The adverse events of ibogaine in humans: an updated systematic review of the literature (2015–2020)

Ona, Genís, Mendes Rocha, Juliana, Bouso, José Carlos, Hallak, Jaime E. C., Borràs, Tre, Colomina, Maria Teresa, dos Santos, Rafael G. · 2021 · Psychopharmacology

AI-extracted · unverified · confirm at source

PRISMA systematic review of 18 studies (2015–2020): QTc prolongation most common AE (max 788ms), TdP in 5 cases, 1 fatality. Extends Alper 2012/Koenig 2015 series.

Dosing: 725 mg ibogaine HCl to 38 g dried root bark across reviewed studies; clinical trials used 20 mg ibogaine or 60–180 mg noribogaine (oral)

Safety data present: QTC, ELECTROLYTE

Contraindications: Pre-existing cardiovascular disease, Hypokalemia, Hypomagnesemia, Concurrent opioid/methadone use (synergistic QT prolongation), Concurrent cocaine use, CYP2D6 poor metaboliser status (2× increased ibogaine/noribogaine exposure), Hepatic impairment, Concurrent use of CYP2D6 inhibitors (e.g., paroxetine), Use of unstandardised root bark preparations (ibogaine content 0.6–11.2%), Concurrent use of P-glycoprotein substrates