Meta Information
ID:valerian-root
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
major
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
null
Description:
Valerian root promotes relaxation and may improve sleep quality by increasing levels of the neurotransmitter GABA in the brain. Its effects are optimized when taken shortly before bedtime.
Actionable advice:
For sleep support, the dose should be taken 30 to 120 minutes before the intended bedtime.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Currently available evidence suggests that herbal extracts may exert some of their hypnotic and anxiolytic activity through interacting with GABA receptors and modulating GABAergic signaling in the brain, but their mechanism of action in the treatment of insomnia is not completely understood.
Label source:
PubMed: Nutrients (2021)
Source url:
Exact phrase from label:
In conclusion, the findings suggest that high doses (300 mg/kg) of valerian extract enhance both the quantity and quality of sleep through the GABAergic pathway and effectively increase sleep duration while reducing the time to fall asleep in a pentobarbital-induced sleep model in mice.
Label source:
PubMed: Antioxidants (Basel, Switzerland) (2024)
Source url:
Exact phrase from label:
gamma-Aminobutyric acid (GABA) transaminase assay indicates that valerian inhalation decreases the activity of the enzyme and enhances GABA activity.
Label source:
PubMed: Chemical senses (2006)
Action type:
separate
Target id:
/class/cns-depressants
Target name:
CNS Depressants (Root)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Valerian root has sedative properties that can add to the effects of other central nervous system depressants, leading to excessive drowsiness, dizziness, and impaired motor skills.
Actionable advice:
Other CNS depressants should not be combined unless directed by a healthcare provider.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
CONCLUSION: The addition of Neurogol to quetiapine (a combination of valerian and lemon balm) can reduce agitation and shorten the length of stay in the ICU without adverse effects.
Label source:
PubMed: Addition of Valerian and Lemon Balm Extract to Quetiapine Reduces Agitation in Critically Ill Patients with Delirium: A Pilot Randomized Clinical Trial. (PMID 34316173)
Action type:
avoid
Target id:
/dietary/alcohol-acute
Target name:
Alcohol (Acute Consumption)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining valerian root with alcohol can cause excessive drowsiness, dizziness, and significantly impair coordination and judgment due to additive sedative effects.
Actionable advice:
Alcohol should not be consumed while taking valerian root.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The active principles of Valerian and passionflower might increase the inhibitory activity of benzodiazepines binding to the GABA receptors, causing severe secondary effects.
Label source:
PubMed: Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam. (PMID 19441067)
Action type:
informational_none
Target id:
/class/benzodiazepines
Target name:
Benzodiazepines
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Both valerian root and benzodiazepines enhance GABAergic activity in the brain, leading to a potentiation of sedative effects and an increased risk of over-sedation.
Actionable advice:
Valerian root should not be taken with benzodiazepines due to the risk of severe sedation.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
For alprazolam, the maximum concentration in plasma was significantly increased after treatment with valerian (25 +/- 7 ng/ml versus 31 +/- 8 ng/ml; p < 0.05).
Label source:
PubMed: Multiple night-time doses of valerian (Valeriana officinalis) had minimal effects on CYP3A4 activity and no effect on CYP2D6 activity in healthy volunteers. (PMID 15328251)
Action type:
avoid
Target id:
/class/opioid-agonists
Target name:
Opioid Medications
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The sedative effects of valerian root can add to the CNS depression caused by opioids, increasing the risk of profound sedation, respiratory depression, and cognitive impairment.
Actionable advice:
Valerian root should not be combined with opioid medications due to the risk of dangerous side effects.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Pharmacodynamic inference: valerian has sedative/GABAergic activity that can add to the CNS depression of opioids, increasing sedation/respiratory-depression risk. Consistent with NIH ODS guidance on additive sedation with CNS depressants.
Label source:
Class inference
Action type:
avoid
Target id:
/procedure/surgery
Target name:
Surgery with General Anesthesia
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
336
Hours after target:
null
Description:
Valerian may prolong the effects of anesthetic drugs used during surgery. It is recommended to discontinue use well in advance to prevent complications with anesthesia.
