Drug & supplement interaction

Iboga + Amitriptyline, Chlordiazepoxide

Amitriptyline, Chlordiazepoxide brand name: Limbitrol DS.

Moderate Interaction
The bottom line Moderate

Amitriptyline, Chlordiazepoxide falls into 3 drug categories that Iboga can interact with; the most serious is rated moderate. Theoretically, taking iboga with serotonergic drugs might increase levels of serotonin, resulting in additive effects with serotonergic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Iboga and Amitriptyline, Chlordiazepoxide

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Iboga interacts with whole categories of medication. Amitriptyline, Chlordiazepoxide falls into 3 of those categories, so it can interact with Iboga in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

SEROTONERGIC DRUGS

1 of 3

Why this applies to Amitriptyline, Chlordiazepoxide

Amitriptyline, Chlordiazepoxide falls under SEROTONERGIC DRUGS — the group Iboga interacts with.

Theoretically, taking iboga with serotonergic drugs might increase levels of serotonin, resulting in additive effects with serotonergic drugs.
Ibogaine, a constituent in iboga, has serotonergic effects. Theoretically, combining serotonergic drugs with iboga might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders. Monitor patients for signs of serotonin syndrome and other serotonergic side effects if using iboga with serotonergic drugs.
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

Limbitrol DS combines amitriptyline, an older antidepressant that raises serotonin in the brain, with chlordiazepoxide, a calming benzodiazepine. The concern here is mostly about the amitriptyline piece. Iboga (through its compound ibogaine) also pushes serotonin levels up, so pairing the two could stack those effects together. In theory that raises the risk of serotonin syndrome, which can show up as agitation, sweating, shivering, a racing heart, muscle twitching, or confusion.

I want to be honest that this is a theoretical concern based on how these substances work, not solid human studies. Still, ibogaine carries real dangers of its own, including serious heart rhythm problems, and it is illegal in the U.S. Please don't change anything on your own. Talk with your doctor or pharmacist first.

References
  1. Glick SD, Maisonneuve IS. Mechanisms of antiaddictive actions of ibogaine. Ann N Y Acad Sci 1998;844:214-26.
  2. Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. PubMed
  3. Litjens RP, Brunt TM. How toxic is ibogaine? Clin Toxicol (Phila). 2016;54(4):297-302. PubMed
Moderate

QT INTERVAL-PROLONGING DRUGS

2 of 3

Amitriptyline, Chlordiazepoxide also falls under QT INTERVAL-PROLONGING DRUGS.

Theoretically, iboga may have an additive effect with drugs that prolong the QT interval.
Numerous case reports suggest that ibogaine, a constituent in iboga, can cause QT interval prolongation.
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 concern with Limbitrol DS, which combines amitriptyline (an older antidepressant) and chlordiazepoxide (a calming benzodiazepine). The amitriptyline part can stretch out the heart's electrical cycle, something we call QT prolongation. Iboga (through ibogaine) has been tied to this same effect in several real-world case reports, including some that ended badly. Put them together and the worry is an additive strain on your heart rhythm, which can rarely trigger dangerous, fast heartbeats, dizziness, fainting, or worse.

This is mostly theoretical and based on scattered case reports, so I don't want to overstate it. But ibogaine carries serious heart risks on its own and is illegal in the U.S. Please don't combine these without talking to your doctor or pharmacist first.

References
  1. O'Connell CW, Gerona RR, Friesen MW, Ly BT. Internet-purchased ibogaine toxicity confirmed with serum, urine, and product content levels. Am J Emerg Med. 2015; 33(7):985.e5-6. PubMed
  2. Vlaanderen L, Martial LC, Franssen EJ, van der Voort PH, Oosterwerff E, Somsen GA. Cardiac arrest after ibogaine ingestion. Clin Toxicol (Phila). 2014;52(6):642-3. PubMed
  3. Asua. Growing menace of ibogaine toxicity. Br J Anaesth. 2013;111(6):1029-30. PubMed
  4. Hoelen DW, Spiering W, Valk GD. Long-QT syndrome induced by the antiaddiction drug ibogaine. N Engl J Med. 2009;360(3):308-9. PubMed
  5. Paling FP, Andrews LM, Valk GD, Blom HJ. Life-threatening complications of ibogaine: three case reports. Neth J Med. 2012;70(9):422-4.
  6. Pleskovic A, Gorjup V, Brvar M, Kozelj G. Ibogaine-associated ventricular tachyarrhythmias. Clin Toxicol (Phila). 2012;50(2):157. PubMed
  7. Litjens RP, Brunt TM. How toxic is ibogaine? Clin Toxicol (Phila). 2016;54(4):297-302. PubMed
  8. Grogan J, Gerona R, Snow JW, Kao L. Ibogaine consumption with seizure-like episodes, QTc-prolongation, and captured cardiac dysrhythmias. J Emerg Med 2019;57(4):e99-e104. PubMed
  9. 105383 Knuijver T, Schellekens A, Belgers M, et al. Safety of ibogaine administration in detoxification of opioid dependent individuals: a descriptive open-label observational study. Addiction 2021. PubMed
  10. Steinberg C, Deyell MW. Cardiac arrest after ibogaine intoxication. J Arrhythm 2018;34(4):455-457. PubMed
Moderate

ANTICHOLINERGIC DRUGS

3 of 3

Amitriptyline, Chlordiazepoxide also falls under ANTICHOLINERGIC DRUGS.

Theoretically, iboga might decrease the effectiveness of anticholinergic 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

Let me start with the big picture: Iboga (and its compound ibogaine) is genuinely dangerous, can trigger life-threatening heart rhythm problems, and is illegal in the U.S. I would not recommend it at all, especially alongside a prescription medicine. Limbitrol DS combines amitriptyline (a tricyclic antidepressant with strong anticholinergic effects) with chlordiazepoxide (a sedating benzodiazepine).

The interaction on file is only theoretical and based on lab studies. The idea is that iboga might raise acetylcholine levels and partly work against amitriptyline's anticholinergic action, possibly blunting some of its effects. Honestly, the bigger worry is overlapping sedation and serious heart rhythm risks from combining these. Please don't experiment here. Talk with your pharmacist or doctor first.

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 Amitriptyline, Chlordiazepoxide one above is among them. If you take anything else, check it against the full list below.

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 Amitriptyline, Chlordiazepoxide

This page covers Iboga only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline, Chlordiazepoxide page lists 298 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).

By severity: 17 major · 231 moderate · 50 minor.

From our pharmacist’s overview on the Amitriptyline, Chlordiazepoxide page

“Alcohol is the first thing to know about here. Beer and wine both carry major, well-documented interactions with Amitriptyline and Chlordiazepoxide (Limbitrol DS), because both drugs already slow the central nervous system, and anything sedating layered on top can deepen ordinary drowsiness into something dangerous.”

Reviewed by 2 · Jul 18, 2026

Open the Amitriptyline, Chlordiazepoxide interaction page

How much people look this up

Where Iboga and Amitriptyline, Chlordiazepoxide 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

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

29 days ago today
Medication Amitriptyline, Chlordiazepoxide
Top half

#930 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
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
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 Iboga and Amitriptyline, Chlordiazepoxide Together: Common Questions

Can you take Iboga with Amitriptyline, Chlordiazepoxide?
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.
Why are there 3 interactions listed for Iboga and Amitriptyline, Chlordiazepoxide?
Amitriptyline, Chlordiazepoxide belongs to more than one drug category, and Iboga interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Iboga and Amitriptyline, Chlordiazepoxide 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.