Table of Contents
Ayahuasca and Drug Interactions Table
| Medication | Interaction | Other Information |
|---|---|---|
| 5-hydroxytryptophan (5-HTP , also known as oxitriptan) | Moderate | The risk or severity of Central nervous system (CNS) depression can be increased |
| Acetaminophen (Tylenol) | Moderate | |
| Acetaminophen / Oxycodone hydrochloride [Percocet] | Moderate | |
| Acorus Calamus Root | No interactions | |
| Actifed | Major | |
| Adderall | Major | Using Adderall with MAOIs can result in high body temperature, seizure, and in some cases, coma. |
| Alaproclate (Alaproclate hydrochloride) | Major | Alaproclate was developed as one of the first selective serotonin reuptake inhibitor (SSRI) antidepressants by Astra AB (now AstraZeneca) in the 1970s. Development was discontinued due to concerns over hepatotoxicity observed in animal studies. |
| Albuterol - Salbutamol [Proventil] | Minor | Concurrent use of drugs known to increase blood pressure is expected to result in an increased risk for supine hypertension. Closely monitor the patient for elevated blood pressure (including in supine and head-elevated positions) and for any evidence of toxicity. |
| Albuterol - Salbutamol sulfate [Ventolin] | Minor | Concurrent use of drugs known to increase blood pressure is expected to result in an increased risk for supine hypertension. Closely monitor the patient for elevated blood pressure (including in supine and head-elevated positions) and for any evidence of toxicity. |
| Albuterol or Salbutamol sulfate [Airomir, Ventolin] | Minor | Concurrent use of drugs known to increase blood pressure is expected to result in an increased risk for supine hypertension. Closely monitor the patient for elevated blood pressure (including in supine and head-elevated positions) and for any evidence of toxicity. |
| Alimemazine tartrate or trimeprazine [Panectyl, Temaril) | Moderate | Motion sickness medication |
| Almotriptan malate [Axert] | Major | Triptans (Serotonin Receptor Agonists) for migraine and headaches, result in increased serum concentration levels of the agonists as well as a subsequent increase in risk and severity of adverse effects associated with the serotonin receptor agonists, including severe syncope, dizziness, bradycardia, and more. |
| Amantadine [Symmetrel] | Moderate | The risk or severity of serotonin syndrome can be increased |
| Amineptine (Survector) | Major | |
| Amitriptyline hydrochloride | Major | Using tricyclic antidepressants within two weeks of taking MAOIs may cause serious side effects including sudden fever, extremely high blood pressure, convulsions, and death. These higher levels of serotonin with concomitant inhibition of serotonin reuptake by tricyclic antidepressants (TCAs) like amitriptyline may lead to more severe adverse effects including serotonin syndrome. |
| Amitriptyline hydrochloride [Elavil, Amitriptyline] | Major | Using tricyclic antidepressants within two weeks of taking MAOIs may cause serious side effects including sudden fever, extremely high blood pressure, convulsions, and death. Tricyclic antidepressants (TCAs) may lead to more severe adverse effects including serotonin syndrome |
| Amoxapine (Asendin) | Major | Using tricyclic antidepressants within two weeks of taking MAOIs may cause serious side effects including sudden fever, extremely high blood pressure, convulsions, and death. Higher levels of serotonin with concomitant inhibition of serotonin reuptake by tricyclic antidepressants (TCAs) may lead to more severe adverse effects including serotonin syndrome. |
| Atomoxedine (atomoxetine) | Major | |
| Benadryl | Moderate | |
| Benylin | Major | |
| Benzedrine | Major | |
| Benzphetamine [Didrex] | Major | |
| Beclomethasone dipropionate monohydrate (Qvar, Qnasl) | No interaction | |
| Bicifadine | Moderate / Major | Bicifadine (DOV-220075) is a nonopioid analgesic. It is an inhibitor of both the norepinephrine and serotonin transporters and an NMDA antagonist with a non-narcotic profile. |
| Brasofensine | Moderate / Major | Brasofensine is an orally administered dopamine reuptake inhibitor being developed for the treatment of Parkinson's Disease. |
| Brofaromine | Moderate / Major | |
| Brompheniramine Maleate (Dimetane-DX cough syrup) | Moderate | |
| Bupropion (Wellbutrin) | Major | Using Bupropion (Wellbutrin) within two weeks of taking MAOIs may cause serious side effects such as seizures. Selective Serotonin Re-uptake Inhibitors (SSRIs), antidepressant. |
