MDAI

Pre-existing hypertension or cardiovascular disease increases risk of hypertensive crisis. MDAI produced blood pressure elevation comparable to 125 mg MDMA in human subjects.

Seizure disorders may be exacerbated. Seizures were observed in rat toxicology studies at high doses.

Personal or family history of psychotic spectrum disorders increases risk of acute psychotic episodes.

Hepatic impairment may increase vulnerability to hepatotoxicity. In vitro data show strong HepG2 cytotoxicity, though no human hepatic adverse events are documented.

No data exist on MDAI in pregnancy or lactation. As a monoamine releasing agent with demonstrated high CNS penetration, fetal exposure is expected. Contraindicated by precautionary principle.

Concurrent or recent use of any monoamine oxidase inhibitor (including moclobemide, phenelzine, tranylcypromine, selegiline, and ayahuasca/harmine-containing preparations) is absolutely contraindicated.

Concurrent use of other serotonergic substances — including SSRIs, SNRIs, other entactogens, serotonergic benzofurans, tramadol, and serotonergic psychedelics — is contraindicated.