Herb & supplement monograph

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

But these pages have grown well beyond that into a full monograph — what Iboga 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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Iboga Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Iboga drug interaction is moderate for most people, and a few combinations call for genuine caution. Nearly all of the hundreds of listed interactions are rated moderate, and one, with paroxetine, is rated major and backed by human study data.

Interactions deserving the most attention

The clearest concern is paroxetine, where a human study found it roughly doubled the body's exposure to iboga's active compound, likely because paroxetine blocks an enzyme the body uses to clear it. Other medicines that block this same enzyme could raise iboga levels in a similar way. Case reports also link iboga to changes in heart rhythm, so combining it with QT interval-prolonging drugs could add to that risk. There is a theoretical chance of too much serotonin when iboga is taken with serotonergic drugs, such as many antidepressants.

What the rest of the list means

A list this long does not mean every combination is harmful. Most entries reflect one shared mechanism, such as effects on an enzyme that processes many medications, or are theoretical concerns from lab research that have not been confirmed in people. The strength of the evidence varies widely across the list.

Check your medications against Iboga

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

Interaction report

Drugs that interact with Iboga

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

1 major interaction. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Iboga.

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

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

AI summaries are generated from our Iboga 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 Iboga 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 Iboga affects

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

All 6 drug categories Iboga interacts with

Paroxetine (paxil)Anticholinergic DrugsCholinergic DrugsCytochrome P450 2d6 (cyp2d6) InhibitorsQt Interval-prolonging DrugsSerotonergic Drugs

Paroxetine (Paxil)

Theoretically, taking paroxetine with iboga might increase the levels and clinical effects of ibogaine.
One pharmacokinetic study shows that taking paroxetine prior to taking ibogaine, a constituent of iboga, 20 mg increases the exposure to ibogaine and its metabolite noribogaine by 2-fold when compared with taking ibogaine alone. This is thought to be due to inhibition of cytochrome P450 2D6 by paroxetine. Additionally, ibogaine has serotonergic effects and may increase the risk for serotonergic adverse effects when taken with paroxetine.

Likelihood Probable Evidence B

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.

Likelihood Possible Evidence D

Cholinergic Drugs

Theoretically, iboga might have additive effects with cholinergic 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.

Likelihood Possible Evidence D

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.

Likelihood Possible Evidence B

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.

Likelihood Possible Evidence D

Serotonergic Drugs

Theoretically, taking iboga with serotonergic drugs might increase levels of serotonin, resulting in additive effects with serotonergic drugs.
Ibogaine, a constituent in iboga, has serotonergic effects. Theoretically, combining serotonergic drugs with iboga might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders. Monitor patients for signs of serotonin syndrome and other serotonergic side effects if using iboga with serotonergic drugs.

Likelihood Possible Evidence D

Monograph

Iboga: Uses, Safety & Side Effects

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

The bottom line

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.

Scientific name: Tabernanthe iboga
Family: Apocynaceae
Part used: Root bark
Common forms: Root bark powder, capsules, extracts; the isolated alkaloid ibogaine (a controlled substance in many countries)

People commonly use it for

Drug and alcohol addiction
Opioid withdrawal
Spiritual and ceremonial rituals
Fatigue and stimulant effects
Mood and emotional issues

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

Safety at a glance

OverallBest avoided

Iboga can cause dangerous heart rhythm problems and has been linked to deaths.

PregnancyInsufficient reliable information

There is insufficient reliable information available about the safety of iboga in pregnancy and lactation. Avoid using.

Read the full pregnancy detail

BreastfeedingInsufficient reliable information

There is insufficient reliable information available about the safety of iboga in pregnancy and lactation. Avoid using.

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

Iboga (Tabernanthe iboga) is a shrub native to the rainforests of Central and West Africa, especially Gabon, Cameroon, and the Congo region. Its root bark has been used for centuries in traditional and spiritual practices, including ceremonies of the Bwiti religion.

The root bark contains many natural chemicals called alkaloids. The best known is ibogaine, which has strong hallucinogenic (mind-altering) and stimulant effects. Today Iboga is best known for being studied as a possible treatment for drug and alcohol addiction.

It is important to know that ibogaine is a Schedule I controlled substance in the United States, meaning it is illegal to possess. It is also restricted or banned in several other countries.

How it works

The active alkaloids in Iboga, especially ibogaine, act on many parts of the brain and nervous system. Ibogaine and its breakdown product noribogaine appear to affect chemical messengers such as serotonin and dopamine, and to interact with receptors involved in addiction and reward.

Researchers think these actions may be why Iboga seems to lower cravings and withdrawal symptoms in some studies. However, much of this is based on animal and laboratory research, and the way it works in people is still not fully understood.

The same effects on the brain and on the heart's electrical system are also what make Iboga dangerous.

Effectiveness

Does Iboga work?

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

Evidence overview · 9 uses evaluated

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

Also studied for 9 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Alcohol use disorder