Drug Interactions, Kratom Guides

Wondering About the Interaction Between Kratom & Estazolam? Here’s What You Should Know

You might be interested in using kratom if you have trouble falling asleep. Likewise, if you wake up exhausted, you could use kratom to keep you awake. Kratom is unique and can provide help on either end, depending on the dose.

What if you’re using a sleep aid like estazolam? Will kratom help it or hinder it? Can these two even be mixed?

Last updated 5 months ago by Dr. Devin Carlson

Wondering About the Interaction Between Kratom & Estazolam? Here’s What You Should Know

Does Kratom Interact With Estazolam (Prosom)?

Yes — kratom and estazolam will interact and are unsafe to use together. These two interact in three ways, making them a dangerous combination.

Estazolam (Prosom) is in the class of benzodiazepines. Kratom and benzodiazepines are a high risk for serious interactions. These two should never be mixed.

Kratom is a central nervous stimulant (CNS), while estazolam reduces activity in the brain. Their relationship is antagonistic since both drugs work towards opposite effects.

However, as kratom’s effects vary considerably depending on dosage, this is not clear-cut.

As the kratom dosage increases, it has more calming, sedative-like properties — similar to estazolam. This would imply a shift from antagonistic to agonistic, indicating that both drugs produce comparable effects.

There is also an important interaction in the area of metabolization.

Estazolam’s metabolization is dependent on the CYP3A4 enzyme [1].  As it turns out, kratom is a potent inhibitor of CYP3A4 [2]. When a drug isn’t metabolized as quickly as it should be, it can cause increased effects. This creates a dangerous situation with many medications, but especially benzodiazepines.

Estazolam Drug Chart

Drug NameEstazolam
Trade NameProsom, Eurodin, Nuctalon
Other NamesN/A
ClassificationBenzodiazepine
CYP MetabolismCYP3A4
Interaction With KratomMetabolic inhibitor, antagonist, agonist
Risk of InteractionHigh

Is it Safe to Take Kratom With Estazolam?

Estazolam is usually only prescribed short-term — often no longer than two weeks. However, this is because it’s highly addictive and doesn’t mean there’s less danger of a drug interaction.

Kratom can increase the effects —making it more addictive, and, worse, it increases the likelihood of respiratory depression, coma, or death.

What is Estazolam?

Estalozam — available commercially as Prosom — is benzodiazepine of the triazolobenzodiazepine class.

Benzodiazepines like estazolam decrease activity in the brain through their interactions with the gamma-aminobutyric acid (GABA) molecule. In other words, they slow down the brain’s signals and make the user calmer and less anxious.

Benzodiazepines all follow this primary mechanism of action.

However, there are many different types of benzodiazepines, and each has its own chemical particularities that make it more suited to treating specific conditions.

Estazolam is a Schedule IV drug in the Controlled Substances Act. This means it has a low potential for abuse compared to compounds in Schedule III or higher.

Nevertheless, estazolam is not usually prescribed for long periods as tolerance can often develop in the body, as well as symptoms of physical and mental dependence.

What is Estazolam Used for?

Estazolam is prescribed for the treatment of sleeping conditions — most often insomnia.

Studies have conclusively shown estazolam effectiveness as a hypnotic medication. It improves sleep latency, total sleep time, number of nocturnal awakenings, depth of sleep, and sleep quality [3].

When combined with non-pharmacological options, a short-term estazolam treatment can lead to long-term sleep benefits even after the use of the drug has been halted [4].

Estazolam also has anxiolytic (anti-anxiety) properties and can thus be effective in treating depression-related insomnia [5].

What’s the Dose of Estazolam?

Only consume estazolam strictly according to your doctor’s prescription.

Not following these instructions could place you at severe risk of contraindications and benzodiazepine dependence.

Also, it is generally not a good idea to follow prescription advice found on the internet as it can never consider all the necessary factors. A doctor needs to take a proper risk assessment and write a prescription.

Nevertheless, estazolam is available in 1 mg or 2 mg tablets and is taken before bed. Ideally, the patient only uses this medicine when they can get at least seven hours of sleep; otherwise, they may have memory problems.

Generic & Brand Name Versions

Estazolam also goes by the following brand names:

  • Prosom
  • Eurodin
  • Nuctalon

What Are the Side Effects of Estazolam

Estazolam can cause some of the side effects associated with benzodiazepine use.

Common side effects from estazolam include:

  • Hangover effect (grogginess)
  • Drowsiness
  • Dizziness
  • Weakness
  • Dry mouth
  • Constipation
  • Aggression
  • Agitation
  • Changes in behavior
  • Slowed or uncoordinated movements
  • Muscle stiffness
  • Leg pain

More severe side effects include:

  • Fever
  • Blisters
  • Rash
  • Hives
  • Swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
  • Difficulty breathing or swallowing

There are also other side effects to estazolam, like rebound insomnia. Once you cease taking estazolam, you might experience difficulty sleeping for 1-2 weeks; this is normal.

Also, it bears reminding that benzodiazepines can cause mental and physical addiction, as well as severe withdrawal symptoms.

In September 2020, the FDA required the boxed warning of all benzodiazepines to be updated to reflect these dangers more accurately.

Benzodiazepine fatalities do occur but are considered rare events. They are frequently associated with misuse and combined with other drugs like alcohol, opioids, and antidepressants [6].

What is Kratom?

