How dangerous is ibogaine treatment?
- Ibogaine is safe if it is used correctly. But to administer it correctly and safely takes training as there are quite strict protocols that must be followed to ensure the safety of the person undergoing ibogaine treatment.
- Ibogaine does not mix well with certain medical conditions, medicines, foods and supplements.
- You must also be prepared physically, emotionally / spiritually for this experience.
- On this page we aim to educate you of the potential risks involved and how to avoid or prepare for them.
- We strongly recommend you seek out a reputable ibogaine provider or ibogaine treatment centre. Don´t be scared to ask them questions
Check they know their stuff!
A good provider will be able to advise you whether you are a good candidate for this work and what to do to prepare for your ibogaine journey. Educate yourself and follow the advice, it will make your journey safer and smoother.
Health Dangers with Ibogaine
Before you take ibogaine your ibogaine provider should interview you about your health. A good provider will ask for a ECG / EKG heart test and a blood panel showing electrolyte levels and may require further tests such as liver function or stress ECG in some cases.
They should also ask about all the medication you currently take and let you know if any of them are bad mixes (contraindicated) with ibogaine. They will be particularly interested in any health conditions you have, especially anything to do with the heart.
Typically if you passed the above tests without any issues and your ibogaine provider knows their stuff. You should be good to move onto preparing for your journey. Most people can take ibogaine safely if they are correctly prepared, monitored and guided through the process. It’s important to remember that ibogaine and iboga mix badly with many other medicines and drugs, even to medications we might not have thought of like antibiotics, herbal remedies and health food supplements.
During the ibogaine experience your heart and general health will need to be carefully monitored and medical interventions may need to be administered by your ibogaine provider or health professional.
For a list of medicines and medical conditions that are contraindicated please visit our Ibogaine Medical Contraindications page
Ibogaine and the heart
Ibogaine is known to effect the heart. So it will require checking out beforehand and during your process, this is what the EKG/ECG and blood panel are for. If you have pre-existing heart conditions or take medication that effects the heart, you need to tread with extra caution and may not be a good candidate for this work as ibogaine does not interact well with some other drugs or pre-exisiting conditions.
- Ibogaine affects the heart and the cardiovascular system.
- Usually lowers the heart rate, although it can raise it too.
- It interacts with cardiac ion hERG channels, which can pose a risk to the heart
- It can raise or lower blood pressure to dangerous levels
- It prolongs QT interval, which puts people at risk of life threatening heart events like a heart attack
- Puts people at risk of overdose if consumed with other drugs like heroin and cocaine.
Summary of most common deaths:
- Low electrolytes potassium and magnesium, vital for heart function. 100% of all ibogaine related deaths had low electrolyte levels. So hydration is very important prepartion prior to your treatment.
- Most had Prolonged QT’s
- VF: ventricular fibrillation; TdP: torsade de point; VT: ventricular tachycardia; Were also common alongside the prolonged QT’s
- Sudden death was also a common cause of death in the other cases
- Drug overdose during or after an ibogaine treatment due to the deep physical reset.
- Interactions with contraindicated drugs, medicines, supplements, herbal remedies.
- Pre-existing medical conditions
- Co-exisiting problems to do with the heart included: coronary artery sclerosis, hypertension, myocardial infarct, cardiac hypertrophy, and dilated cardiomyopathy
- Seizures caused by Benzodiazepine withdrawal. Ibogaine does not help with the physical aspect of a benzo withdrawal, (benzos are things like valium, diazepam, xanax, there are many variations often ending with the suffix “..pam”).
- Full list of Ibogaine Medical Contraindications here
QT Prolongation and Ibogaine
The QT interval is a measurement made on an electrocardiogram used to assess some of the electrical properties of the heart.
As ibogaine extends QT it is important that your QTc is less than 430 for a man and less than 450 for a woman.
Ideally for a flood dose (a large dose) a QTc should be below 400.
A QTc of >470 and >450 ms was associated with an increased risk of sudden death.
Blood Pressure and Heart Rate
Ibogaine can lower or raise both the heart rate (pulse) and blood pressure to dangerous levels which can put the patient at risk.
Ibogaine typically causes Bradycardia (a low pulse below 60bmp) although can also cause Tachycardia (a high pulse).
Your blood pressure and pulse will need to be monitored before, during and after your ibogaine flood dose and your ibogaine provider or medical professional should be equiped to manage typical heart events.
When does it become dangerous?