| Buspirone hydrochloride [Buspar] | Major | Using Buspirone (Buspar) with MAOIs may cause high blood pressure and increased sedative effects. Incidences of elevated blood pressure have been reported with the concomitant use of buspirone with monoamine oxidase inhibitors (MAOIs) or regiments containing MAOIs. MAOIs are known to cause hypertensive crisis, commonly known as the "cheese effect", via interacting with high contents of tyramine that creates a pressor effect and increases blood pressure 2. This occurs due to tyramine being a substrate of the monoamine oxidase enzyme, which is inhibited by MAOIs |
| Butriptyline (Evadyne) | Moderate / Major | |
| Carbamazepine [Tegretol, Epitol] | Major | Using Carbamazepine (Tegretol) with MAOIs may result in fever and may increase seizures, especially in epileptics. Evidence from in vitro studies suggest that carbamazepine may enhance the release of serotonin at the hippocampus which indicate that due to elevated levels of circulating monoamine neurotransmitters. Co-administration of carbamazepine with monoamine oxidase inhibitors may lead to increased risk for serotonin syndrome. |
| Carbidopa / Levodopa or L dopa [Sinemet, Inbrija, Dopar, Larodopa] | Moderate | Incidences of orthostatic hypotension have occurred with monoamine oxidase inhibitors (MAOIs) therapy 1. Co-administration of hypotensive drugs in presence of a MAOI may result in increased risk for developing orthostatic hypotension due to an additive effect. |
| Cetirizine [Zyrtec] | Moderate | The risk or severity of CNS depression can be increased |
| Chlorpheniramine [Wal-finate, Aller-chlor] | Moderate | |
| Chlorpheniramine / Chlorphenamine (Chlor-Trimeton/Chlor Trimeton) | Moderate | |
| Chlorthalidone | Moderate | Orthostatic hypotension is a common side effect of monoamine oxidase inhibitors (MAOI), especially irreversible MAOIs 1. Such hypotensive effects generally occur 2-3 weeks after MAOI treatment |
| Cimetidine [Tagamet] | Moderate | The metabolism of Ayahuasca can be decreased when combined with Cimetidine. |
| Citalopram | Major | The risk or severity of serotonin syndrome can be increased |
| Clomipramine [Anafranil] | Major | |
| Cocaine | Major | Using cocaine, amphetamines, or MDMA (ecstasy) with MAOIs may cause a severe increase in blood pressure, increasing the chances for stroke and cerebral hemorrhage and making it possible to overdose on a relatively small amount of cocaine. (A fatality has been recorded involving combining peganum harmala and cocaine. Fatalities resulting from combining amphetamines with pharmaceutical MAOIs have been recorded in the medical literature.) |
| Codeine sulfate | Major | Prescribing information for several different narcotics and inhibitors of monoamine oxidase (MAO)6,9 recommend against their concurrent use. With some narcotics, such as fentanyl, tramadol, and meperidine, concomitant use with MAO inhibitors can lead to the development of serotonin syndrome.2 The combination of MAO inhibitors with other narcotics, such as morphine, may result in a potentiation of adverse effects such as respiratory depression. |
| Compazine (Compoz) | Moderate | |
| Cyclizine hydrochloride [Marezine] | Moderate | |
| Cyclobenzaprine hydrochloride [Fexmid, Amrix, Flexeril] | Major | Cyclobenzaprine may increase the serotonergic activities |
| Dapoxetine [Priligy] | Major | Both monoamine oxidase inhibitor (MAOI) and selective serotonin reuptake inhibitor (SSRI) drug classes work by increasing the levels of circulating serotonin. |
| Desipramine [Norpramin, Pertofrane] | Major | |
| Desvenlafaxine succinate [Pristiq] | Major | Both monoamine oxidase inhibitor (MAOI) and selective serotonin reuptake inhibitor (SSRI) drug classes work by increasing the levels of circulating serotonin. Co-administration of agents from the drug classes may result in potentiated levels of serotonin at the synapse, enhanced serotonergic effects, and increased risk for developing serotonin toxicity, including fatal serotonin syndrome. |
| Dextroamphetamine sulfate [Dexedrine, Zenzedi, Procentra, Xelstrym] | Major | Monoamine oxidase inhibitors (MAOIs) impede amphetamine metabolism, leading to potentiated effects of amphetamine and enhanced release of norepinephrine and other monoamines from adrenergic nerve endings. Due to synergistic effects, the concurrent use of these medications may result in serotonin syndrome. This can cause headaches, fever, hypertensive crisis, as well as arrhythmias. |
| Dextromethorphan (Bromarest-DM, DXM, Benylin DM) | Major | Dextromethorphan is a serotonergic agent that may potentially cause serotonin syndrome. As monoamine oxidase inhibitors are also associated with the same risk, the concomitant use of dextromethorphan with monoamine oxidase inhibitors (MAOIs) may lead to elevated risk for that adverse reaction. |
