Drug & supplement interaction

Ayahuasca + Flecainide

Flecainide brand name: Tambocor.

Moderate Interaction
The bottom line Moderate

Ayahuasca has a moderate interaction with Flecainide. Theoretically, ayahuasca might increase plasma concentrations of CYP2D6 substrates.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ayahuasca and Flecainide

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Flecainide

Flecainide falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Ayahuasca interacts with.

Theoretically, ayahuasca might increase plasma concentrations of CYP2D6 substrates.
Ayahuasca contains beta-carboline alkaloids, including harmine and harmaline. In vitro research suggests that the beta-carboline alkaloids might inhibit CYP2D6 enzymes. This effect has not been reported in humans.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for flecainide: your body relies heavily on a liver enzyme called CYP2D6 to clear it out. The beta-carboline compounds in ayahuasca (harmine and harmaline) appear to slow that enzyme down, at least in lab dish studies. If CYP2D6 gets blocked, flecainide can build up higher than intended.

That matters a lot here, because flecainide has a narrow safety window. Too much can actually worsen heart rhythm problems, cause dizziness, blurred vision, or dangerously slow or irregular heartbeats. To be fair, this effect has only been seen in test tubes, not in real people, so it stays theoretical for now. Still, with a heart-rhythm drug this serious, please loop in your doctor or pharmacist before mixing the two.

References
  1. Zhao, T., He, Y. Q., Wang, J., Ding, K. M., Wang, C. H., and Wang, Z. T. Inhibition of human cytochrome P450 enzymes 3A4 and 2D6 by β-carboline alkaloids, harmine derivatives. Phytother Res 2011;25(11):1671-1677.
  2. dos Santos RG. Safety and side effects of ayahuasca in humans--an overview focusing on developmental toxicology. J Psychoactive Drugs. 2013 Jan-Mar;45(1):68-78. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ayahuasca Also Interacts With Other Medications

Ayahuasca has 803 moderate known drug interactions in our database — the Flecainide one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Ayahuasca

Covers the 2,830 medications we’ve checked against Ayahuasca. Pick one to open its full report.

From our Q&A

Questions About Ayahuasca or Flecainide

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ayahuasca or Flecainide, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Flecainide

This page covers Ayahuasca only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Flecainide page lists 86 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 7 major · 61 moderate · 18 minor.

From our pharmacist’s overview on the Flecainide page

“Flecainide (Tambocor) exists to control serious heart rhythm problems, so anything that disturbs the rhythm it protects deserves genuine caution. Six of the seven major-rated entries among the 86 supplements and herbs on file, grapefruit in large amounts included, can prolong the QT interval, the heart's electrical reset time, adding t…”

Reviewed by 2 · Jul 18, 2026

Open the Flecainide interaction page

How much people look this up

Where Ayahuasca and Flecainide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ayahuasca
Top half

#654 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Flecainide
Top 25%

#631 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ayahuasca

What is Ayahuasca?

Ayahuasca
  • Spiritual and ceremonial rituals
  • Depression
  • Anxiety
  • Substance use disorders
  • Personal or emotional insight

Ayahuasca is a powerful psychoactive brew that combines a DMT-containing plant with a vine that allows the DMT to take effect, causing intense hallucinations. It is illegal in many places, can trigger dangerous reactions, and is not recommended for self-use; talk to a doctor or pharmacist before considering it.

Read the full Ayahuasca monograph & all interactions
Medication

About Flecainide

What Is Flecainide Used For?

Brand name: Tambocor

Flecainide Acetate tablets are used to prevent episodes of certain abnormal heart rhythms. In patients without structural heart disease, it is approved to prevent paroxysmal supraventricular tachycardia (PSVT — episodes of rapid heart rate starting above the ventricles) and paroxysmal atrial fibrillation/flutter (PAF — intermittent episodes of irregular, rapid heart rhythm in the upper chambers), when these cause disabling symptoms.

Flecainide Acetate tablets are also used to prevent life-threatening ventricular arrhythmias — dangerous rapid rhythms starting in the lower chambers of the heart, such as sustained ventricular tachycardia. It is not recommended for less serious ventricular arrhythmias, for patients with a recent heart attack, or for chronic (ongoing, persistent) atrial fibrillation.

See full Flecainide drug information
Keep checking

Other Drugs & Ayahuasca

Browse every other medication we’ve checked against Ayahuasca — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
803Moderate
0Minor
2,026No known interaction
Moderate

803 interactions

Showing 60 of 803 moderate interactions — see all 803 on the Ayahuasca page.

No interaction 2,026 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Ayahuasca and Flecainide Together: Common Questions

Can you take Ayahuasca with Flecainide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Ayahuasca and Flecainide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Flecainide and Ayahuasca?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.