The ibogaine deaths occurred between 1.5–76 hours after drug intake. It has a half-life of only 4–7 hours but converts to noribogaine which is believed to stay in the body for a long time after dosing (potentially months).
Also, QT interval prolongation after ibogaine administration typically lasts for more than 24 hours and has even been observed to occasionally last for longer than a week. So these conditions may need to be observed from anywhere from a few days to weeks after ibogaine consumption. Again your ibogaine provider should be able to advise you.
Stopping Contraindicated Medication
Contraindicated Medication means any medicines that are a bad mix with ibogaine. This also includes most illicit drugs, some foods, health supplements and herbal remedies.
Any medication that you are advised to stop should be carefully managed and checked to make sure it is safe for you to stop taking it. Consultation with your physician is advised. Typically you will be asked to stop any contraindicated medicine 4 to 7times the half life of that medicine. Half-lives can be found online. It is important to check it out early on as some medications can take weeks to get out of the system, whilst others only a day or so.
If you cannot stop taking it, or move to a substitute that is not contraindicated, you may be considered a bad candidate for this work or a microdosing regime may be suggested.
Ibogaine should be administered under strict observation, some people believe it should only be done with continuous electrocardiographic monitoring (until the T wave normalises). Although this is disputed by some in cases were patients have good health and preparation. Although even in these cases the heart will be continuously monitor with a blood pressure cuff and an EKG / ECG and bloodpanel will have been taken as a part of a thorough prescreening protocol before treatment.
The Following Should be considered Risk factors:
- A prolonged QT
- Bradycardia (low pulse below 60bpm) and Tachycardia (high pulse)
- High or low blood pressure (High Blood Pressure is anything over 140/90 and Low Blood pressure anything below 90/60)
- Abnormal electrolyte levels (in particular Low Potassium and Magnesium)
- Pre-existing heart disease
- Ion channel (e.g., hERG) mutations
- Drug-drug interactions (any medication, supplements, herbal remedies, drugs you currently take)
- Genetic variants influencing drug metabolism (How fast a body processes the drug)
- Please view full list here: Ibogaine Medical Contraindications
For anti-addiction treatment with ibogaine, two among the named risk factors deserve special attention:
- Bradycardia (slow heart rate) Ibogaine itself induces bradycardia
- Hypokalaemia (Low Potassium). Hypokalaemia is frequent in drug users
Pre-Existing Health Conditions That Require Consideration
People with these conditions may still be able to take ibogaine under the right conditions but require special attention and preparation
- Prolonged QT
- Heart problems. Such as coronary artery sclerosis, hypertension, myocardial infarct, cardiac hypertrophy, and dilated cardiomyopathy
- Hepatitis, liver cirrhosis and steatosis (may still be able to take it)
- Circulatory problems
- Bradycardia and hypotension
- Bi-polar – May have mania for a few weeks after then feel better
- Irregular heart rhythms (Arrhythmias)
- Childhood congenital heart defects
- Heart attack (Myocardial Infarction)
- Coronary Vasospasm – which is a constriction of the coronary artery
- Valve Stenosis (Valve that doesn’t open properly because it is too narrow)
- Regurgitation (Leaking Heart Valve)
- Prolapse (Stretchy Valves)
- History of Pericarditis (Inflammation of the Pericardium – fibrous sack around heart)
- History of Endocarditis (Inflammation of the inside lining of the heart chamber)
- Get an echocardiogram for any of the above.
- Family history of heart attack/sudden cardiac death before 50 years of age
- Major heart/vascular/pulmonary surgery i.e. transplant, Coronary Artery Bypass Grafting, artificial heart valves, surgeries for Coronary Heart Disease, other surgeries.
- Internal or External Pacemaker
- History of blood clots
- Stroke or transient ischemic attack
- Deep vein thrombosis.
- Abnormal Heart Rate/Rhythm
o Resting heart rate of ≥120 beats per minute or higher; or ≤50 beats per minute
- High/Low blood pressure (Hypertension /Hypotension)
- Other cardiac disease risk factors
- Certain psychiatric conditions.
