Iboga - Plaquenil (Hydroxychloroquine) Interaction

Interaction Details

Hydroxychloroquine is classified as belonging to the following category: 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.

Interaction Rating

Likelihood of Occurrence

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

References

• 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.
• 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.
• Asua. Growing menace of ibogaine toxicity. Br J Anaesth. 2013;111(6):1029-30.
• Hoelen DW, Spiering W, Valk GD. Long-QT syndrome induced by the antiaddiction drug ibogaine. N Engl J Med. 2009;360(3):308-9.
• Paling FP, Andrews LM, Valk GD, Blom HJ. Life-threatening complications of ibogaine: three case reports. Neth J Med. 2012;70(9):422-4.
• Pleskovic A, Gorjup V, Brvar M, Kozelj G. Ibogaine-associated ventricular tachyarrhythmias. Clin Toxicol (Phila). 2012;50(2):157.
• Litjens RP, Brunt TM. How toxic is ibogaine? Clin Toxicol (Phila). 2016;54(4):297-302.
• 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.
• 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.
• Steinberg C, Deyell MW. Cardiac arrest after ibogaine intoxication. J Arrhythm 2018;34(4):455-457.

Interaction Details

Hydroxychloroquine is classified as belonging to the following category: Cytochrome P450 2D6 (Cyp2D6) Inhibitors

Theoretically, taking iboga with CYP2D6 inhibitors might increase the levels and clinical effects of ibogaine.
Ibogaine, the active constituent of iboga, is a substrate of CYP2D6. One pharmacokinetic study shows that taking the CYP2D6 inhibitor paroxetine prior to taking ibogaine 20 mg increases the exposure to ibogaine and its metabolite noribogaine by 2-fold when compared with ibogaine alone.

Interaction Rating

Likelihood of Occurrence

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

References

• Henstra M, Wong L, Chahbouni A, et al. Toxicokinetics of ibogaine and noribogaine in a patient with prolonged multiple cardiac arrhythmias after ingestion of internet purchased ibogaine. Clin Toxicol (Phila). 2017;55(6):600-602.
• Glue P, Winter H, Garbe K, et al. Influence of CYP2D6 activity on the pharmacokinetics and pharmacodynamics of a single 20?mg dose of ibogaine in healthy volunteers. J Clin Pharmacol. 2015;55(6):680-7.
• Rodriguez P, Urbanavicius J, Prieto JP, et al. A single administration of the atypical psychedelic ibogaine or its metabolite noribogaine induces an antidepressant-like effect in rats. ACS Chem Neurosci 2020;11(11):1661-1672.

Hydroxychloroquine Overview

• Hydroxychloroquine is used to prevent and treat acute attacks of malaria in adults and children weighing more than 31 kg (68 lbs). It is also used to treat discoid lupus erythematosus (DLE; a chronic inflammatory condition of the skin) or systemic lupus erythematosus (SLE or lupus; an autoimmune disease in which the immune system attacks healthy parts of the body such as joints, skin, blood vessels, and organs) and rheumatoid arthritis. Hydroxychloroquine is in a class of drugs called antimalarials and is also an antirheumatic drug. It works by killing the organisms that cause malaria. Hydroxychloroquine may work to treat rheumatoid arthritis and systemic lupus erythematosus by decreasing the activity of the immune system.

Iboga - More Interactions

Iboga interacts with 490 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.