| Dibenzazepine | Major | |
| Diethylpropion hydrochloride [Tepanil] | Major | |
| Diphenhydramine [Benadryl] | Moderate | As a first-generation antihistamine, the H1 histamine receptor antagonist diphenhydramine is known to elicit various anticholinergic (ie. antimuscarinic) effects such as dry mouth, dry eyes, and others 3,4,1,2. Subsequently, since monoamine oxidase inhibitors also demonstrate similar adverse effects including drowsiness, dry mouth, urinary retention, blurred vision, and others 5 there is a concern that the concomitant use of a monoamine oxidase inhibitor(s) and diphenhydramine could result in a synergistic enhancement of such effects |
| Disopyramide [Norpace, Rythmodan] | Minor | May lead to increased risk for developing hypoglycaemia. |
| Dopamine (Intropin) | Moderate | |
| Dosulepin [Espin] | Major | |
| Doxepin hydrochloride [Silenor, Zonalon, Sinequan] | Major | May increase the serotonergic activities of Doxepin. |
| Dristan Cold & Flu | Major | |
| Duloxetine [Irenka, Yentreve] | Major | The risk or severity of serotonin syndrome can be increased |
| Effexor | Major | Selective Serotonin Re-uptake Inhibitors (SSRIs), antidepressant, |
| Eletriptan [Relpax] | Moderate | Triptans. Due to their serotonergic actions, uncommon incidences of serotonin syndrome or neuroleptic malignant syndrome (NMS) were rarely reported with the use of serotonin modulators. Combination use of two agents that are associated with the same adverse reaction, such as serotonin syndrome or neuroleptic malignant syndrome (NMS), may result in an additive effect to create prolonged, or intensified adverse reaction. |
| Ephedrine [Akovaz] | Minor | The risk or severity of hypertension can be increased when Moclobemide is combined with Ephedrine. |
| Epinephrine hydrochloride [Adrenalin] | Moderate | May increase the hypertensive activities of Epinephrine. |
| Escitalopram oxalate [Lexapro, Cipralex] | Major | The risk or severity of serotonin syndrome can be increased |
| Fenfluramine [Fintepla, Pondimin] | Major | The risk or severity of serotonin syndrome can be increased |
| Flavoxate Hydrochloride (Urispas) | Inconclusive | |
| Fluoxetine hydrochloride or Befloxetone [Prozac] | Major | Using Fluoxetine (Prozac) within five weeks of taking MAOIs may cause high fever, rigidity, high blood pressure, mental changes, confusion, and hypomania. |
| Flupentixol | Moderate | Serotonin modulators often inhibit cytochrome CYP2D6 in the liver. This enzyme metabolizes several antipsychotics. This may lead to increased adverse effects of the antipsychotics metabolized by CYP2D6. |
| Fluticasone propionate [Xhance, Flonase, Beser] | Moderate | Nasal spray. Central nervous system (CNS) depressants can cause sedation, falls, respiratory depression, coma, and death |
| Fluvoxamine [Luvox] | Major | May increase the serotonergic activities of Fluvoxamine. |
| Frovatriptan succinate [Frova] | Moderate | Triptans. Due to their serotonergic actions, uncommon incidences of serotonin syndrome or neuroleptic malignant syndrome (NMS) were rarely reported with the use of serotonin modulators. Combination use of two agents that are associated with the same adverse reaction, such as serotonin syndrome or neuroleptic malignant syndrome (NMS), may result in an additive effect to create prolonged, or intensified adverse reaction. |
| Furazolidone / Kaolin / Pectin | Major | The use of one or more MAOIs together at the same time can result in an increased or even uncontrolled hypertensive effect (hypertensive crisis). |
| Furoxone | Major | The use of one or more MAOIs together at the same time can result in an increased or even uncontrolled hypertensive effect (hypertensive crisis). |
| Gabapentin enacarbil [Gralise, Neurontin] | Moderate | Central nervous system (CNS) depressants can cause sedation, falls, respiratory depression, coma, and death |
| Guanadrel (Hylorel) | Moderate-Major | Anti-hypertensive medication |
| Guanethidine | Moderate-Major | No longer being sold, Anti-hypertensive medication |
| Guanethidine (Ismelin) | Moderate-Major | Anti-hypertensive medication |
| Hydroxyzine hydrochloride (Atarax, Vistaril) | Moderate | Antihistamine. Hydroxyzine may potentiate the effects of central nervous system depressants, due to an additive effect. |
| Hydralazine hydrochloride [Apresoline] | Moderate | may increase the hypotensive activities of Hydralazine. |
| Imipramine hydrochloride [Tofranil] | Major | |
| Imipramine hydrochloride [Tofranil] | Major | |
| Iprindole [Prondol, Galatur, and Tertran] | Moderate-Major | No longer being sold |