Actionable advice:
Valerian root should be stopped at least two weeks before any scheduled surgery.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Pre-operative herbal-safety guidance: valerian can potentiate anesthetic/GABAergic sedation, so discontinuing it before surgery is advised to avoid additive CNS depression. Standard peri-operative recommendation.
Label source:
Class inference
Action type:
informational_none
Target id:
/activity/driving-operating-machinery
Target name:
Driving or Operating Heavy Machinery
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
null
Hours after target:
8
Description:
The sedative effects of valerian root can impair alertness, coordination, and reaction time, increasing the risk of accidents. This effect can persist into the next morning.
Actionable advice:
Driving and operating machinery should be avoided until it is clear how valerian affects a person, and for at least 8 hours after taking.
Validation status:
validated_via_clinical_guidance
Evidence tier:
tier_b
Evidence basis:
clinical_guidance_verbatim
Evidence anchors:
Exact phrase from label:
In one study an increase in sleepiness was noted the morning after 900 mg of valerian was taken
Label source:
NIH ODS Valerian fact sheet. FLAG: the SAME sheet notes 600 mg 'did not have a clinically significant effect on reaction time, alertness, and concentration the morning after ingestion' - the next-day impairment is dose-dependent and inconsistent; soften the blanket claim.
Action type:
separate
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The safety of valerian root during pregnancy has not been established, and its use is not recommended due to potential unknown risks to the developing fetus.
Actionable advice:
Valerian root should not be used at all during pregnancy.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Source url:
Exact phrase from label:
Little is known about whether it’s safe to use valerian during pregnancy or while breastfeeding.
Label source:
Anecdotal: NIH NCCIH
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is unknown if components of valerian root pass into breast milk or what effects they might have on a nursing infant; therefore, its use should be avoided.
Actionable advice:
Valerian root should not be used at all while breastfeeding.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
It is not known if valerian passes into breast milk.
Label source:
Anecdotal: WebMD
Action type:
avoid
Target id:
/condition/hepatic-impairment
Target name:
Liver Disease or Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Since valerian is metabolized by the liver and has been rarely associated with hepatotoxicity, its use in individuals with pre-existing liver disease is not recommended.
Actionable advice:
Valerian root should not be used by people with any form of liver disease.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Ashwagandha, kava kava, green tea extract, skullcap, turmeric, and valerian have known idiosyncratic hepatotoxic potential and may complicate the liver transplantation course.
Label source:
PubMed: Current psychiatry reports (2024)
Source url:
Exact phrase from label:
The study was designed to investigate the hepatic metabolism and transport system of valerenic acid, a main active constituent of valerian, in isolated perfused livers from Wistar and Mrp2-deficient TR(-) rats.
Label source:
PubMed: Journal of pharmaceutical sciences (2009)
Action type:
avoid
Target id:
/class/barbiturates
Target name:
Barbiturates
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The combination of valerian and barbiturates can lead to profound CNS and respiratory depression due to synergistic effects on GABA receptors.
Actionable advice:
Valerian root should not be taken with barbiturates due to the risk of severe sedation and respiratory compromise.
Validation status:
validated_via_clinical_guidance
Evidence tier:
tier_b
Evidence basis:
clinical_guidance_verbatim
Evidence anchors:
Exact phrase from label:
Individuals taking valerian should be aware of the theoretical possibility of additive sedative effects from alcohol or sedative drugs, such as barbiturates and benzodiazepines
Label source:
NIH ODS Valerian fact sheet. Supports additive CNS depression with barbiturates (ODS frames it as 'theoretical').
Action type:
avoid
Target id:
/intervention/kava
Target name:
Kava
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Both Kava and Valerian are potent CNS depressants and are associated with a risk of hepatotoxicity; combining them significantly increases the risk of both severe sedation and liver damage.
Actionable advice:
Valerian root and kava should not be combined due to significant risks of sedation and liver injury.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Ashwagandha, kava kava, green tea extract, skullcap, turmeric, and valerian have known idiosyncratic hepatotoxic potential and may complicate the liver transplantation course.
