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Lethal interactions

By drug class

  • MAOIslethal2 mechanismsconfidence high

Dangerous interactions

26 dangerous interactions recorded for this substance.

See the full interactions table

Contraindications

Cardiovascular

  • cardiovascular diseaserelative

    Pre-existing cardiovascular disease (coronary artery disease, heart failure, uncontrolled hypertension) increases risk of adverse cardiovascular events during DOC's prolonged sympathomimetic activation.

Neurological

  • epilepsyrelative

    Individuals with epilepsy or other seizure disorders face elevated seizure risk. Seizures are documented in published DOC toxicity cases.

Psychiatric

  • psychotic disordersabsolute

    Personal or family history of psychotic disorders (schizophrenia, schizoaffective disorder) is an absolute contraindication for DOC. All potent 5-HT2A agonists carry this risk.

  • bipolar disorderabsolute

    Bipolar I and II disorder are absolute contraindications. Extended psychedelic states carry elevated risk of mood destabilization.

Pregnancy & Breastfeeding

  • pregnancyabsolute

    Pregnancy is an absolute contraindication. No safety data exist for DOC in pregnancy.

Other

  • lithium co-administrationabsolute

    Concurrent lithium use is an absolute contraindication. Reports of severe adverse reactions (seizures, prolonged psychosis) exist for other 5-HT2A agonist psychedelics combined with lithium.

  • MAOI co-administrationabsolute

    Concurrent MAOI use is an absolute contraindication due to serotonin syndrome risk. No published DOC + MAOI case reports exist, but the mechanistic basis is established.

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