O-PCE

Pre-existing hypertension or cardiovascular disease increases risk of hypertensive crisis or cardiac events given the high rate of cardiovascular stimulation observed clinically.

Patients with coronary artery disease face elevated risk from the cardiovascular stimulation profile of arylcyclohexylamine dissociatives.

The elevated convulsion rate observed clinically makes epilepsy and other seizure disorders an absolute contraindication until the proconvulsant mechanism is understood.

All dissociative NMDA antagonists are contraindicated in individuals with active psychotic disorders or personal history of psychosis due to risk of symptom precipitation or exacerbation.

Contraindicated in pregnancy as a precautionary measure based on class-level evidence of NMDA antagonist neurodevelopmental toxicity in animal models.

Concurrent use of serotonin-norepinephrine reuptake inhibitors should be considered a relative contraindication pending mechanistic characterization of the fatal venlafaxine interaction.

Monoamine oxidase inhibitors should not be combined with O-PCE. This is a class-level contraindication not verified substance-specifically.

Combined use with CNS depressants increases risk of respiratory depression, loss of consciousness, and death.