Drug & supplement interaction

Iboga + Perphenazine

Perphenazine brand name: Trilafon.

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

Perphenazine falls into 2 drug categories that Iboga can interact with; the most serious is rated moderate. Theoretically, iboga might decrease the effectiveness of anticholinergic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Iboga and Perphenazine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Iboga interacts with whole categories of medication. Perphenazine falls into 2 of those categories, so it can interact with Iboga in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTICHOLINERGIC DRUGS

1 of 2

Why this applies to Perphenazine

Perphenazine falls under ANTICHOLINERGIC DRUGS — the group Iboga interacts with.

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

Here's the idea behind this one. Perphenazine (Trilafon) has some anticholinergic activity, meaning part of how it works involves blocking the messenger acetylcholine. In lab dish studies, Iboga seems to do the opposite by slowing the enzyme that breaks acetylcholine down, which could raise acetylcholine levels and theoretically blunt that side of perphenazine's effect. If that played out in the body, it might make perphenazine work a little less well.

I want to be honest about the strength of this, though. It's based only on test-tube research, and ibogaine itself, the main active part of Iboga, doesn't seem to cause this effect. So this is more of a theoretical concern than something proven in people. The bigger worry is that Iboga (ibogaine) carries real risks to heart rhythm and is illegal here. 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
Moderate

CYTOCHROME P450 2D6 (CYP2D6) INHIBITORS

2 of 2

Perphenazine also falls under 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.
Severity Moderate Likelihood Possible Evidence B

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 key thing to understand about this pairing: perphenazine blocks an enzyme called CYP2D6, which is the very same enzyme your body uses to break down ibogaine, the active compound in Iboga. So in this case it's the perphenazine slowing the clearance of the Iboga, not the other way around. The result is that ibogaine can build up to much higher levels (one study showed roughly a doubling), which raises the risk of ibogaine's most dangerous effect, serious heart rhythm changes.

I want to be honest with you here. Ibogaine is illegal in the U.S. and has been linked to deaths, so I can't recommend using it at all, especially alongside a medication like perphenazine. If you take Trilafon, please talk with your pharmacist or doctor before considering anything like this.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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. PubMed
  2. 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. PubMed
  3. 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. 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 Perphenazine one above is among them. If you take anything else, check it against the full list below.

Major 1 Moderate 500 No known interaction 2,329 (incl. Perphenazine)
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 Perphenazine

This page covers Iboga only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Perphenazine page lists 147 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Henbane (major), Indian Snakeroot (major), Rauvolfia Vomitoria (major) and Scopolia (major).

By severity: 5 major · 108 moderate · 34 minor.

From our pharmacist’s overview on the Perphenazine page

“Perphenazine (Trilafon) treats schizophrenia and severe nausea, and this list deserves real care. Five of the 147 ingredients on file rate major, and those five are the ones to understand first.”

Reviewed by 2 · Jul 18, 2026

Open the Perphenazine interaction page

How much people look this up

Where Iboga and Perphenazine 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

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

29 days ago today
Medication Perphenazine
Steady interest

#1,498 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
Medication

About Perphenazine

What Is Perphenazine Used For?

Brand name: Trilafon

Perphenazine tablets are approved to treat schizophrenia in adults. They are also used to control severe nausea and vomiting in adults when other measures are not enough.

Perphenazine has not been shown effective for managing behavioral problems in patients with intellectual disabilities, and it is not approved for dementia-related psychosis in elderly patients.

See full Perphenazine 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
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 Perphenazine, 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 Perphenazine supplement interactions › Every supplement checked against Perphenazine, ranked by severity Perphenazine drug information › The full plain-English guide to this medication 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 Perphenazine Together: Common Questions

Can you take Iboga with Perphenazine?
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 2 interactions listed for Iboga and Perphenazine?
Perphenazine 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 Perphenazine 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 Perphenazine and Iboga?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.