| Iproclozide (Sursum, Sinderesin) | Major | An irreversible and selective hydrazine class based monoamine oxidase inhibitor (MAOI). Although it was employed as an antidepressant for a time, the fact that the agent is capable of causing fulminant hepatitis and that its use has been documented as the cause for at least three reported fatalities has resulted ultimately in the agent being discontinued. |
| Iproniazid (Marsilid, Rivivol, Euphozid, Iprazid, Ipronid, Ipronin, Propilniazida) | Moderate-Major | A monoamine oxidase inhibitor (MAOI) that was developed as the first anti-depressant. |
| Isocarboxazid [Marplan] | Major | the use of one or more MAOIs together at the same time can result in an increased or even uncontrolled hypertensive effect (hypertensive crisis). Furthermore, because the combination use of one or more MAOIs at the same time may also enhance the serotonergic effect of each other, the risk of developing serotonin syndrome for the patient. |
| Isoniazid (Rifampicin, Rifamate, Rimactane) | Major | CYP2C19 inhibitors may increase the exposure to CYP2C19 substrates, increasing the risk of adverse effects and toxicity. This occurs due to a lack of metabolism resulting from the inhibition of CYP2C19. |
| Isoniazid [Isotamine, Laniazid, Nydrazid] | Major | CYP2C19 inhibitors may increase the exposure to CYP2C19 substrates, increasing the risk of adverse effects and toxicity. This occurs due to a lack of metabolism resulting from the inhibition of CYP2C19. |
| Isoprenaline hydrochloride [Isuprel] | Minor | Concurrent use of drugs known to increase blood pressure is expected to result in an increased risk for supine hypertension. Closely monitor the patient for elevated blood pressure (including in supine and head-elevated positions) and for any evidence of toxicity. |
| Lamotrigine (Lamictal) | Moderate | Central nervous system (CNS) depressants can cause sedation, falls, respiratory depression, coma, and death. Medication used to treat epilepsy and stabilize mood in bipolar disorder. |
| Linezolid [Zyvox, Zyvoxam, Zyvoxid] | Major | The risk or severity of serotonin syndrome can be increased |
| Lithium carbonate [Lithane, Lithmax, Lithobid, Eskalith] | Moderate | The risk or severity of serotonin syndrome can be increased |
| Lofepramine (Gamanil, Lomont, and Tymelyt) | Moderate | |
| Loratadine (Alavert, Wal-itin, Claritin, Aleve, Roletra) | No interaction | |
| Macromerine | Moderate | Macromerine is a psychedelic, hallucinogenic and entheogenic of the phenethylamine family. |
| Maprotiline Hydrochloride [Ludiomil] | Major | Co-administration of tetracyclic antidepressants with a MAOI may lead to elevated levels of circulating catecholamines 2,1 and increased risk for developing antidepressant-related adverse reactions. |
| MDMA (Ecstacy) | Moderate - Major | Using MDMA (ecstasy) with MAOIs may cause a severe increase in blood pressure, increasing the chances for stroke and cerebral hemorrhage Fatalities resulting from combining amphetamines with pharmaceutical MAOIs have been recorded in the medical literature. |
| Melitracen | Major | May increase the serotonergic activities of Melitracen. |
| Meperidine hydrochloride - Pethedine [Demerol] | Major | Synthetic opioid pain medication, the risk or severity of serotonin syndrome and opioid toxicity can be increased |
| Metamfetamine hydrochloride [Desoxyn] | Major | Due to synergistic effects, the concurrent use of these medications may result in serotonin syndrome. This can cause headaches, fever, hypertensive crisis, as well as arrhythmias. |
| Metaproterenol / Orciprenaline Sulfate / Orciprenalina [Alupent, Metaprel] | Minor | The risk or severity of hypertension can be increased |
| Metaraminol (Aramine) | Inconclusive | |
| Methyldopa (Aidomet) | Major | Since methyldopa is an antihypertensive agent, co-administration of methyldopa with a MAOI may lead to altered hypotensive actions of methyldopa. |
| Methylphenidate [Ritalin, Jornay] | Major | Risk of severe hypertension. When coadministered with a MAO inhibitor, the hypertensive actions of methylphenidate may be potentiated which may result in hypertensive crises 1. This interaction applies to both immediate release and sustained release forms of methylphenidate and its isomers. |
| Mianserin hydrochloride | Major | |
| Milnacipran hydrochloride [Savella] | Major | Both monoamine oxidase inhibitor (MAOI) and selective serotonin reuptake inhibitor (SSRI) drug classes work by increasing the levels of circulating serotonin. Co-administration of agents from the drug classes may result in potentiated levels of serotonin at the synapse, enhanced serotonergic effects, and increased risk for developing serotonin toxicity, including fatal serotonin syndrome. |
