Drug & supplement interaction

Iboga + Nelarabine

Nelarabine brand name: Atriance.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Iboga and Nelarabine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Iboga and Nelarabine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Nelarabine and Iboga in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Iboga safety at a glance

Iboga overall Avoid Iboga can cause dangerous heart rhythm problems and has been linked to deaths.
Pregnancy Avoid Not enough safety information; the risks make it unsafe during pregnancy.
Breastfeeding Avoid No safety data; avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Nelarabine and Iboga? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Nelarabine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nelarabine is filed under 3 classifications — immunosuppressants, cns depressants, seizure threshold lowering drugs. Iboga has documented interactions with 6 drug classes — the most serious being paroxetine (paxil) (major), anticholinergic drugs (moderate) and cholinergic drugs (moderate) — and none of Nelarabine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Iboga Does Interact With Other Medications

Iboga has 1 major, 501 moderate known drug interactions in our database — Nelarabine isn’t one of them. If you take anything else, check it against the full list below.

Major 1 Moderate 501 No known interaction 2,328 (incl. Nelarabine)
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.

What to actually watch for

No Interaction Found — But Data Suggests Iboga and Nelarabine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 4 of them are worth acting on rather than waiting out — marked below.

  • Unsteadiness Worth acting on Additional detail

    Iboga

    “Ibogaine, a constituent of iboga, taken orally in doses ranging from 10-32 mg/kg may cause confusion, dizziness, dream-like states, hallucinations, and headaches. Ibogaine in doses up to 25 mg/kg has been associated with cases of extreme sensitivity to color and sound, sweating, cold sensations, increased energy and appetite, insomnia, and a strong aphrodisiac effect.”

    Iboga · Natural Medicines adverse-effect record, reported in common cold.

    6 sources cited
    1. 89199. Schenberg EE, de Castro Comis MA, Chaves BR, da Silveira DX. Treating drug dependence with the aid of ibogaine: a retrospective study. J Psychopharmacol. 2014;28(11):993-1000. PubMed
    2. 105389. Davis AK, Barsuglia JP, Windham-Herman AM, Lynch M, Polanco M. Subjective effectiveness of ibogaine treatment for problematic opioid consumption: Short- and long-term outcomes and current psychological functioning. J Psychedelic Stud 2017;1(2):65-73. PubMed
    3. 111735. Mosca A, Chiappini S, Miuli A, et al. Ibogaine/Noribogaine in the Treatment of Substance Use Disorders: A Systematic Review of the Current Literature. Curr Neuropharmacol. 2023;21(11):2178-2194. PubMed
    4. 92952. Sheppard SG. A preliminary investigation of ibogaine: case reports and recommendations for further study. J Subst Abuse Treat. 1994 Jul-Aug;11(4):379-85. PubMed
    5. 105383. 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
    6. 89183. 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

    Nelarabine

    Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine. Read the label on DailyMed ›

  • Low potassium Worth acting on Additional detail

    Iboga

    “Ibogaine, a constituent of iboga, taken orally may cause nausea and vomiting in some individuals. Doses up to 25 mg/kg have been associated with diarrhea. In one case report, a 61-year-old male developed hypokalemia following heavy vomiting and diarrhea within 6-12 hours of ingesting a single dose of 5.6 grams of ibogaine.”

    Iboga · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 89199. Schenberg EE, de Castro Comis MA, Chaves BR, da Silveira DX. Treating drug dependence with the aid of ibogaine: a retrospective study. J Psychopharmacol. 2014;28(11):993-1000. PubMed
    2. 92951. Alper KR, Lotsof HS, Frenken GM, et al. Treatment of acute opioid withdrawal with ibogaine. Am J Addict. 1999 Summer;8(3):234-42. PubMed
    3. 92952. Sheppard SG. A preliminary investigation of ibogaine: case reports and recommendations for further study. J Subst Abuse Treat. 1994 Jul-Aug;11(4):379-85. PubMed
    4. 105383. 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
    5. 105386. Steinberg C, Deyell MW. Cardiac arrest after ibogaine intoxication. J Arrhythm 2018;34(4):455-457. PubMed
    6. 105389. Davis AK, Barsuglia JP, Windham-Herman AM, Lynch M, Polanco M. Subjective effectiveness of ibogaine treatment for problematic opioid consumption: Short- and long-term outcomes and current psychological functioning. J Psychedelic Stud 2017;1(2):65-73. PubMed

    Nelarabine

    Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine. Read the label on DailyMed ›

  • Confusion / Seizures Worth acting on Additional detail

    Iboga

    Recorded for Iboga in the same Natural Medicines adverse-effect record shown under Unsteadiness above.

    Nelarabine

    Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine. Read the label on DailyMed ›

  • Trouble sleeping / Dizziness Additional detail

    Iboga

    Recorded for Iboga in the same Natural Medicines adverse-effect record shown under Unsteadiness above.

    Nelarabine

    Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine. Read the label on DailyMed ›

  • Diarrhea / Vomiting / Nausea Additional detail

    Iboga

    Recorded for Iboga in the same Natural Medicines adverse-effect record shown under Unsteadiness above.

    Nelarabine

    Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine. Read the label on DailyMed ›

  • Headache Additional detail

    Iboga

    Recorded for Iboga in the same Natural Medicines adverse-effect record shown under Unsteadiness above.

    Nelarabine

    Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine. Read the label on DailyMed ›

Reported for Iboga but not commonly for Nelarabine: an irregular heartbeat, hallucinations, anxiety or restlessness and sweating.

