Mephedrone
4-methylmethcathinone
Standing risks
- Compulsive use risk, monitor frequencyconfidence medium
- Compulsive redosing
- high
- Dose escalation
- moderate
Lethal interactions
Specific substances
- Tramadollethal
By drug class
- Ibogainelethal3 mechanismsconfidence medium
- MAOIslethal3 mechanismsconfidence high
Dangerous interactions
35 dangerous interactions recorded for this substance.
See the full interactions tableContraindications
Cardiovascular
- pre-existing cardiovascular diseaseabsolute
coronary artery disease, hypertension, cardiac arrhythmias, cardiomyopathy
Conditions including coronary artery disease, hypertension, cardiac arrhythmias, cardiomyopathy, and valvular disease represent absolute contraindications given the reliable cardiovascular stress produced at all recreational doses.
Psychiatric
- concurrent serotonergic medicationabsolute
SSRI use, SNRI use, MAOI use, tramadol use, lithium use, triptan use
Concurrent use of any serotonergic medication creates substantial risk for serotonin syndrome. This includes SSRIs, SNRIs, MAOIs, tramadol, lithium, and triptans.
- psychotic disordersabsolute
Individuals with a personal or family history of psychotic disorders face elevated risk of mephedrone-precipitated psychosis.
Metabolic
- CYP2D6 poor/intermediate metabolizer statusabsolute
Individuals with genetically reduced CYP2D6 function or those taking CYP2D6 inhibitors (fluoxetine, paroxetine, bupropion) face disproportionately elevated toxicity risk due to impaired mephedrone clearance.
Pregnancy & Breastfeeding
- pregnancy and breastfeedingabsolute
No reproductive safety data exist for mephedrone. Use during pregnancy or breastfeeding is contraindicated based on precautionary principle.
Other
- hot/warm environmentsrelative
Use in hot environments (nightclubs, raves, outdoor festivals) substantially increases the risk of hyperthermia.
- alcohol co-userelative
Concurrent alcohol use amplifies cardiovascular effects, enhances euphoria, and masks alcohol-related sedation.