| Minaprine (Brantur, Cantor) | Moderate | A monoamine oxidase inhibitor antidepressant drug, a role as an antidepressant, a serotonin uptake inhibitor |
| Mirtazapine [Remeron] | Minor | May increase the serotonergic activities of Mirtazapine. |
| Moclobemide (Manorix, Amira, Aurorix, Clobemix, Depnil) | Moderate-Major | Reversible MAOI. the use of one or more MAOIs together at the same time can result in an increased or even uncontrolled hypertensive effect (hypertensive crisis). Furthermore, because the combination use of one or more MAOIs at the same time may also enhance the serotonergic effect of each other, the risk of developing serotonin syndrome for the patient. |
| Modafinil [Provigil,Nuvigil] | Moderate | Avoid mixing with ayahuasca |
| Montelukast (Singulair, Xalar) | No interaction | |
| Naratriptan hydrochloride [Naramig] | Moderate | Triptans (Serotonin Receptor Agonists) for migraine and headaches, The coadministration of monoamine oxidase A (MAO-A) inhibitors with substrates of this enzyme may lead to decreased metabolism and excretion, potentiating the toxicity of MAO-A substrates. |
| Nefazodone hydrochloride | Major | May increase the serotonergic activities |
| Nialamide (Niamid, Niamide, Nuredal, Surgex) | Moderate-Major | Non-selective, irreversible monoamine oxidase inhibitor of the hydrazine class that was used as an antidepressant. It was withdrawn by Pfizer several decades ago due to the risk of hepatotoxicity. |
| Nisoxetine | Inconclusive | A potent and selective inhibitor of norepinephrine uptake, |
| Nomifensine | Inconclusive | Nomifensine is a norepinephrine-dopamine reuptake inhibitor, i.e. a drug that increases the amount of synaptic norepinephrine and dopamine available to receptors by blocking the dopamine and norepinephrine reuptake transporters. |
| Norepinephrine [Levophed] | Minor | |
| Nortriptyline hydrochloride [Aventyl, Pamelor] | Major | May increase the serotonergic activities of Nortriptyline. |
| Orphenadrine citrate [Orfenace, Norflex] | Moderate | Central nervous system depressants may potentiate the effects of orphenadrine, due to synergistic pharmacological effects. |
| Oxybutynin chloride [Ditropan, Gelnique] | Moderate | The subject drug is known to be an inhibitor of CYP2D6 while the affected drug is reported to be metabolized by CYP2D6. Concomitant administration of these agents can cause an increase in the serum concentration of the affected drug due to a decrease in metabolism by CYP2D6, which may result in increased incidence and/or severity of adverse effects related to the affected drug. |
| Oxymetazoline hydrochloride (Afrin, Upneeq, Rhofade) | Moderate | Usually avoid combination. Use combination only under special circumstances, avoid in some patients. |
| Pargyline (Eutonyl) | Inconclusive - likely moderate-major | Pargyline is an irreversible selective monoamine oxidase-B inhibitor drug It was brought to market in the US and the UK by Abbott in 1963 as an antihypertensive drug branded "Eutonyl". It was one of several MAO inhibitors introduced in the 1960s including nialamide, isocarboxazid, phenelzine, and tranylcypromine. |
| Paroxetine (Paxil, Seroxat) | Major | An antidepressant of the selective serotonin reuptake inhibitor class |
| Pemoline (Cylert) | Inconclusive | A stimulant medication which has been used in the treatment of attention-deficit hyperactivity disorder and narcolepsy. It has been discontinued in most countries due to rare but serious problems with liver toxicity; its risk outweighed its benefit. |
| Phendimetrazine [Fendique, Plegiline] | Major | May increase the hypertensive activities of Phendimetrazine. |
| Phenelzine [Nardil] | Major | Norepinephrine is an endogenous chemical substance that can cause blood vessels to constrict as a means to raise blood pressure. Since one of the principal mechanisms of action of Monoamine Oxidase Inhibitors (MAOIs) involves inhibiting the destruction of norepinephrine, the use of one or more MAOIs together at the same time can result in an increased or even uncontrolled hypertensive effect (hypertensive crisis). Furthermore, because the combination use of one or more MAOIs at the same time may also enhance the serotonergic effect of each other, the risk of developing serotonin syndrome for the patient. |
| Phenergan | Moderate | |
| Phenmetrazine | Major | Its actions and mechanisms are similar to dextroamphetamine. A stimulant drug first synthesized in 1952 and originally used as an appetite suppressant, but withdrawn from the market in the 1980s due to widespread abuse. |
| Phentermine hydrochloride [Adipex-P, Lomaira] | Major | May increase the hypertensive activities of Phentermine. |
