Psilocybin mushrooms
4-phosphoryloxy-N,N-dimethyltryptamine
Lethal interactions
By drug class
- MAOIslethal2 mechanismsconfidence high
Dangerous interactions
17 dangerous interactions recorded for this substance.
See the full interactions tableContraindications
Cardiovascular
- Cardiovascular diseaserelative
uncontrolled hypertension, recent cardiac events
Uncontrolled hypertension or recent cardiac events. Transient increases in blood pressure and heart rate are common during acute psilocybin effects. A case series of P. keralensis poisonings documented myocardial injury with cardiovascular complications, though these findings have not been replicated with P. cubensis.
Psychiatric
- Active suicidal ideationabsolute
active suicidal ideation with intent or plan
Active suicidal ideation with intent or plan. Excluded from all clinical trials. Emotional amplification and ego dissolution effects may intensify suicidal cognition in an uncontrolled manner.
Pregnancy & Breastfeeding
- Pregnancyrelative
pregnancy
No peer-reviewed human safety data exist for psilocybin use during pregnancy. Animal reproductive toxicology data are very limited. Presumed contraindicated pending evidence — this is a no-data contraindication rather than documented harm.
Age
- Pediatric userelative
under 18 years of age
No clinical safety data exist for psilocybin use in individuals under 18. All clinical trials enroll adults only. Contraindicated in clinical contexts due to absence of pediatric safety evidence.
Other
- Tramadol userelative
current tramadol therapy
Current tramadol therapy. Tramadol's serotonergic activity combined with psilocybin's 5-HT2A agonism creates pharmacologically plausible risk for serotonin toxicity. No peer-reviewed case reports or mechanistic pharmacokinetic studies of the tramadol-psilocybin combination were identified.