Contraindications

Contraindications

contraindications

Psychoactive Medications

Candidates must stop taking all psychoactive medications (such as amitriptyline, Elavil, Prozac, Zoloft, Paxil) for a minimum of five days prior to Ibogaine treatment.

Ibogaine is known to interact and increase the effects of some drugs.  For this reason Ibogaine must not be taken until we can be sure that certain types of drugs, especially antidepressants, antipsychotics, amphetamines, and other prescription medications or illicit drugs, are cleared out of your system.

 

Fentanyl

Fentanyl use must be suspended 2 weeks prior to treatment and preferably the patient switch over to a short-acting opiate such as hydrocodone or oxycodone. Ibogaine treatment directly after fentanyl use has been shown to cause arrhythmias.

 

Methadone

Methadone use must be suspended minimum 10 days prior to treatment and ideally 2-3 weeks to ensure best results with Ibogaine and no post-acute withdrawal symptoms. Switching over to a short-acting opiate is also advisable for controlling withdrawals during this time.

 

Suboxone/Subutex (Buprenorphine)

Regarding these replacement therapies, we have seen success with a minimum of 7 days suspension (3 weeks is ideal but not always possible or advisable) but often this requires boosters for several weeks, which we can accommodate. Again, switching over to a short-acting opiate if possible is helpful to deal with withdrawal symptoms before doing Ibogaine treatment.

 

Other Medications

Other medications that should not be combined with Ibogaine include omeprazol (Losec), anti-fungal medications (Diflucan), clarityne, and macrolide type antibiotics (Azithromycin, Zithromax).   All of these need to be suspended at least 5 days before Ibogaine treatment.

 

Drugs metabolized through CYP2D6 and QT prolonging drugs

Drugs metabolized through CYP2D6 and QT prolonging drugs need to be stopped prior to dosing with Ibogaine.  For a list of these medications see:  http://medicine.iupui.edu/clinpharm/ddis/clinicalTable.aspx.

Cytochrome P450 2D6 (CYP2D6) is an enzyme that is involved in the metabolism of numerous drugs. Enzymes are proteins that help initiate or accelerate certain chemical processes in the body, they increase the speed of chemical reactions that would generally run slow, if at all, such as the break down of foods or drugs.

Ibogaine is broken down in the liver into nor-Ibogaine by the CYP2D6 enzyme. This enzyme is also involved in the break down or activation of many other drugs.

More than a quarter of all prescription drugs and some herbs and foods are metabolized through CYP2D6. This is why it is extremely important that no CYP2D6 drugs that might interact negatively with Ibogaine be in the system prior to taking it.

The use of all potential QT interval lengthening drugs must be stopped prior to Ibogaine dosing.  A list of these drugs can be found here:  http://www.azcert.org/medical-pros/drug-lists/list-01.cfm?sort=Brand_name.

Ibogaine, like many other drugs that are metabolized by CYP2D6, may produce a lengthening of the QT interval of the heart rate. The QT interval is a measurement from an EKG (electrocardiogram) that tells how long electricity takes to get through a portion of the heartbeat; a prolonged Q-T interval means that the impulse takes longer than expected and is a risk factor for ventricular tachyarrhythmias and sudden death.

A prolonged QT interval may lead to a potentially fatal disorder known as Torsades de Pointes.

Many prescription and over the counter drugs and other substances can prolong the QT interval. Thus, all QT prolonging substances should be discontinued prior to therapy with Ibogaine. To allow these drugs to get out of the system one must allow for at least four half-lives of that substance to pass before initiating Ibogaine therapy. A half-life is the time it takes for one-half of the original dose of a medication to leave the body.

If you have been taking any drug listed above then you should consult with your doctor, psychiatrist and medical staff at the Ibogaine University whether it is safe to stop using them, how to taper down, and how long it would be before it is safe to take Ibogaine.

 

Transdermal Fentanyl

Taken oral is ok.

 

OTC medications that may cause adverse effects include:

Decongestants, Allergy/Hay Fever medications, Corticosteroids, Pain relievers, Stimulants, Antacids and Sleep medications.

Products and foods that should be discontinued prior to Ibogaine:

Goldenseal/Berberine, St. John’s Wort, Asafoetida, Black seed, Curcuma and Garden Cress, Kava kava, Valerian, Black Cohosh, Scotch Broom (inhibitors of CYP2D6).

Grapefruit, Licorice, Quinine and Bitter Orange (These are all QT-prolonging substances and should not be taken with or before Ibogaine).

Cascara Sagrada, Senna, Aloe Vera (taken internally), Horsetail, Celery seed, Yellow Dock, Buckthorn (not to be confused with Sea Buckthorn), plus other laxatives and diuretics, may deplete electrolytes.

Mistletoe, diuretics, laxatives, may cause hypotension (low blood pressure).

Stimulants: that should be suspended Ephedra (aka: Ma Huang), Kola Nut, Guarana.

 

Risk of Exclusion from the program

Anyone with the following conditions may be at risk and would need to be cleared medically prior to treatment and may not qualify:

Cancer
Cerebella dysfunction
Coagulation abnormalities or a history of blood clots
Diabetes (uncontrolled)
Emphysema
Epilepsy
Crohn’s Disease Fainting (chronic)
Gastric ulcer
Heart disease, heart murmurs, or heart arrhythmias
Hepatitis with liver enzymes over four times normal
High blood pressure (uncontrolled)
Infections (active) including ulcers, or skin abscesses
Irritable Bowel Syndrome
Obesity (severe)
Pneumonia
Kidney disease
Liver disease with liver enzymes over four times normal
Pregnancy
Psychiatric disorders (serious)
Stroke

Given the potential for serious adverse drug interaction with Ibogaine as well as problems that can occur when Ibogaine is given to people with the medical conditions outlined above, the medical staff at Ibogaine University reserves the right to exclude candidates from further consideration on the basis of failing to completely or honestly report all information sought by staff at Ibogaine University and provided by the patient.  This, of course, is for your safety.