| Phenylalanine | Inconclusive | |
| Phenylephrine hydrochloride (Dimetane, Dristan decongestant, Neo Synephrine, 4-way, Sudo-tab, Mydfrin) | Major | As monoamine oxidase inhibitors may increase the levels of catecholamines, the pressor effect of α1-adrenergic receptor agonists may be enhanced when used in combination with MAOIs. This may lead to a hypertensive crisis. |
| Phenylpropanolamine | Minor | In many cold medications. The risk or severity of hypertension can be increased, make sure it is not mixed with Acetaminophen, as this increases interaction to Moderate. |
| Procainamide hydrochloride [Procan, Pronestyl] | Major | |
| Procarbazine hydrochloride [Matulane] | Major | Norepinephrine is an endogenous chemical substance that can cause blood vessels to constrict as a means to raise blood pressure. Since one of the principal mechanisms of action of Monoamine Oxidase Inhibitors (MAOIs) involves inhibiting the destruction of norepinephrine, the use of one or more MAOIs together at the same time can result in an increased or even uncontrolled hypertensive effect (hypertensive crisis). Furthermore, because the combination use of one or more MAOIs at the same time may also enhance the serotonergic effect of each other, the risk of developing serotonin syndrome for the patient. |
| Promethazine hydrochloride [Phenergen, Phenadoz] | Moderate | The risk or severity of extrapyramidal symptoms can be increased |
| Protriptyline hydrochloride (Vivactil) | Major | May increase the serotonergic activities |
| Prozac | Major | Selective Serotonin Re-uptake Inhibitors (SSRIs), antidepressant, |
| Pseudoephedrine hydrochloride [Nexafed, Wal-phed, Sudafed] | Major | Monoamine oxidase inhibitors (MAOIs) impede amphetamine metabolism, leading to potentiated effects of amphetamine and enhanced release of norepinephrine and other monoamines from adrenergic nerve endings. Due to synergistic effects, the concurrent use of these medications may result in serotonin syndrome. This can cause headaches, fever, hypertensive crisis, as well as arrhythmias. |
| Quetiapine fumarate (Seroquel) | Moderate | Incidences of orthostatic hypotension have occurred with monoamine oxidase inhibitors (MAOIs) therapy 1. Co-administration of hypotensive drugs in presence of a MAOI may result in increased risk for developing orthostatic hypotension due to an additive effect. |
| Quinidine sulfate (Quinidex) | Major | |
| Rabies vaccine | No interaction | |
| Rasagiline mesylate [Azilect] | Major | Norepinephrine is an endogenous chemical substance that can cause blood vessels to constrict as a means to raise blood pressure. Since one of the principal mechanisms of action of Monoamine Oxidase Inhibitors (MAOIs) involves inhibiting the destruction of norepinephrine, the use of one or more MAOIs together at the same time can result in an increased or even uncontrolled hypertensive effect (hypertensive crisis). Furthermore, because the combination use of one or more MAOIs at the same time may also enhance the serotonergic effect of each other, the risk of developing serotonin syndrome for the patient. |
| Reboxetine mesilate | Moderate | Central nervous system (CNS) depressants can cause sedation, falls, respiratory depression, coma, and death |
| Reserpine (Renese-R, Serpasil) | Moderate | Reserpine is an indole alkaloid, antipsychotic, and antihypertensive agent that promotes the release of monoamines 1. Since monoamine oxidase inhibitors (MAOIs) work by preventing the breakdown of monoamines, co-administration of reserpine with a MAOI may result in increased risk for adverse reactions related to reserpine due to elevation of serotonin and norepinephrine levels. |
| Risperidone tartrate [Risperdal, Uzedy] | Moderate | Serotonin modulators often inhibit cytochrome CYP2D6 in the liver. This enzyme metabolizes several antipsychotics. This may lead to increased adverse effects of the antipsychotics metabolized by CYP2D6. |
| Rizatriptan benzoate [Maxalt] | Major | Triptans. When co-administered, MAO-A inhibitors, such as the subject drug, can attenuate rizatriptan metabolism, increasing the systemic exposure of rizatriptan and elevating the risk for drug-related adverse events |
| Robitussin-DM | Major | |
| Salmeterol xinafoate [Serevent] | Minor | Concurrent use of drugs known to increase blood pressure is expected to result in an increased risk for supine hypertension. Closely monitor the patient for elevated blood pressure (including in supine and head-elevated positions) and for any evidence of toxicity. |
