Eutylone

cardiac arrhythmia, hypertension, coronary artery disease, cardiomyopathy

Pre-existing cardiac arrhythmia, hypertension, coronary artery disease, and cardiomyopathy represent absolute contraindications. Eutylone's sympathomimetic mechanism directly increases cardiac work, heart rate, and arrhythmia risk. The published fatal case involved cardiac arrest as the apparent mechanism of death.

epilepsy, seizure history, seizure disorder

Pre-existing seizure disorders represent an absolute contraindication. Cathinones lower seizure threshold, and seizures are documented as a component of the eutylone clinical toxidrome in emergency department presentations and WHO ECDD review documentation.

schizophrenia, schizoaffective disorder, psychotic disorder NOS

Pre-existing vulnerability to psychosis represents an elevated risk factor. Eutylone-induced paranoia, delirium, and psychosis are documented in case reports and WHO ECDD review documentation. DAT inhibition with IC50 of 120 nM directly potentiates mesolimbic dopamine, the pathway most implicated in psychosis.

cirrhosis, hepatic insufficiency, severe liver disease

Hepatic metabolism is eutylone's primary elimination pathway, with five identified biotransformation routes and confirmed biliary excretion. Impaired hepatic function may prolong systemic exposure and increase accumulation of potentially toxic metabolites. CYP3A4 and CYP2D6 involvement is inferred by structural analogy.

chronic kidney disease, renal insufficiency

Rhabdomyolysis is a documented complication of stimulant cathinone toxicity, and pre-existing renal compromise increases the risk of acute kidney injury from myoglobin-mediated renal tubular damage. Renal clearance contributes to eutylone elimination alongside biliary/hepatic pathways.

pregnancy, planned pregnancy

No reproductive toxicity data exist for eutylone. Catecholaminergic stimulation from DAT/NET inhibition poses theoretical risks to fetal cardiovascular development and placental perfusion. This is a precautionary absolute contraindication based on class-level stimulant pharmacology.

phenelzine use, tranylcypromine use, selegiline use, moclobemide use

Concurrent use of monoamine oxidase inhibitors with eutylone carries risk of serotonin syndrome and hypertensive crisis through dual blockade of monoamine degradation and reuptake/release. This is a mechanism-inferred absolute contraindication applying to all MAOIs.

hot environment exposure, prolonged physical exertion in heat

Hot ambient temperatures combined with physical exertion amplify eutylone's thermoregulatory disruption — the primary life-threatening mechanism in cathinone toxicity. Festival and dance venue settings are particularly high-risk environments.