Drug & supplement interaction

Ayahuasca + Mexiletine

Mexiletine brand name: Mexitil.

Moderate Interaction
The bottom line Moderate

Ayahuasca has a moderate interaction with Mexiletine. 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 Mexiletine

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

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Mexiletine

Mexiletine 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 mexiletine: your liver leans on an enzyme called CYP2D6 to clear it from your body. Ayahuasca's beta-carboline compounds (harmine and harmaline) appear to slow that same enzyme down. If CYP2D6 is blocked, mexiletine can build up to higher levels than usual, and that's worth paying attention to because mexiletine is a heart rhythm drug with a fairly narrow safety margin.

Higher levels could mean more side effects like nausea, tremor, dizziness, lightheadedness, or, less commonly, the very rhythm problems it's meant to control. I'll be honest though, this comes from lab studies only and hasn't been shown in real people. Still, given mexiletine's job and ayahuasca's other serious risks, please loop in your doctor or pharmacist before combining them.

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 Mexiletine 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.

Everything else you take

See Every Supplement That Interacts With Mexiletine

This page covers Ayahuasca only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mexiletine page lists 152 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), 1,3-dmaa (moderate), Acacia Rigidula (moderate), Active Hexose Correlated Compound (ahcc) (moderate) and Adrafinil (moderate).

By severity: 1 major · 107 moderate · 44 minor.

From our pharmacist’s overview on the Mexiletine page

“Mexiletine (Mexitil) steadies the heart's rhythm, and its benefit depends on holding a fairly precise blood level, so the 152 supplements on this list deserve real attention rather than a shrug. Only one entry, activated charcoal, is rated major, because it can soak up the drug in the gut and cut how much actually reaches your bloodstr…”

Reviewed by 2 · Jul 18, 2026

Open the Mexiletine interaction page

How much people look this up

Where Ayahuasca and Mexiletine 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

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

29 days ago today
Medication Mexiletine
Top half

#727 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 Mexiletine

What Is Mexiletine Used For?

Brand name: Mexitil

Mexiletine Hydrochloride capsules are indicated for the treatment of documented, life-threatening ventricular arrhythmias — for example, sustained ventricular tachycardia (a dangerously fast heart rhythm originating in the lower chambers). Because mexiletine itself can trigger arrhythmias, it is not recommended for minor or symptom-free irregular heartbeats.

Treatment is started in a hospital setting so heart rhythm can be monitored closely. Antiarrhythmic drugs, including mexiletine, have not been shown to improve overall survival in patients with ventricular arrhythmias.

See full Mexiletine 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 Mexiletine Together: Common Questions

Can you take Ayahuasca with Mexiletine?
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 Mexiletine 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

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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.