| Selegiline [Emsam] | Major | the use of one or more MAOIs together at the same time can result in an increased or even uncontrolled hypertensive effect (hypertensive crisis). Furthermore, because the combination use of one or more MAOIs at the same time may also enhance the serotonergic effect of each other, the risk of developing serotonin syndrome for the patient. |
| Selegiline hydrochloride [Zelapar, Emsam, Eldepryl] | Major | Norepinephrine is an endogenous chemical substance that can cause blood vessels to constrict as a means to raise blood pressure. Since one of the principal mechanisms of action of Monoamine Oxidase Inhibitors (MAOIs) involves inhibiting the destruction of norepinephrine, the use of one or more MAOIs together at the same time can result in an increased or even uncontrolled hypertensive effect (hypertensive crisis). Furthermore, because the combination use of one or more MAOIs at the same time may also enhance the serotonergic effect of each other, the risk of developing serotonin syndrome for the patient. |
| Sertraline hydrochloride [Zoloft] | Major | When sertraline is administered within 14 days of taking or stopping monoamine oxidase inhibitors, the risk of serotonin syndrome is increased. This drug interaction occurs because both drugs increase the level of serotonin at the synaptic cleft, potentiating serotonin-related adverse effects.1,3 Serotonin syndrome is a potentially life-threatening condition. Signs or symptoms consist of agitation, anxiety, tremor, restlessness, dilated pupils, ocular clonus, dry mucous membranes, and hyperreflexia.2 |
| Sibutramine (Meridia) | Moderate | Sibutramine, formerly sold under the brand name Meridia among others, is an appetite suppressant which has been discontinued in many countries. It works as a serotonin–norepinephrine reuptake inhibitor similar to a tricyclic antidepressant. |
| St. John’s Wort (hypericum perforatum) | Moderate | herbal antidepressant |
| Sumatriptan hemisulfate [Alsuma, Imitrex, Onzetra, Zembrace, Treximet] | Major | Triptans (Serotonin Receptor Agonists) for migraine and headaches, result in increased serum concentration levels of the agonists as well as a subsequent increase in risk and severity of adverse effects associated with the serotonin receptor agonists, including severe syncope, dizziness, bradycardia, and more. |
| Sumatriptan hemisulfate [Imitrex] | Major | A number of serotonin receptor agonists like rizatriptan, sumatriptan, and zolmitriptan are predominantly metabolized by the isoenzyme monoamine oxidase A (MAO-A) 4,5. Subsequently, if any such MAO-A metabolized serotonin receptor agonists are used concurrently with a monoamine oxidase inhibitor, there is a concern that the metabolism of the serotonin receptor agonists would be minimized. Such an interaction would consequently result in increased serum concentration levels of the agonists as well as a subsequent increase in risk and severity of adverse effects associated with the serotonin receptor agonists, including severe syncope, dizziness, bradycardia, and more. |
| Terfenadine (Seldane D) | Moderate | |
| Tesofensine | Inconclusive | Tesofensine is a serotonin–noradrenaline–dopamine reuptake inhibitor from the phenyltropane family of drugs, which is being developed for the treatment of obesity |
| Theophylline [Theo-24, Theo-Dur, Uniphyl, Quibron-T] | Major | |
| Tianeptine sodium [Stablon] | Major | Tianeptine increases the rate of serotonin re-uptake by neurons in the cortex and hippocampus 3. Concomitant use of tianeptine with a monoamine oxidase inhibitor (MAOI) that also exert serotonergic effects may lead to enhanced risk for serious interactions and reactions including serotonin syndrome. The risks of cardiovascular collapse, paroxysmal hypertension, convulsions, hyperthermia and death exist for the concomitant use of MAOIs with tianeptine based on experiences of co-administration of MAOIs with other antidepressants |
| Tramadol [Ultram, Qdolo] | Major | Risk or severity of serotonin syndrome and seizure can be increased |
| Tranylcypromine sulfate [Parnate] | Moderate | The subject drug is a moderate CYP2D6 inhibitor and the affected drug is metabolized by CYP2D6. Concomitant administration may decrease the metabolism of the affected drug, leading to increased serum concentrations as well as increased risk and severity of adverse effects. |
| Trazodone hydrochloride [Desyrel, Oleptro] | Moderate | May increase the serotonergic activities |
| Trimipramine [Surmontil, Stangyl]] | Major | Using tricyclic antidepressants within two weeks of taking MAOIs may cause serious side effects including sudden fever, extremely high blood pressure, convulsions, and death. Tricyclic antidepressants (TCAs) may lead to more severe adverse effects including serotonin syndrome |
