Ibogaine
Standing risks
| Risk | Recorded values | Confidence | Article section |
|---|---|---|---|
| High overdose risk, use caution |
| high | View in article: High overdose risk, use caution |
Lethal interactions
| Combination | Type | Severity | Mechanisms | Confidence |
|---|---|---|---|---|
| GHB, GBL | Drug class | lethal | 2 | medium |
| Local anesthetics | Drug class | lethal | 3 | medium |
| Opioids | Drug class | lethal | 4 | medium |
| Stimulants | Drug class | lethal | 3 | medium |
Dangerous interactions
44 dangerous interactions recorded for this substance.
See the full interactions tableContraindications
| Condition | Severity | Note |
|---|---|---|
| Cardiovascular | ||
| long QT syndrome | absolute | Baseline QTc >450 ms (men) or >470 ms (women) is a treatment exclusion. Pre-existing conduction abnormalities amplify ibogaine's QT-prolonging effect. |
| structural heart disease | absolute | Cardiac arrhythmia, cardiomyopathy, valvular disease, and other structural heart conditions are absolute contraindications. |
| Hepatic | ||
| hepatic impairment | relative | Severe hepatic impairment is a relative contraindication. Mild-to-moderate impairment requires clinical judgment and possible dose adjustment. |
| Metabolic | ||
| electrolyte imbalances | relative | Serum potassium and magnesium must be within normal range before treatment. Correction of deficiencies is mandatory. The MISTIC protocol co-administers magnesium as a QTc stabilizer. |
| Pregnancy & Breastfeeding | ||
| pregnancy | absolute | Pregnancy is an absolute contraindication due to complete absence of safety data. |
| Other | ||
| concurrent QT-prolonging medication | absolute | All QT-prolonging medications must be cleared before ibogaine administration. The combination is potentially lethal. |
| concurrent opioid use | absolute | Complete opioid washout is required before ibogaine administration. One fatality in published case series attributed to possible surreptitious heroin use during treatment. |
| CYP2D6 inhibitor use without dose adjustment | relative | CYP2D6 inhibitors must be washed out or ibogaine dose must be reduced. CYP2D6 genotyping before treatment is recommended. |