How toxic is ibogaine?
AI-extracted · unverified · confirm at source
Reviews 27 ibogaine fatalities and 8 cardiac case reports (QTc 460–730ms), 7 in patients without pre-existing cardiac conditions. CYP2D6 polymorphism affects toxicity. Noribogaine at least as cardiotoxic as ibogaine.
Dosing: 10–25 mg/kg therapeutic; toxicity cases typically >2g; Lambarène 8mg/tablet historical (oral)
Safety data present: QTC
Contraindications: Pre-existing cardiovascular conditions (cardiomyopathy, prior infarction, coronary stenosis), QT interval prolongation or family history of cardiac-rhythm abnormalities, CYP2D6 poor metaboliser status (requires ≥50% dose reduction), Concurrent medications metabolised by CYP2D6 (e.g., paroxetine doubles active moiety), Concurrent methadone or benzodiazepine use, Concurrent buprenorphine use (CYP3A4 competition slows ibogaine clearance), Concurrent use of other QT-prolonging substances, Unsupervised or limited medical supervision settings