Ibogaine: Therapeutic Potential, Cardiac Safety, and Translational Perspectives in the Treatment of Substance Use Disorders—A Scoping Review
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Most comprehensive cardiac safety review to date; synthesises QTc prolongation, arrhythmias, 19+ fatalities; mechanistic analysis of hERG blockade and noribogaine-driven delayed cardiotoxicity
Dosing: Varies across reviewed studies; NOAEL 25mg/kg (preclinical) (oral)
Safety data present: QTC, HERG, ELECTROLYTE
Contraindications: Pre-existing cardiac arrhythmias, Congenital long QT syndrome, Concurrent QT-prolonging medications, CYP2D6 poor metaboliser status, Hepatic impairment, Electrolyte disturbances, Concurrent opioid use (respiratory depression; pharmacokinetic interaction), Concurrent methadone use (independent hERG blockade and QT prolongation; extremely long half-life), Active alcohol use or recent alcohol withdrawal (independent hERG inhibition; withdrawal-related seizure risk), Concurrent benzodiazepine use or recent benzodiazepine withdrawal (withdrawal-related seizure risk)