Overview

Kratom is a plant called Mitragyna speciosa. Products that contain kratom are made from the leaves of the plant. People take kratom for many different reasons, although its benefits are not well defined. Common side effects may include constipation, dizziness, drowsiness, nausea or vomiting, and fast heartbeat. Serious side effects are less common but may include liver damage, seizures, and psychotic-like behavior. Some people may have physical dependence, which means their bodies begin to rely on kratom. Before taking kratom, make sure to tell your health care provider about any health conditions you have or medicines you are taking.

Uses

What is kratom used for?

Kratom (Mitragyna speciosa) is used for many different reasons. However, its benefits are not well defined. Some common reasons that people use kratom include the following.

• Anxiety
• Depression
• Pain
• Substance withdrawal, including opioid withdrawal

Note: Kratom is not approved by the FDA for any use. The FDA also does not consider kratom to be a legal dietary ingredient in the U.S. Learn more about the legal status of kratom here.

How does kratom work (mechanism of action)?

Kratom is a plant called Mitragyna speciosa. Products that contain kratom are made from the leaves of this plant.

Certain chemicals in kratom, including mitragynine and 7-hydroxymitragynine (7-OH), have effects on the body. These chemicals bind to opioid receptors, which can cause opioid-like effects. Kratom may also change the levels of certain chemicals in the brain, such as serotonin or dopamine. This may cause stimulant-like effects. These effects may depend on the dose that is used, but the actual effects of kratom are not well understood.

Herbal products like kratom naturally contain many different chemicals. The amount of each chemical in a specific product may vary from product to product. Some, none, or all of these chemicals may have effects on the body. These effects may change depending on how much of each chemical is found in the product you are using.

How should I store kratom?

You should store kratom according to the product label. Most herbal products should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of kratom?

The most common side effects of kratom are listed below. These side effects may vary depending on the dose you are taking or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.

• Constipation
• Dizziness
• Drowsiness
• Nausea or vomiting
• Fast heartbeat

There may be other side effects of kratom that are not listed here. Contact your health care provider if you think you are having a side effect of an herbal product. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of kratom?

While less common, the most serious side effects of kratom are described below, along with what to do if they happen.

Severe Allergic Reactions. Kratom may cause allergic reactions, which can be serious. Stop taking kratom and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Dependence and Withdrawal Reactions.Kratom may cause physical dependence, which means your body relies on it. This risk may be higher in people who use high doses of kratom regularly for a while. If you stop kratom suddenly, it could lead to withdrawal symptoms, which may be life-threatening. If you have been using kratom regularly for a while, do not stop taking it without talking with your health care provider. Your health care provider may be able to help you stop kratom in a way that will reduce the risk of withdrawal reactions. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

• Unusual movements, responses, or expressions
• Seizures
• Sudden and severe mental or nervous system changes
• Seeing or hearing things that others do not see or hear, also called hallucinations
• An extreme increase in activity or talking
• Losing touch with reality

Hallucinations or Psychotic-like Behaviors. Kratom may cause hallucinations or psychotic-like behaviors. This risk may be higher in people who use high doses of kratom or people who also use street drugs. Tell your health care provider right away if you have any of the following symptoms, or if you have been told by others that you have these symptoms.

• Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
• Delusional thoughts, such as false beliefs that you are being controlled
• Disorganized thoughts, such as jumping between topics or having a hard time focusing
• Sudden decline in self-care, such as personal hygiene or academic/work performance
• Aggressive behavior

Liver Damage.Liver damage, also called hepatotoxicity, can happen when taking kratom. This risk may be higher in people who use high doses of kratom or people who also use street drugs or drink alcohol. Stop taking kratom and call your health care provider right away if you have any of the following symptoms of liver damage.

• Nausea or vomiting
• Stomach or belly pain
• Fever
• Weakness or unusual tiredness
• Itching
• Loss of appetite
• Light-colored poop
• Dark-colored urine (pee)
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Seizures. Some people who have taken kratom have reported having seizures. This may be more likely to happen in people who take high doses of kratom or people who are also using street drugs. There are many different types of seizures and some of them are not easy to recognize. Stop taking kratom and call your health care provider if you have any of the following signs that a seizure is happening or could happen.

• Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
• Stiffening of your arms and legs
• Feeling anxious, nervous, confused, or a sense of dread
• Feeling dizzy or lightheaded
• Falling or losing consciousness

Precautions

Who should not use kratom?

Allergies to Ingredients. People who are allergic to any of the following should not take kratom.

• Kratom
• Mitragyna speciosa
• Mitragynine
• Any of the ingredients in the specific product

Ask your health care provider if you are not sure what ingredients are in a kratom product.

What should I know about kratom before using it?

The FDA does not consider kratom to be a legal dietary ingredient. Some U.S. states have banned the sale of kratom. However, kratom products may still be available for purchase in many places. These products are not regulated and have not been tested to confirm that they contain the ingredients stated on their labels.

Keep kratom out of the reach of children.

Kratom can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how kratom affects you.

If you have been taking kratom on a regular basis, do not stop taking it abruptly without talking to your health care provider. Stopping too quickly may cause serious side effects. See the Side Effects section for more details.

Herbal products, such as kratom, naturally contain many different chemicals. The amount of each chemical in a specific kratom product can change for many reasons, including how and where the plant was grown and the way that the plant was processed. The type of product, such as a liquid extract, ground powder, or tea, can also affect the chemicals naturally found in kratom. If the amounts of certain chemicals are higher or lower in different products, this can increase or decrease the effects of kratom. If you switch to a new bottle or a different brand, you may not have the same effects or side effects because of this variability. Talk to your health care provider if you have questions or concerns.

What should I tell my health care provider before using kratom?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if kratom is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions.Tell your health care provider if you have any of the following.

• Alcohol use disorder
• Substance use disorder, including cocaine, opioid, or methamphetamine use disorder
• Mental health problems, such as depression or anxiety
• Heart problems
• High blood pressure
• Liver problems
• Seizures
• Upcoming surgery or medical procedure

Other Medicines and Supplements.Kratom may interact with other medicines and supplements. Before taking kratom, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Kratom may cause harm to an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if kratom passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does kratom interact with foods or drinks?

There are no known interactions between kratom and foods or drinks.

It is unknown if drinking alcohol will affect kratom. But the risk of serious side effects may be increased if you drink alcohol while taking kratom.

Does kratom interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking kratom.

• Any medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, or medicines for anxiety
• A barbiturate, such as butalbital, phenobarbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
• A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
• A muscle relaxant, such as carisoprodol (Soma), cyclobenzaprine, metaxalone, or tizanidine (Zanaflex)
• An opioid, such as codeine, fentanyl, morphine, oxycodone, or tramadol, which is a medicine used to treat certain types of pain
• Street drugs, such as cocaine, heroin, or methamphetamine

The interactions between kratom and medicines are not fully understood. As with most herbal products, the research on drug interactions with kratom is incomplete. Always check with your health care provider before using kratom with any medicines.

Dosing

What should I do if I accidentally use too much kratom?

If you or someone else has used too much kratom, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Kratom products are made from the leaf of the plant. Kratom may have different effects depending on the dose that is used, but it is not clear what a typical dose should be. Some people have had physical dependence while using kratom, which means their bodies come to rely on it. Stopping kratom suddenly can lead to withdrawal.

Read the product label closely and speak with a health care provider before using kratom. Do not take double or extra doses.