Drug & supplement interaction

Iboga + Procainamide

Procainamide brand names: Pronestyl, Procanbid, Procan SR, Procan, Pronestyl-SR.

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

Procainamide falls into 2 drug categories that Iboga can interact with; the most serious is rated moderate. Theoretically, iboga may have an additive effect with drugs that prolong the QT interval.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Iboga and Procainamide

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. Procainamide 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

QT INTERVAL-PROLONGING DRUGS

1 of 2

Why this applies to Procainamide

Procainamide falls under QT INTERVAL-PROLONGING DRUGS — the group Iboga interacts with.

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 this pairing. Procainamide is a heart rhythm drug that can stretch out the heart's electrical reset time, something we call the QT interval. Iboga, through its active piece ibogaine, has been linked in real-world case reports to that same QT stretching. Put them together and the effects can stack up, which raises the risk of a dangerous, fast, irregular heartbeat (one we call torsades de pointes) along with fainting or palpitations.

This isn't a prodrug situation, it's an additive one, two things pushing in the same risky direction. The evidence here is mostly anecdotal, but Procainamide already carries its own QT warning, so I'd treat this seriously. Iboga is also illegal in the U.S. and has caused deaths. Please talk with your doctor or pharmacist before combining anything with your heart medicine.

Contact Dr. Brian directly if you have additional questions on this interaction
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

2 of 2

Procainamide 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

Here's the idea behind this pairing. Lab studies (test tube only) suggest Iboga may block an enzyme called acetylcholinesterase, which can raise levels of acetylcholine, a nerve-signaling chemical. Procainamide has mild anticholinergic activity, meaning it tends to lower acetylcholine effects. So in theory, Iboga could push in the opposite direction and slightly blunt that part of how procainamide behaves.

Honestly, this is very weak, theoretical evidence, and the main Iboga compound (ibogaine) didn't even show this effect. The bigger concern is that both Iboga and procainamide can affect your heart rhythm, and procainamide is a narrow-margin heart drug where small changes matter. Iboga also carries serious, sometimes deadly heart risks and is illegal in the U.S. Please don't combine these, and talk with 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

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 Procainamide 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. Procainamide)
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 Procainamide

This page covers Iboga only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Procainamide page lists 59 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 9 major · 39 moderate · 11 minor.

From our pharmacist’s overview on the Procainamide page

“Procainamide treats serious heart rhythm problems, and anything that nudges the heart's electrical timing further can turn a helpful drug into a hazard, so I would give this list genuine care. Nine of the 59 supplements on file carry a major rating, and the 13 QT prolongers are the ones to understand first.”

Reviewed by 2 · Jul 18, 2026

Open the Procainamide interaction page

How much people look this up

Where Iboga and Procainamide 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

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

29 days ago today
Medication Procainamide
Top 25%

#565 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 Procainamide

What Is Procainamide Used For?

Brand names: Pronestyl, Procanbid, Procan SR, Procan, Pronestyl-SR

Procainamide hydrochloride injection treats documented ventricular arrhythmias (abnormal heart rhythms starting in the lower heart chambers) that your doctor judges to be life-threatening. One example is sustained ventricular tachycardia, a fast, dangerous heartbeat.

It is generally not recommended for milder rhythm problems. It should be avoided for asymptomatic ventricular premature contractions (extra beats that cause no symptoms). The same use is listed for the Procainamide Hydrochloride, Procainamide HCl and Procainamide Hci injection products.

See full Procainamide 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 Procainamide, 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 Procainamide supplement interactions › Every supplement checked against Procainamide, ranked by severity Procainamide 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 Procainamide Together: Common Questions

Can you take Iboga with Procainamide?
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 Procainamide?
Procainamide 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 Procainamide 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 Procainamide and Iboga?

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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.