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Rare but relevant: Ibogaine and cardiovascular complications—prolonged QT interval and ventricular arrhythmias

Brunt, Tibor Markus · 2026 · Addiction

Safety (cardiac & more) Review high

AI-extracted · unverified · confirm at source

Narrative review, no new primary fatalities: QTc prolongation at therapeutic doses even without cardiac history; CYP2D6 poor metabolisers at higher risk; safe dose ~0.87 mg/kg (10× lower, may lack efficacy); recommends genotyping + monitoring.

Dosing: Safe dose ~0.87 mg/kg (10× lower than therapeutic 8–14 mg/kg) (oral)

Safety data present: QTC, HERG, ELECTROLYTE

Contraindications: QTc prolongation (≥450 ms males, ≥460 ms females), CYP2D6 poor metaboliser status (genotyping recommended), Concurrent QT-prolonging medications, Doses exceeding ~0.87 mg/kg without cardiac monitoring

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