Herb & supplement monograph

Ayahuasca Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Ayahuasca interacts with medications. The heart of this page is the interaction list — every drug Ayahuasca is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Ayahuasca is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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On this page

Ayahuasca Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, Ayahuasca drug interactions carry a moderate potential risk for most people, mainly because ayahuasca can affect brain chemicals and the way the body clears many medications. Every listed interaction is rated moderate rather than major, and nearly all rest on lab or animal research rather than confirmed effects in people.

Interactions deserving the most attention

The combinations we would watch most closely involve serotonergic drugs, meaning medications that raise serotonin levels, because ayahuasca's natural compounds block an enzyme the body uses to break down serotonin, and combining the two could push serotonin activity too high. Dopamine agonists also deserve care, since animal research shows an ayahuasca constituent raises dopamine levels. Ayahuasca may also slow liver enzymes that clear a wide range of medications, which could raise their levels, though this has not been reported in humans.

What the rest of the list means

The very long list of interacting medications comes mostly from these shared, theoretical mechanisms rather than from reports of actual harm. Most entries reflect possible effects on enzymes the body uses to process medications, based on lab and animal studies, and these predicted changes have not been confirmed as clinically meaningful in people.

Check your medications against Ayahuasca

Based on HelloPharmacist’s Ayahuasca interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Ayahuasca

805 medications have a known interaction with Ayahuasca, graded by severity. Select any drug for the full evidence-based detail.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Ayahuasca using our pharmacist-reviewed interaction data.

AI summaries are generated from our Ayahuasca interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. Interaction 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.
Possible. 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
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Ayahuasca combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Ayahuasca affects

Every type of medication (drug category) Ayahuasca is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 4 drug categories Ayahuasca interacts with

Cytochrome P450 2d6 (cyp2d6) SubstratesCytochrome P450 3a4 (cyp3a4) SubstratesDopamine AgonistsSerotonergic Drugs

Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, ayahuasca might increase plasma concentrations of CYP2D6 substrates.
Ayahuasca contains beta-carboline alkaloids, including harmine and harmaline. In vitro research suggests that the beta-carboline alkaloids might inhibit CYP2D6 enzymes. This effect has not been reported in humans.

Likelihood Probable Evidence D

Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, ayahuasca might increase plasma concentrations of CYP3A4 substrates.
Ayahuasca contains beta-carboline alkaloids. In vitro research suggests that beta-carboline alkaloids competitively inhibit CYP3A4 enzymes. This effect has not been reported in humans.

Likelihood Possible Evidence D

Dopamine Agonists

Theoretically, ayahuasca might have additive effects when used with dopamine agonists.
Ayahuasca contains the beta-carboline constituent harmine. Animal research shows that harmine increases extracellular dopamine levels.

Likelihood Possible Evidence D

Serotonergic Drugs

Theoretically, ayahuasca might increase levels of serotonin, which may have additive effects with serotonergic drugs.
In vitro and animal research shows that harmaline and harmine, constituents of ayahuasca, strongly and reversibly inhibit monoamine oxidase A and weakly inhibit monoamine oxidase B. The dimethyltryptamine and tetrahydroharmine constituents of ayahuasca have also demonstrated serotonergic activity. A case of serotonin syndrome characterized by tremors, sweating, shivering, confusion, nausea, vomiting, and disorientation has been reported in a 36-year-old male who consumed 100 mL of ayahuasca while taking fluoxetine 20 mg daily. Combining serotonergic drugs with ayahuasca might increase the risk of serotonergic side effects including serotonin syndrome and cerebral vasoconstrictive disorders.

Likelihood Possible Evidence D

Monograph

Ayahuasca: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Ayahuasca is a powerful psychoactive brew that combines a DMT-containing plant with a vine that allows the DMT to take effect, causing intense hallucinations. It is illegal in many places, can trigger dangerous reactions, and is not recommended for self-use; talk to a doctor or pharmacist before considering it.

Scientific name: Banisteriopsis caapi
Family: Malpighiaceae
Part used: Vine and bark of Banisteriopsis caapi, combined with leaves of DMT-containing plants such as Psychotria viridis
Common forms: Brewed tea or decoction (the ceremonial drink)

People commonly use it for

Spiritual and ceremonial rituals
Depression
Anxiety
Substance use disorders
Personal or emotional insight

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallBest avoided

Ayahuasca is a potent hallucinogen with serious safety risks and uncertain legal status in many areas.

PregnancyBest avoided

There is no safety data; avoid during pregnancy.

BreastfeedingLikely Unsafe

When used orally. In addition to its hallucinogenic effects, animal research shows that chronic administration of higher doses of ayahuasca to pregnan...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Ayahuasca is a psychoactive drink that has been used for centuries by Indigenous peoples of the Amazon basin in South America. It is brewed by boiling the Banisteriopsis caapi vine together with the leaves of another plant, most often Psychotria viridis (chacruna). The combination is what makes the drink active.

The brew is best known for causing strong, long-lasting hallucinations and altered states of awareness. It is traditionally taken in group ceremonies led by an experienced guide or shaman, often for spiritual, religious, or healing purposes.

Today, ayahuasca has spread beyond the Amazon and is used in some religious settings and in informal "retreats" worldwide. Its legal status varies widely, and in many countries it is a controlled substance because it contains DMT.

How it works

Ayahuasca contains two main types of active compounds working together. The Psychotria viridis leaves provide DMT (dimethyltryptamine), a powerful hallucinogen that normally would be broken down quickly in the gut if swallowed.

The Banisteriopsis caapi vine provides beta-carboline alkaloids (such as harmine and harmaline) that act as monoamine oxidase inhibitors, or MAOIs. These compounds block the enzyme that would otherwise destroy DMT, allowing it to reach the brain and cause its effects.

DMT mainly acts on serotonin receptors in the brain, which is thought to explain the changes in perception, mood, and thinking. Much of what we know comes from small human studies and laboratory research, and many details are still not well understood.

Effectiveness

Does Ayahuasca work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 8 uses evaluated

8 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

For Ayahuasca, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 8 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Alcohol use disorder