- No accessible veins for IV port access
- Irregular Thyroid
- Major respiratory conditions
- Metabolism, Diet, and Gastrointestinal Issues
- CMC or Metabolic Panel results outside of normal ranges (Electrolyte levels)
- Constipation or Impaction
- Obesity, Anorexia, Bulimia, Eating disorders
- Crohn’s disease, Irritable bowel syndrome, diverticulosis, diverticulitis
- Pancreatitis – inflammation of the pancreas
- Chronic infectious diseases (i.e. Tuberculosis, Hepatitis B or C, HIV)
- Overdose history
- History of head trauma with loss of consciousness for a significant amount of time
- Age 60+
- Family history of certain psychiatric conditions primarily in patients under 30 years of age
- Bipolar disorder
- Depersonalization and/or Derealization disorder
- Cerebellar dysfunction
- Organic brain disease
Absolute Exclusion Criteria –
These conditions exclude people from being treated with ibogaine due to the gravity of the risks
Certain psychiatric conditions
• Bipolar disorder for which patient has been hospitalized or medicated
• Depersonalization and/or Derealization Disorder
• Cerebellar dysfunction
• Psychosis or acute confusional state
• Organic brain disease
Certain pre-existing heart conditions
- Patients with blood pressure above 170 mm Hg systolic/105 mm Hg diastolic or below 80 mm Hg systolic/60 mm Hg diastolic
- A pulse greater than 120 beats per minute or less than 50 beats per minute.
- Prolonged QTc Interval ( > 450 milliseconds for males and > 470 milliseconds for females)
- History of heart failure, enlarged or hypertrophic heart
- Active blood clots / Pulmonary embolism / Deep vein thrombosis
- Certain major respiratory conditions
- Low oxygen levels and required steroid treatments lead to excessive risks.
- Chronic Obstructive Pulmonary Disorder
- Cystic Fibrosis
Severe or chronic gastrointestinal issues
• Bleeding ulcer
• Leaky gut syndrome
Other criteria for absolute exclusion
- Abnormal blood test results, especially if potassium or magnesium are outside normal ranges they should be corrected.
- Impaired Kidney or Liver function
- Any patient with liver enzymes greater than 2.5 times normal levels, on dialysis for kidney failure
- Abnormal Blood Urea Nitrogen (BUN) or creatinine (break down of creatine phosphate in muscles) levels
- Active infection or abscess
- Within 6 months of major surgeries.
For a more detailed list of medical conditions and drugs that are contraindicated please visit our Ibogaine Medical Contraindications page
Baseline screening must include:
- A medical evaluation
- Physical examination
- ECG recording,
- Blood chemistries & electrolyte levels
- Haematological workup (blood test showing health of the body)
- Psychiatric Report
- Chemical dependency evaluations.
In some cases, more extensive evaluations are required to rule out cardiac risk factors. Liver function tests may be required in some cases.
Drug Interactions with Ibogaine
Many drugs, medicines and some foods, health supplements and herbal remedies don’t mix well with ibogaine and iboga.
- Alcohol, cocaine, opiates, amphetamine, subutex and methadone. Very dangerous if these substances are still in your system when ibogaine is applied.
- Any mediciation that inhibits enzyme CYP2D6 (30% of most drugs are).
- Medicines / drugs that prolong the QT
- Medicines / drugs that cause bradycardia
- Anything that effects the heart
- Centrally acting medication
- Most psych meds and anti depressants are very bad mixes
- Many health food supplements such as Kava Kava and plants containing MAOI’s
- DO NOT STOP BENZODIAZIPINES (diazepam, valium, xanax, etc). It is important that you do not stop taking your usual dose of benzos. Stopping benzos during ibogaine can cause seizures. Ibogaine doesn’t help for benzo withdrawals.
- Since noribogaine is similar to ibogaine these conditions may need to be observed for several weeks after.
- For a full list of medicines and drugs that are contraindicated please visit our Ibogaine Medical Contraindications page
Different people process ibogaine differently. Some are much more sensitive than others. How quickly someone metabolises ibogaine is also of concern. Usually a test dose will give your provider an idea of this.
People can be divided into different classes of metabolisers:
In poor noribogaine metabolizers, a single ibogaine dose may create effects persisting for weeks.
Ibogaine Flood Dose
- A flood dose is a large dose of ibogaine which typically produces visions and ataxia (wobbly).
- Dosage is usually worked out based on your weight, BMI, and observation of your provider.
- The term “Flood Dose” can vary in meaning and is not an exact quanity. But it is typically considered a strong dose. Some people may call a strong flood dose an intitiation dose, such as initiates to the African iboga cult Bwiti might undergo as part of their initiation into the religion.
- It is considered a very special event, many people reporting deep and profound healings and change coming from this ceremony.
- But, not unsurprisingly, a flood or initiation dose carries more risk than other methods of taking iboga or ibogaine.
- At these high doses there is a strong likelyhood of physical changes occuring in the body, including QT and QTc prolongation, increased or decreased blood pressure and heart rate. Bloackade of hERG ions channels.
