Supplements, Sedatives, Sleep Medicines and Alcohol

Urgent first

If someone who has mixed alcohol, sleep medicines or sedating products cannot be woken, is breathing very slowly or with difficulty, or has collapsed, call 911 now. For other poisoning questions, Poison Help is 1-800-222-1222 (US). For a mental health crisis, call or text 988 (US). The NHS page for the sleep medicine zopiclone says alcohol can cause breathing problems and make it very difficult to wake up. [1]

The short answer

Two things can both make you drowsy: a sleep or anti-anxiety medicine, and a calming herb or supplement. Official sources do not describe a "safe" pairing. They say to ask a pharmacist or prescriber before combining them. [2] This page does not tell anyone to stop or change a prescribed medicine; that is a decision for the prescriber or pharmacist.

How to read the labels on this page

Statements below are marked documented (an official source states it), reported (case reports), preliminary (lab or small studies) or theoretical (reasoned but not shown). See how interactions work for what these words mean.

What the sources say

Alcohol and sleep medicines

Alcohol is its own interaction. NIAAA says alcohol and medicines can make you sleepy or lightheaded and the effects can add up; it lists zolpidem and similar sleep medicines with slowed or difficult breathing, impaired motor control, unusual behavior and memory problems. [5] The NHS says not to drink alcohol with diazepam or zopiclone. [11] [1] MedlinePlus gives the same message for zolpidem. [9] NIAAA also notes that alcohol and medicines can interact even if they are not taken at the same time. [5]

Melatonin

NCCIH says people with epilepsy and people taking blood thinners need medical supervision when taking melatonin supplements. [12] For chronic insomnia, NCCIH reports that guidelines found not enough strong evidence on effectiveness or safety to recommend melatonin. [12] The NHS lists benzodiazepines, zolpidem, zopiclone, antidepressants, blood pressure medicines, opiates and warfarin among medicines that can change melatonin's drowsy effect. [7] More on the supplement itself is on melatonin for sleep.

Who should ask first

• Older adults. NIAAA says older people face a particularly high risk from alcohol-medicine interactions. [5]
• Pregnancy and breastfeeding. NCCIH says kava may carry special risks because of harmful pyrone constituents, and little is known about valerian. [4] [3]
• Liver conditions. NCCIH links kava to rare serious liver injury and reports very rare liver injury with valerian, most often with other herbals. [4] [3]
• Before surgery. Tell the surgical and anesthesia team about every supplement. [13]

What research says about benefit

This page is about safety, not whether these products help. NCCIH describes the evidence for valerian and sleep as inconsistent. [3] Traditional use is covered on the herb pages, such as valerian and kava; tradition is not proof of safety with medicines.

Limits

Proper evidence not found in the pages we read for specific valerian, kava or melatonin pairings with each named sleep medicine beyond the lines above. We searched NCCIH, NHS, MedlinePlus, NIAAA and FDA pages. Absence of reports is not safety. Products also vary: NCCIH notes supplements bought in stores or online may differ from products tested in studies. [13] See quality testing and certifications and natural sleep aids compared.