Risk Assessment of Herbal Preparations Containing Tabernanthe iboga
AI-extracted · unverified · confirm at source
RIVM advises against consumer use of T. iboga; 34 sudden deaths tabulated (from 4.5 mg/kg); QTc prolongation not dose-dependent across individuals; no safe dose derivable
Dosing: 1–30 mg/kg bw oral (common use); 0.3–55 mg/kg bw (clinical studies); LD₅₀ 263 mg/kg bw mice, 327 mg/kg bw rats; noribogaine LD₅₀ 630 mg/kg bw mice (oral)
Safety data present: QTC, ELECTROLYTE
Contraindications: Pre-existing cardiac disease (cardiomyopathy, valvular disease, coronary artery disease), History of myocardial infarction, Active neurological disorders (cerebellar dysfunction, organic brain disease, dementia), Active psychiatric disorders (psychosis, bipolar illness, major depression), Hepatic or renal impairment, Gastrointestinal disease, Concurrent use of CYP2D6 inhibitors (e.g. paroxetine), Concurrent use of QT-prolonging medications, Concurrent methadone use (extremely long half-life 15–55 hours), Concurrent benzodiazepine use, Concurrent opioid agonist use, Concurrent cocaine or stimulant use, CYP2D6 poor metaboliser status (higher ibogaine plasma levels, altered toxicokinetics), P-glycoprotein substrate medications (ibogaine inhibits P-gp), Hypokalemia or hypomagnesemia