Cocaine
Standing risks
| Risk | Recorded values | Confidence | Article section |
|---|---|---|---|
| High overdose risk, use caution |
| high | View in article: High overdose risk, use caution |
| Compulsive use risk, monitor frequency |
| high | View in article: Compulsive use risk, monitor frequency |
| High dependence, taper carefully |
| high | View in article: High dependence, taper carefully |
| Chronic toxicity, limit exposure |
| high | View in article: Chronic toxicity, limit exposure |
Lethal interactions
| Combination | Type | Severity | Mechanisms | Confidence |
|---|---|---|---|---|
| 2-Aminoindane | Substance | lethal | — | — |
| 2-FEA | Substance | lethal | — | — |
| MCPP | Substance | lethal | — | — |
| MDEA | Substance | lethal | — | — |
| Methylnaphthidate | Substance | lethal | — | — |
| Tramadol | Substance | lethal | — | — |
| αMT | Substance | lethal | — | — |
| Ibogaine | Drug class | lethal | 3 | medium |
| Opioids | Drug class | lethal | 4 | medium |
Dangerous interactions
39 dangerous interactions recorded for this substance.
See the full interactions tableContraindications
| Condition | Severity | Note |
|---|---|---|
| Cardiovascular | ||
| long QT syndrome | absolute | Cocaine's Na+ channel blockade compounds pre-existing repolarization abnormalities. Genetic long QT variants substantially modify cocaine fatality risk. |
| coronary artery disease | absolute | Cocaine users carry 7-fold elevated MI risk. Pre-existing coronary disease dramatically amplifies this risk through additive vasospasm on fixed lesions. |
| hypertension | relative | Uncontrolled hypertension combined with cocaine's acute blood pressure elevation creates dangerous additive cardiovascular stress. |
| concurrent beta-blocker therapy | absolute | Patients on beta-blockers who use cocaine face paradoxical worsening of coronary vasospasm due to unopposed alpha-stimulation. |
| Neurological | ||
| cerebrovascular disease | absolute | History of stroke, TIA, or intracranial aneurysm is an absolute contraindication. Cocaine causes stroke through vasospasm, hypertension, and impaired hemostasis. |
| Psychiatric | ||
| psychotic disorders | absolute | Personal or family history of schizophrenia or other psychotic disorders. Cocaine induces paranoid psychosis in over 50% of dependent users even without psychiatric history. |
| Hepatic | ||
| hepatic impairment | relative | Hepatic impairment reduces cocaine clearance and may alter norcocaine formation, while cocaine itself causes hepatocyte necrosis via oxidative stress. |
| Renal | ||
| renal impairment | relative | Cocaine-induced rhabdomyolysis and renal vasoconstriction are more dangerous in the setting of pre-existing renal compromise. |
| Pregnancy & Breastfeeding | ||
| pregnancy | absolute | Cocaine is associated with multiple adverse pregnancy outcomes through placental vasoconstriction and direct fetal effects. |