Kratom (Mitragyna speciosa) is a herbal compound with a vast suite of psychoactive properties.

It is made from the leaves of the Mitragyna speciosa — an evergreen species of tree native to Southeast Asia. Indigenous peoples and native farmers have harvested and consumed kratom there for years.

Kratom works through its interaction with opioid receptors in the CNS. Its psychoactive effects stem from the plant-based alkaloids contained within it.

Kratom is now available for consumption in a wide array of methods. You can enjoy kratom tea, crushed powder pills, kratom tinctures, and more.

What is Kratom Used for?

The effects of kratom depend on the amount ingested.

A lower dose promotes nootropic, mind-based effects like increased mental energy and mood-enhancing properties. Higher doses lead to more analgesic and sedative-like effects — ideal for chronic pain and relaxation.

Essentially, kratom’s many properties help treat numerous ailments, but they can also serve as nootropic supplements.

In terms of medication, kratom can help relieve chronic pain. It also has anxiolytic qualities and can help ease the symptoms of depression and anxiety.

Additionally, kratom has shown promise as a weight-loss supplement and alleviates opiate dependence & benzodiazepine withdrawal symptoms.

Only time will tell what else kratom helps treat.

What’s the Dose of Kratom?

There’s no one-size-fits-all approach to kratom doses. You’ll have to base your amount on the desired effects and always start low.

The general kratom dosage recommendations are:

  • Low dose (1-5 g)
  • Medium dose (5-10 g)
  • High dose (10-15 g)

Keep in mind that these are just averages.

The smartest option is always to go slow and determine how your body responds to a specific compound through small amounts.

Once you know how a low dose affects you, you can experiment with more significant quantities.

Be sure to exercise caution and responsibility when selecting your kratom dose.

What Are the Side Effects of Kratom?

Like all drugs, kratom has its share of side effects. Although, when compared to pharmacological options, kratom’s side effects are pretty mild.

Kratom’s common side effects are:

  • Constipation
  • Dizziness
  • Insomnia
  • Nausea

There are a few more serious side effects, though they’re rare. These include:

  • Itchiness
  • Loss of muscle coordination
  • Low blood pressure
  • Low libido
  • Nausea
  • Poor appetite
  • Seizures
  • Tremors

The most significant adverse effect of kratom consumption is the possibility of developing physical or mental dependence.

Luckily, this possibility is reduced by spacing out your kratom intake.

What Are the Different Types of Kratom?

Kratom is available in several types of strains.

These strains have contrasting alkaloid profiles, leading to different expressions of the same basic kratom properties. These differences in alkaloid content can be primarily because of genetic differences, but soil composition can also be relevant.

This is good news if you’re only interested in kratom because of one specific benefit, it’s relatively easy to narrow it down, and you should be able to identify what strain works best for your intended purpose.

A) White Vein Kratom

White vein kratom offers powerful nootropic benefits like increased attention span, enhanced creativity, and mood-enhancing effects.

B) Red Vein Kratom

On the other hand, red-veined kratom strains accentuate analgesic and anxiolytic relief. Additionally, they are also known to simulate generalized feelings of relaxation — perfect for sleep support.

C) Green Vein Kratom

Green vein kratom doesn’t emphasize a particular area of the kratom spectrum. It holds a great balance of properties from both red and white strains.

Basically, if you choose this strain, you get the whole kratom package but sacrifice a more targeted experience.

D) Yellow Vein Kratom

Yellow vein kratom has no significant differences compared to green vein kratom except for one: the kratom community agrees it’s a milder strain.

Yellow vein kratom is perfect for beginners or those with a proven sensibility to kratom.

Key Takeaways: Is it Safe to Mix Kratom & Estazolam?

No. It is not safe to mix estazolam with kratom.

Benzodiazepines like estazolam never mix well with anything that can cause sedation, whether it’s alcohol, other sleeping pills, or kratom.

This dangerous drug interaction can lead to serious health complications like respiratory depression, coma, and death. Benzodiazepines are also very addictive, and kratom could increase the risk of dependence.

Always talk to your doctor before using kratom with any medication to avoid complications.

References

  1. Miura, M., Otani, K., & Ohkubo, T. (2005). Identification of human cytochrome P450 enzymes involved in the formation of 4-hydroxyestazolam from estazolam. Xenobiotica, 35(5), 455-465.
  2. Hanapi, N. A., Ismail, S., & Mansor, S. M. (2013). Inhibitory effect of mitragynine on human cytochrome P450 enzyme activities. Pharmacognosy research, 5(4), 241.
  3. Pierce, M. W., & Shu, V. S. (1990). Efficacy of estazolam:: The United States clinical experience. The American journal of medicine, 88(3), S6-S11.
  4. Rosen, R. C., Lewin, D. S., Goldberg, L., & Woolfolk, R. L. (2000). Psychophysiological insomnia: combined effects of pharmacotherapy and relaxation-based treatments. Sleep medicine, 1(4), 279-288.
  5. Post, G. L., Patrick, R. O., Crowder, J. E., Houston, J. O. H. N., Ferguson, J. M., Bielski, R. J., … & Pierce, M. W. (1991). Estazolam treatment of insomnia in generalized anxiety disorder: a placebo-controlled study. Journal of clinical psychopharmacology, 11(4), 249-253.
  6. Kang, M., Galuska, M. A., & Ghassemzadeh, S. (2018). Benzodiazepine toxicity.