Label source:
PubMed: Herbal and Non-Herbal Dietary Supplements for Psychiatric Indications: Considerations in Liver Transplantation. (PMID 38941032)
Action type:
avoid
Target id:
/class/hepatotoxic-agents
Target name:
Other Potentially Liver-Toxic Substances
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Although rare, there are reports of liver injury with valerian use. Combining it with other substances known to be hard on the liver may theoretically increase this risk.
Actionable advice:
This is best used with caution and under medical supervision when taking other potentially hepatotoxic drugs or supplements.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Ashwagandha, kava kava, green tea extract, skullcap, turmeric, and valerian have known idiosyncratic hepatotoxic potential and may complicate the liver transplantation course.
Label source:
PubMed: Current psychiatry reports (2024)
Source url:
Exact phrase from label:
A 53-year-old woman presented to the emergency department with a 3-day history of jaundice and increased abdominal girth after a month-long use of a combination herbal "liver-cleansing" compound and a nightly herbal "sleep aid." The "Liver Detoxifier and Regenerator" listed multiple constituents, including concentrated scute root and turmeric root; "Restful Sleep" listed multiple constituents, including valerian.
Label source:
PubMed: The Journal of emergency medicine (2021)
Source url:
Exact phrase from label:
If used beyond 8 weeks, Echinacea could cause hepatotoxicity and therefore should not be used with other known hepatoxic drugs, such as anabolic steroids, amiodarone, methotrexate, and ketoconazole.
Label source:
PubMed: Archives of internal medicine (1998)
Action type:
informational_none
Target id:
/class/anticonvulsants
Target name:
Anticonvulsant Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Valerian can enhance the sedative side effects of many anticonvulsant medications, leading to excessive drowsiness and dizziness.
Actionable advice:
It is important to talk to a doctor before using valerian while taking anticonvulsant medications.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
c Valproate sodium and valproic acid are similar medications.
Label source:
Action type:
informational_none
Target id:
/intervention/passionflower
Target name:
Passionflower
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining valerian with other sedative herbs like passionflower can result in additive drowsiness and CNS depression.
Actionable advice:
Caution is a good idea when combining with other sedative supplements, as the combined effect may be stronger than anticipated.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The addition of Neurogol to quetiapine (a combination of valerian and lemon balm) can reduce agitation and shorten the length of stay in the ICU without adverse effects.
Label source:
PubMed: Addition of Valerian and Lemon Balm Extract to Quetiapine Reduces Agitation in Critically Ill Patients with Delirium: A Pilot Randomized Clinical Trial. (PMID 34316173)
Action type:
informational_none
Target id:
/intervention/lemon-balm
Target name:
Lemon Balm
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining valerian with other sedative herbs like lemon balm can result in additive drowsiness and CNS depression.
Actionable advice:
Caution is a good idea when combining with other sedative supplements, as the combined effect may be stronger than anticipated.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Melissa officinalis (lemon balm) is a traditional herbal medicine, which enjoys contemporary usage as a mild sedative, spasmolytic and antibacterial agent.
Label source:
PubMed: Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). (PMID 12062586)
Action type:
informational_none
Target id:
/class/cyp3a4-substrates
Target name:
Drugs Metabolized by CYP3A4
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Some in-vitro evidence suggests valerian may weakly inhibit the CYP3A4 enzyme, which could theoretically increase the concentration and side effects of drugs metabolized by this pathway.
Actionable advice:
It is worth watching out for increased effects or side effects if taken with medications metabolized by CYP3A4.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
However, strong inhibitors of CYP3A4 (e.g., ketoconazole, itraconazole, ritonavir)
may increase the plasma concentrations of amlodipine to a greater extent.
Label source:
Action type:
monitor
Target id:
/intervention/chamomile-extract
Target name:
Chamomile
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining valerian with chamomile, which has mild sedative properties, may lead to increased drowsiness.
Actionable advice:
Using these supplements together may increase sleepiness.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
informational_none
Target id:
/condition/paradoxical-excitation-response
Target name:
Paradoxical Excitation
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
In a small subset of individuals, particularly children and the elderly, valerian root can cause a paradoxical reaction of anxiety, restlessness, and insomnia instead of sedation.
Actionable advice:
Use is best discontinued if increased anxiety or restlessness occurs instead of the expected calming effect.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid