Iboga - Invega Trinza (Paliperidone Palmitate) Interaction
Herbal: Iboga
Also Known As: Tabernanthe iboga, Bois Sacré, Eboka
Drug: Paliperidone Palmitate
Brand names:
Invega Trinza
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 11, 2025
Interaction Details
Paliperidone Palmitate 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
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
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.
Iboga Overview
Iboga is a shrub native to Central and West Africa that has been used in traditional medicine and spiritual practices. Its root bark contains a number of alkaloids, including ibogaine, which has hallucinogenic and stimulant properties. Iboga has been studied in regard to its use in those suffering from alcohol and drug addiction, but the main constituent of Iboga (ibogaine) is a schedule I controlled substance in the United States, and possession is illegal. Its use as a traditional medicine is generally not recommended due to safety concerns.
Paliperidone Palmitate Overview
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Paliperidone extended-release injections (Invega Hafyera, Invega Sustenna, Invega Trinza) are used to treat schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions). Paliperidone extended-release injection (Invega Sustenna) is also used alone or with other medications to treat schizoaffective disorder (a mental illness that causes both a loss of contact with reality and mood problems [depression or mania]). Paliperidone extended-release injection is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain.
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.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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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
Drug descriptions are provided by MedlinePlus.
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In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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