Drug & supplement interaction

Ayahuasca + Tolcapone

Tolcapone brand name: Tasmar.

Moderate Interaction
The bottom line Moderate

Ayahuasca has a moderate interaction with Tolcapone. Theoretically, ayahuasca might have additive effects when used with dopamine agonists.

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

Ayahuasca and Tolcapone

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

Moderate

DOPAMINE AGONISTS

Why this applies to Tolcapone

Tolcapone falls under DOPAMINE AGONISTS — the group Ayahuasca interacts with.

Theoretically, ayahuasca might have additive effects when used with dopamine agonists.
Ayahuasca contains the beta-carboline constituent harmine. Animal research shows that harmine increases extracellular dopamine levels.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's the gist for Tolcapone (Tasmar). You take it alongside levodopa/carbidopa to help your Parkinson's medication last longer by blocking an enzyme (COMT) that breaks down dopamine. So tolcapone's whole job is keeping more dopamine activity around. Ayahuasca contains harmine, which animal studies suggest can also raise dopamine levels and acts as an MAO inhibitor.

Stacking two things that push dopamine up could, in theory, add together and lead to too much dopamine activity: things like nausea, confusion, dizziness, low blood pressure, or worsening involuntary movements (dyskinesias). I want to be honest, though, this is a theoretical concern based on pharmacology, not solid human studies. Given that ayahuasca is risky on its own, please talk with your doctor or pharmacist before mixing the two.

References
  1. Iurlo, M., Leone, G., Schilstrom, B., Linner, L., Nomikos, G., Hertel, P., Silvestrini, B., and Svensson, H. Effects of harmine on dopamine output and metabolism in rat striatum: role of monoamine oxidase-A inhibition. Psychopharmacology (Berl) 2001;159(1 PubMed
  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 Tolcapone 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 Tolcapone

This page covers Ayahuasca only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tolcapone page lists 58 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Ashwagandha (moderate).

By severity: 4 major · 45 moderate · 9 minor.

Open the Tolcapone interaction page

How much people look this up

Where Ayahuasca and Tolcapone 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

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

29 days ago today
Medication Tolcapone
Steady interest

#2,538 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 Tolcapone

What Is Tolcapone Used For?

Brand name: Tasmar

Tolcapone tablets (sold as Tasmar and as generic tolcapone) are used as an add-on therapy to levodopa/carbidopa for idiopathic Parkinson's disease — meaning Parkinson's that arises on its own, not from another cause. It is intended for patients who are experiencing symptom fluctuations and are not responding well to, or are not good candidates for, other add-on treatments.

Because of the serious risk of liver failure, tolcapone is reserved for patients who need additional symptom control and must be stopped within 3 weeks if it is not producing a clear benefit.

See full Tolcapone 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 Tolcapone Together: Common Questions

Can you take Ayahuasca with Tolcapone?
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 Tolcapone 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.