It’s very important to let us know a complete list of medications you are taking (prescriptions, over-the-counter, and supplements), prior to receiving ibogaine treatment at Transcend Clinic.
Ibogaine goes through first-pass liver metabolism and gets converted to its’ primary metabolite via O-demethylation at the 12-position to yield 12-hydroxyibogamine (noribogaine). Metabolism of ibogaine occurs primarily via two — or more — enzymes catalyzed by cytochrome P4502D6 (CYP2D6). [Mash, et al.]
The CYP2D6 enzymes are extensively used to metabolize a plethora of medications, as well as certain supplements and foods. The primary problem with many of the medications listed, is that they can prolong QT intervals and cause cardiac arrhythmias when combined with ibogaine.
The risk of experiencing cardiac complications while undergoing ibogaine treatment is significantly increased when any of the following medications are used:
Cytochrome P4502D6 (CYP2D6) blockers/competitors
Anti-arrhythmic drugs:
- Metoprolol
- Propafenone
- Timolol maleate
Antidepressant drugs:
- Amitriptyline (Elavil)
- Citalopram (Celexa)
- Clomipramine
- Desipramine
- Duloxetine (Cymbalta, Ariclaim, Xeristar, Yentreve, Duzela, Dulane)
- Escitalopram (Lexapro)
- Imipramine (Tofranil)
- Paroxetine (Paxil)
- Venlafaxine (Effexor)
Antipsychotics:
- Aripiprazole (Abilify, Aripiprex)
- Haloperidol (Haldol)
- Pimozide (Orap)
- Risperidone (Risperdal)
- Thioridazine (Mellaril, Sonapax, Thioril)
Drugs that prolong QT intervals (not a good combination with ibogaine treatment):
- Amiodarone
- Azithromycin (Zithromax)
- Bepridil (Vascor)
- Chloroquine (Aralen)
- Chlorpromazine (Thorazine, Largactil)
- Clarithromycin (Biaxin)
- Disopyramide (Norpace)
- Dofetilide (Tikosyn)
- Droperidol (Inapsine, Droleptan, Dridol, Xomolix, Innovar)
- Erythromycin (Isotrexin)
- Flecainide acetate (Tambocor, Almarytm, Apocard, Ecrinal, Flécaine)
- Halofantrine (Halfan)
- Moxifloxacin (Avelox, Avalox, Avelon, Vigamox, Moxeza)
- Pentamidine (NebuPent)
- Procainamide (Pronestyl, Procan, Procanbid)
- Quinidine (Quinaglute)
- Sevoflurane (Ulane)
Other common medications that compete with the ibogaine molecule:
- Codeine (3-methylmorphine)
- Dextromethorphan (DXM, DM)
- Methadone (Methadose)
- Mexiletine (Mexitil)
- Ondansetron (Zofran)
- Tamoxifen (Nolvadex, Istubal, Valodex)
- Tramadol (Ultram, Ralivia, Tramal)
Foods such as grapefruit juice, and a variety of other supplements and over-the-counter medications such as Prilosec (Omeprazole), various gastric drugs, anti-fungal medications, HIV treatment drugs, and some antihistamines, can all contribute to significantly prolonging QT intervals and cause problems when still circulating within the body at time of ibogaine treatment.
This is not a complete list, but it’s presented with the hopes that fewer people will experience unneeded problems and complications. It is extremely important to let the M.D.’s at Transcend Clinics ibogaine treatment center in Cancun know a complete list of medications you are taking (prescriptions, over-the-counter, and supplements).
With best wishes,
Dr. Alberto Solá