- Therefore you must be monitored continously and for the following days following administration of a flood dose to ensure that these changes stay within safe parameters.
- This is usually done with a blood pressure cuff and a ECG.
- Typical floods can range from 12mg/kg to 22mg/kg of HCL ibogaine. Many people believing that 18mg/kg+ is necessary to break an opiate habit (some people sayin that this should be administered within a four hour window).
- Psycho-spiritual doses could be as low as 7mg/kg.
- Quantities can change dramatically depending on which form of ibogaine your provider uses either: HCL, PTA, TA or Rootbark. With HCL being measured by the milligram and rootbark by the spoon (or in grams).
- Mg to kg measurements are rough guides and your ibogaine provider will adjust it based on your ideal BMI, and their observations of your sensitivity and metabolism rate.
- They may be modified for other reasons such as health concerns.
- Your ibogaine provider should work all of this out for you based on your pre-screening and their personal observations.
- If a person is under or over weight then their ideal BMI needs to be considered alongside sensitivity and metabolism. The dosages should be adjusted based on the observations of a trained professional.
- It’s important that this is worked out very carefully as 24mg/kg is considered the upper limit and that it is dangerous to go above that amount.
- It is possible to overdose on ibogaine and it could cause a fatal heart event like a heart attack or toursades. So it is important that this is done by someone who knows what they are doing as overdose could result from an error in calculations.
*Note: All weights are based on Ibogaine HCL, these weights would change (drastically in many cases) depending on the form of iboga or ibogaine you are taking.
Low dose and Microdosing Ibogaine
- Often for people with health concerns (or those wishing to avoid the visions) a microdosing regime or a series of smaller floods (called Low Dose Regime) may be recommended.
- People can typically reduce their opiate habit by 25% a day by using a correctly managed ibogaine low dose and microdosing detox.
- Mixing ibogaine with opiates is very dangerous as the risk for overdose is VERY high.
- These kinds of detoxes need to be managed in a safe place, controlled way by trained staff. With special attention being paid to timings, drug quantities and patients state.
Summing up ibogaine safety
Assuming protocol is followed by a skilled ibogaine provider, paying special attention to monitoring cardiac condition throughout the treatment, you´ve prepared correctly, don’t have any pre-existing medical conditions or take any substance that interacts with ibogaine in a bad way, then you are going to be fine.
The experience can be intense and you will need to be cared for during the process. Your ibogaine provider should regularly check your blood pressure and monitor your cardiac health throughout and give you advice for preparation prior to arrival
“I know you’re tired but come, this is the way.”
Most of this website content was written by Rich Hughes, as well as the website creation itself.
In the photo to the left, he is the man on the right hand side.
He worked and volunteered for more than 5 years at various ibogaine detox clinics in México and Portugal before striking out on his own in Spain, his clinic is called Madera Sagrada which is Spanish for sacred wood, the indigenous Bwiti name for iboga.
During this time he has experienced the good, the bad and the ugly of ibogaine treatment; from the countless dozens who gained their freedom and even witnessing a death whilst working as a volunteer. This drove him to better understand the health and safety aspects, including how to read an ECG/EKG and an advanced first aid course.
It is with his hard won information, and a desire to see ibogaine knowledge distributed around the world, saving lives, as it has saved his life from Crack and heroin addiction.
"I´m just a common man who through his own experience and desire has studied ibogaine and iboga and their correct administration. I stand on the shoulders of giants and through my web and graphic design skills I´ve decided to disseminate this info to a wider audience, with the hope of spreading liberty to those that desire it
Learn about the jaw-dropping benefits of Ibogaine and Iboga. They do so much more than just addiction treatment
Ibogaine can be dangerous for some people. Educate yourself to see if you are a good candidate for this work
Learn what medication and medical health conditions are a bad mix with ibogaine and iboga.
Make sure you go to a good place! There are some shady operations going on out there…
Talk to us!
Our knowledgeable volunteers will share their personal experience of ibogaine with you and advise you on how to find a good clinic.
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We wish you luck on your journey. This incredible medicine has changed so many lives, but to do safe and effective work it must be treated with respect.
It’s important that you find a good provider or clinic to do your ibogaine treatment with. Don’t end up with the cowboys!
We do our best to keep this website updated as our collective knowledge and experience of the use of ibogaine grows, and we would love you contributions and suggestions. Email us
Ibogaine Adverse Reactions & Safety – Jamie Mac – Ibogaine / Cardiac Nurse – Notes from the European Ibogaine Forum