderate Be cautious with this combination.

Kratom might slow down how quickly the body breaks down venlafaxine. This could increase the effects and side effects of venlafaxine. Until more is known, avoid kratom if you are taking venlafaxine.

Interactions with herbs & supplements

Jimson weed: Taking kratom and jimson weed together might increase the risk for side effects, including seizures and coma.

Interactions with foods

There are no known interactions with foods.