| Tryptophan | Major | The risk or severity of serotonin syndrome and hypomania can be increased when Tryptophan is combined with Moclobemide. |
| Tyrosine | Major | Usually combined with other substances that should not be taken with ayahuasca, like: Bupropion or Metformin |
| Vanoxerine | Inconclusive | Vanoxerine is a piperazine derivative which is a potent and selective dopamine reuptake inhibitor. Vanoxerine binds to the target site on the dopamine transporter ~ 50 times more strongly than cocaine, but simultaneously inhibits the release of dopamine. |
| Venlafaxine hydrochloride [Effexor] | Major | Although rare, both venlafaxine and monoamine oxidase inhibitors (MAOIs) are associated with a risk of serotonin syndrome |
| Vicks formula 44-D | Major | |
| Viloxazine [Qelbree, Vivalan] | Major | Viloxazine falls under this precaution: the use of viloxazine with an MAOI may lead to a potentially life-threatening hypertensive crisis.. Viloxazine, sold under the brand name Qelbree and formerly as Vivalan among others, is a noradrenergic medication which is used in the treatment of attention deficit hyperactivity disorder in children and adults. |
| Yohimbine hydrochloride | Moderate | Central nervous system (CNS) depressants can cause sedation, falls, respiratory depression, coma, and death |
| Zimelidine | Major | Zimelidine (INN, BAN) was one of the first selective serotonin reuptake inhibitor (SSRI) antidepressants, withdrawn in 1984 because of its idiosyncratic side-effects. Similar effects have been introduced recently, of which fluvoxamine, fluoxetine and paroxetine are the best known |
| Ziprasidone hydrochloride [Geodon] | Moderate | Ziprasidone is associated with central nervous system (CNS) adverse effects such as drowsiness and dizziness; therefore, concomitant administration with other CNS depressants may exacerbate the associated adverse effects |
| Zolmitriptan [Zomig] | Major | Triptans. The co-administration of these agents can significantly increase the risk of serotonin syndrome, which typically manifests as changes to mental status, autonomic instability, seizures, and gastrointestinal upset. |
| Zoloft | Major | Selective Serotonin Re-uptake Inhibitors (SSRIs), antidepressant, |
| Zolpidem tartrate [Tovalt, Ambien] | Moderate | Zolpidem is known to exert CNS depressant effects. Administering CNS depressants with zolpidem may lead to profound CNS depression due to additive effects. In addition, “sleep-driving” and other complex behaviors may occur with zolpidem use while the patient is not fully awake. |
Many people interested in our ayahuasca retreats approach have specific questions about how ayahuasca interacts with certain types of medication or prescribed drugs.
We’ve created the table below to easily check whether the medication you’re on is compatible with ayahuasca.
Generally speaking, we ask that participants of our retreats suspend use of all types of medication and supplements at least 2 weeks prior to the retreat. There are, of course, specific types of medication, such as anti-depressants, that should not be suspended abruptly. Anyone taking medication that contains Monoamine Oxidase Inhibitors (MAOI’s) or meds that affects the serotonin system, should first consult with their psychiatrist – no exceptions.
How was this ayahuasca – drug interaction table created?
This table was created by first collecting the names of common pharmaceutical drugs that our visitors are taking, including a range of anti-depression medication. We also gathered drug names from online resources such as Reddit and a comprehensive list from Temple of the Way of Light (there are unfortunately many typos on their page which have been corrected in the table below).
From here we manually cross-checked drug interactions using online tools and databases such as Medscape UK and Drug Bank (we checked on both) to determine whether there may be interactions.
Since these databases don’t list “ayahuasca”, we used Moclobemide, which is a RIMA like the harmala alkaloids in ayahuasca and ideal for checking interactions.
All of this data has been compiled and included in the below directory so that you can conduct a search for your medication/drug.
How to use this table
You can use the table’s search field, or hit Control+F on your keyboard to search the entire page.
Interactions range from Minor to Moderate to Major, although some results are Inconclusive or there is No Interaction.
Important: We are still adding drugs and interactions to this table. If you don’t find yours, let us know and we would be happy to help.
