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Contraindicated Drugs, Medications and Herbs Ibogaine is known to greatly increase or affect the effects of some drugs. For this reason ibogaine must not be taken until we can be sure that certain types of drugs (such as antidepressants, antipsychotics, alcohol, amphetamines, stimulants, and other prescription medications or illicit drugs) are cleared out of your system. It is possible that ibogaine can cause an adverse (undesirable and/or dangerous) effect in combination with some substances. Anyone who is taking medications (prescribed or otherwise) that may interact with ibogaine will be excluded from participating in ibogaine therapy until we are sure the substance in question is no longer in the system. We will also exclude anyone on necessary long-term medication if there is no information available on possible interactions with ibogaine. If you have been taking any medications (prescribed or otherwise), illicit substances or other substances such as herbal remedies and supplements please inform us immediately, as some medications may not be mixed with ibogaine and may be dangerous or harmful in combination with it, and this may affect your therapy session and our ability to administer any ibogaine to you.
Disclaimer: The following information and list of substances is only a guide to help inform you of possible contraindications, there may be other substances that are not listed here. Please contact us for a consultation regarding any substance that you are currently taking or have taken recently.
Drugs metabolized through the CYP 450-2D6 liver enzyme The liver breaks ibogaine down into nor-ibogaine through an enzyme in the liver known as Cytochrome P450-2D6 (CYP2D6). An enzyme is a chemical in the body that breaks down food, liquids, drugs, or anything else people ingest, through a process called metabolism. More than a quarter of all prescription drugs (including virtually all anti-depressants, beta-blockers and psychiatric medications) plus some herbs and foods are also primarily metabolized through CYP2D6. Therefore it is extremely important that no CYP2D6 drugs that might interact negatively with ibogaine be in the system prior to taking it. A list of drugs metabolized through CYP2D6 can be found here:
Potential QT Interval Lengthening Drugs Ibogaine may possibly produce a lengthening of the QT interval of the heart rate. The QT interval is the section on an electrocardiogram (ECG, heart test) that indicates the time it takes for the heart’s electrical system to fire an impulse through the ventricles and then recharge itself. A prolonged QT interval may lead to a potentially fatal disorder known as Torsades de Pointes. Having an EKG before ibogaine therapy may indicate whether there is a pre-existing prolonged QT interval, and this information indicates whether you should be treated with ibogaine or not. Many prescription and over the counter medications and well as foods and other substances can prolong the QT interval by interfering with CYP2D6. Thus, all QT prolonging substances should be discontinued for at least four half-lives of that substance, prior to therapy with ibogaine. A half-life is the time it takes for one-half of the original dose of a medication to leave the body. Substances and medications known to potentially prolong the QT interval include: anti-arrhythmics, antibiotics, anti-cancer medications, anti-convulsants, antidepressants, anti-hypertensives, anti-fungals, anti-infectives, anti-malarials, anti-mania medications, anti-nauseants, anti-psychotics, appetite suppressants, bronchodilators, catecholamines, cholinesterase inhibitors, decongestants, diuretics, immunosupressants, muscle relaxants, opiates, sedatives, stimulants, sympathomimetics, and vasoconstrictors. Grapefruit and Quinine (often used as flavor in tonic water) are also strong QT prolonging substances and should not be taken with or before ibogaine. A list of QT prolonging drugs can be found here: http://www.azcert.org/medical-pros/drug-lists/drug-lists.cfm
Herbal Supplements, Over the Counter Remedies & Nutraceuticals Herbs that may contraindicate with ibogaine include the following;
OTC medications that may cause adverse effects include:
Note: Some of the potential contraindicating actions of drugs/herbs listed above may be dependant on dose, frequency and length of use and individual metabolism. If you have been taking any substance that may fit into the categories described above then you should consult with your prescribing doctor, pharmacist or psychiatrist and the ITH program director or medical/intake screener about whether it is necessary to stop taking them, whether it is safe to stop using them, how to taper down if so, and how long it would be before it is safe to take ibogaine. If you are wishing to stop taking or taper down from any substance, you should do so safely and with the assistance and recommendation of your physician, pharmacist/pharmacologist or psychiatrist. You will not be given ibogaine until it can be determined that the substance in question is no longer in your system. We may request to speak to your therapist, doctor, psychiatrist, etc., to verify that this has been done according to their advice or recommendation.
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