Drug & supplement interaction

Iboga + Amifampridine

Amifampridine brand name: Ruzurgi.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Iboga has a moderate interaction with Amifampridine. Theoretically, iboga might have additive effects with cholinergic drugs.

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

Iboga and Amifampridine

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

Moderate

CHOLINERGIC DRUGS

Why this applies to Amifampridine

Amifampridine falls under CHOLINERGIC DRUGS — the group Iboga interacts with.

Theoretically, iboga might have additive effects with cholinergic drugs.
In vitro research shows that iboga can inhibit acetylcholinesterase and might increase acetylcholine levels. However, the constituent ibogaine does not appear to have this effect.
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 idea behind this pairing. Amifampridine (Ruzurgi) works by boosting nerve signaling, and it raises activity in your cholinergic system, the same chemical pathway that uses acetylcholine to talk to muscles. Lab studies hint that Iboga may also nudge acetylcholine levels up by blocking the enzyme that breaks it down. If both pushed in the same direction, you could in theory see stronger cholinergic effects: things like tingling around the mouth, stomach upset, sweating, or in a bigger sense, seizures, which is already a known risk with amifampridine.

I want to be honest about how soft this is. This is theoretical, based on test-tube data, and ibogaine itself didn't show that effect. On top of that, Iboga carries serious heart rhythm risks and is illegal in the U.S. Please don't combine these without talking to your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Alper K, Reith ME, Sershen H. Ibogaine and the inhibition of acetylcholinesterase. J Ethnopharmacol. 2012;139(3):879-82. 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

Iboga Also Interacts With Other Medications

Iboga has 1 major, 500 moderate known drug interactions in our database — the Amifampridine one above is one of them. If you take anything else, check it against the full list below.

Major 1 Moderate 500 No known interaction 2,329 (incl. Amifampridine)
Taking anything else?

Check Another of Your Medications Against Iboga

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

Everything else you take

See Every Supplement That Interacts With Amifampridine

This page covers Iboga only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amifampridine page lists 44 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Bacopa (moderate), Bael (moderate), Betel Nut (moderate) and Biofeedback (moderate).

By severity: 1 major · 33 moderate · 10 minor.

From our pharmacist’s overview on the Amifampridine page

“Activated charcoal is the one supplement to know first with amifampridine (Ruzurgi). It soaks up medicines in the gut and can strip away enough of the drug to blunt the muscle strength it restores in Lambert-Eaton myasthenic syndrome, and it carries the only major rating of the 44 entries, reason enough to treat this list with real care.”

Reviewed by 2 · Jul 18, 2026

Open the Amifampridine interaction page

How much people look this up

Where Iboga and Amifampridine 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 Iboga
Top half

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

29 days ago today
Medication Amifampridine
Steady interest

#1,480 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 Iboga

What is Iboga?

Iboga
  • Drug and alcohol addiction
  • Opioid withdrawal
  • Spiritual and ceremonial rituals
  • Fatigue and stimulant effects
  • Mood and emotional issues

Iboga is a Central African shrub whose root bark contains ibogaine, a powerful hallucinogenic compound studied mainly for addiction. It carries serious safety risks, including dangerous heart rhythm changes and deaths, and ibogaine is illegal in the United States and many other countries. We do not recommend its use outside of tightly controlled research settings.

Read the full Iboga monograph & all interactions
Keep checking

Other Drugs & Iboga

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

1Major
500Moderate
0Minor
2,328No known interaction
1 Major 500 Moderate 2,328 No interaction
Major

1 interaction

Moderate

500 interactions

Showing 60 of 500 moderate interactions — see all 500 on the Iboga page.

No interaction 2,328 drugs checked — show the list

We also checked Iboga against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,328 medications checked with no known interaction — see the full Iboga list.

See the full Iboga interactions page
See every supplement checked against Amifampridine, ranked by severity
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

Keep exploring
Iboga monograph › Uses, safety, and every drug interaction in one place Amifampridine supplement interactions › Every supplement checked against Amifampridine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Iboga and Amifampridine Together: Common Questions

Can you take Iboga with Amifampridine?
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 Iboga and Amifampridine 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 Amifampridine and Iboga?

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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.