valerian

General

Pronunciation
VUH-lare-ee-en [Pronunciation]

Trade Name(s)

• 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

Ther. class.
antianxiety agents
sedative/hypnotics

Action

May increase concentrations of the inhibitory CNS transmitter GABA.

Therapeutic Effect(s):
Improvement in sleep quality.

Pharmacokinetics

Absorption: Unknown.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

TIME/ACTION PROFILE

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

Contraindication/Precautions

Contraindicated in:
Pregnancy and lactation.

Use Cautiously in:

• Alcohol use (may have additive sedative effects);

• Surgery (discontinue use 2 weeks prior to elective procedures).

Adverse Reactions/Side Effects

CNS: drowsiness, headache.

GI: dry mouth.

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

*CAPITALS indicates life-threatening.
*italic indicates most frequent.

Interactions

Natural Products-Drug

• Additive CNS depression with alcohol , antihistamines , anesthetic agents sedative hypnotics and other CNS depressants .

• Alcohol-containing preparations may interact with disulfiram and metronidazole .

Natural Products-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 hours 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.

Potential Nursing Diagnoses

• Anxiety

• Risk for injury (Side Effects)

Implementation

• Take one to two hours 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 weeks prior to elective surgical procedures.

• Inform patients not to take this herbal supplement if pregnant or breast-feeding.

• Notify patients that dependence with withdrawal symptoms may develop with prolonged use.

Evaluation/Desired Outcomes

• Decreased anxiety level.

• Improvement in sleep with a feeling of restfulness without drowsiness upon awakening.