Effects for Nelarabine come from the ADVERSE REACTIONS section of its FDA label; effects for Iboga come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 956 voluntary FDA FAERS reports for Nelarabine that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Nelarabine

This page covers Iboga only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nelarabine page lists 130 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Kava (major) and L-tryptophan (major).

By severity: 6 major · 118 moderate · 6 minor.

From our pharmacist’s overview on the Nelarabine page

“Nelarabine (Atriance) is chemotherapy for a rare T-cell leukemia and lymphoma, and its most feared side effect is damage to the nervous system, from heavy drowsiness up to seizures. Most of the 130 supplement and herbal ingredients on this list press on exactly that weak point.”

Reviewed by 2 · Jul 18, 2026

Open the Nelarabine interaction page

How much people look this up

Where Iboga and Nelarabine 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

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

29 days ago today
Medication Nelarabine
Steady interest

#1,668 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Iboga reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Iboga and Nelarabine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Tabernanthe iboga · Apocynaceae · Root bark · Root bark powder, capsules, extracts; the isolated alkaloid ibogaine (a controlled substance in many countries)

An interaction check asks whether these two react with each other — it does not ask whether Iboga is a good idea for someone in your situation. Here is what our Iboga record says about it on its own.

Iboga: dosing

There is no established safe or standard dose of Iboga or ibogaine for any condition. Because the compound is unpredictable and can harm the heart, doses cannot be recommended here.Ibogaine is a controlled substance in the United States, so it cannot be legally bought or used as a supplement. Do not attempt to dose yourself with Iboga.

From our Iboga monograph — the full record covers uses, side effects and every documented interaction.

Read the full Iboga monograph & all interactions
Medication

About Nelarabine Injection

What Is Nelarabine Injection Used For?

Brand name: Atriance

Nelarabine injection (brand name Arranon) is used to treat two aggressive blood cancers: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL). It is approved for adult and pediatric patients age 1 year and older whose disease has not responded to — or has come back after — at least two prior chemotherapy regimens.

Nelarabine injection may also be given in combination with multi-agent chemotherapy as part of treatment for newly diagnosed T-ALL and T-LBL in certain settings, as studied in clinical trials.

Most-Reported Side Effects for Nelarabine

From FAERS, the FDA’s public side-effect reporting system (956 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Febrile neutropenia 75 reports
Neuropathy peripheral 60 reports
Neurotoxicity 60 reports
Sepsis 56 reports
Muscular weakness 55 reports
See full Nelarabine Injection drug information
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
501Moderate
0Minor
2,327No known interaction
1 Major 501 Moderate 2,327 No interaction
Major

1 interaction

Moderate

501 interactions

Showing 60 of 501 moderate interactions — see all 501 on the Iboga page.

No interaction 2,327 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 2,327 medications checked with no known interaction — see the full Iboga list.

See the full Iboga interactions page
See every supplement checked against Nelarabine, ranked by severity
Evidence & sources

Iboga References

The 26 references that drive our Iboga monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  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. Marta CJ, Ryan WC, Kopelowicz A, Koek RJ. Mania following use of ibogaine: A case series. Am J Addict. 2015;24(3):203-5. PubMed
  4. 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
  5. 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
  6. Asua. Growing menace of ibogaine toxicity. Br J Anaesth. 2013;111(6):1029-30. PubMed
  7. 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
  8. Jalal S, Daher E, Hilu R. A case of death due to ibogaine use for heroin addiction: case report. Am J Addict. 2013;22(3):302. PubMed
  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.
  10. Papadodima SA, Dona A, Evaggelakos CI, Goutas N, Athanaselis SA. Ibogaine related sudden death: a case report. J Forensic Leg Med. 2013;20(7):809-11. PubMed
  11. Pleskovic A, Gorjup V, Brvar M, Kozelj G. Ibogaine-associated ventricular tachyarrhythmias. Clin Toxicol (Phila). 2012;50(2):157. PubMed
  12. Schenberg EE, de Castro Comis MA, Chaves BR, da Silveira DX. Treating drug dependence with the aid of ibogaine: a retrospective study. J Psychopharmacol. 2014;28(11):993-1000. PubMed
  13. Alper K, Reith ME, Sershen H. Ibogaine and the inhibition of acetylcholinesterase. J Ethnopharmacol. 2012;139(3):879-82. PubMed
  14. Alper KR, Lotsof HS, Frenken GM, et al. Treatment of acute opioid withdrawal with ibogaine. Am J Addict. 1999 Summer;8(3):234-42. PubMed
  15. Sheppard SG. A preliminary investigation of ibogaine: case reports and recommendations for further study. J Subst Abuse Treat. 1994 Jul-Aug;11(4):379-85. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Iboga and Nelarabine Together: Common Questions

Is it safe to take Iboga with Nelarabine?
We do not list a known interaction between Iboga and Nelarabine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Iboga and Nelarabine have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Iboga and Nelarabine combination checked?
Interactions in our licensed database are recorded against drug classes. Nelarabine is filed under 3 classifications, and Iboga has documented interactions with 6 drug classes — none of Nelarabine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Iboga interact with any other medications?
Yes. Iboga has 502 documented drug interactions in our database — Nelarabine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Nelarabine interact with any supplements?
Yes. Nelarabine has documented interactions with 130 supplements in our database — Iboga is not one of them. The Nelarabine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Iboga monograph Uses, safety profile, and every drug interaction in one place Nelarabine Injection drug information The full plain-English guide to this medication Nelarabine supplement interactions Every supplement checked against Nelarabine, 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 References The 26 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nelarabine and Iboga?

Our pharmacists answer your medication & supplement questions — free.

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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.