Ayahuasca & Loveyhuasca Precautions & Interactions
some of which nobody knows about -- add your own if you find them!
Disclaimer
This overview is based on current clinical and ceremonial guidelines. The effects of combining substances can be unpredictable, so always prioritize safety and seek expert medical advice.
Note, for other entheogen and recreational drug interactions, visit TripSit.)
Ayahuasca and Loveyhuasca contain MAOi drugs (specifically, reversible monoamine oxidase A inhibitors, in the form of harmala alkaloids) and DMT (or NMT in the case of Loveyhuasca)—is a very powerful panacea which stakes its territory in you: it can interact with a wide array of drugs and herbs, as well as some foods. These interactions can result in potentially severe and sometimes life-threatening reactions. It is crucial to approach Aya & Loveyhuasca with caution and full awareness of these risks. (Most people think of these interactions as being purely due to MAOi, but there are also some that are not just due to the MAOi interaction, such as lithium, cinnamon, iodine, and thyroid drugs.)
But before even considering medication interactions, certain medical conditions contraindicate ayahuasca use:
Medical Conditions Requiring Caution
Advanced diabetes: Blood sugar interactions (generally, ayahuasca reduces blood sugar, and Syrian rue or B. caapi are capable of curing type 1 and 2 diabetes (here is one study, but there are many, with a key role played by harmine).
Bipolar disorder: Risk of triggering manic episodes.
Cardiovascular disease: Ayahuasca can significantly affect heart rate and blood pressure, usually lowering it, but sometimes increasing it.
Gut inflammation: Ayahuasca can cause irritation if your guts are already inflamed.
Pregnancy: Use of any herbs or drugs can be dangerous during pregnancy, especially at high doses producing powerful experiences, which sometimes might also produce vomiting, seizures, and lack of bodily awareness. Syrian rue is a uterotonic herb and should not be used during pregnancy. Traditionally, B. caapi vine is given to pregnant women wanting to use ayahuasca, but they are not given large doses.
Psychotic disorders: May worsen symptoms
PTSD: Any type of intensive spiritual or emotional therapy can be triggering for people with PTSD. They need to have a slow, gentle approach to communing with this medicine, not a 1 day expensive retreat, and they need trained sitters and a safe environment in case they do freak out. Ideal would be in a rural communal setting set up for this.
Recent surgery: Bleeding and healing concerns
Severe asthma: Breathing complications possible. If you nebulize dimethylsulfoxide (DMSO) on an hourly basis it should keep the asthma under control. Albuterol/Salmeterol inhalers are generally considered safe to continue. Theophylline requires medical consultation due to cardiovascular effects.
Severe parasitic and pathogenic infections: While ayahuasca and loveyhuasca have saved my life from some infections all by themselves very rapidly, it is nicer if you take care of the infections before using aya/loveyhuasca so that you can get the full emotional, mental, and spiritual benefits rather than just fighting a physical battle in your body. That’s why…
Pre-cleansing Is Highly Recommended!
Many people are using Aya & Loveyhuasca for physical cleansing, and it can certainly do a lot of physical cleansing, but it really works its best magic when you are already clean physically. Thus, I recommend following my detox guide first.
Drug Interactions with Aya/Loveyhuasca
Medications That Carry Significant Risk
Antidepressants (SSRIs, SNRIs, Tricyclics, including cough medication Dextromethorphan/DXM): Combining these with Aya/loveyhuasca can cause a life-threatening condition called serotonin syndrome due to dangerously high levels of serotonin. Main symptoms of serotonin syndrome include sweating and fever (over 101F), seizures, agitation or restlessness, abnormal eye movements, fast heartbeat and high blood pressure, loss of coordination.
Blood Pressure and Blood Sugar medications: Ayahuasca can increase the effects of these medications.
Lithium: causes seizures with classical psychedelics.
Prescription MAOIs: Combining prescription MAOIs with Ayahuasca’s natural MAOIs can lead to a hypertensive crisis, seizures, fever, delirium, and circulatory collapse, due to additive effects.
Stimulant drugs, including MDMA, Cathinones (including Bupropion/Wellbutrin), Cocaine, Amphetamines (and ADHD meds), Weight-Loss drugs, Phenethylamines, and stimulating tryptamines like Foxy, 5-MeO-DMT, DPT, etc: The potency and duration of these substances can increase unpredictably, creating a high risk of hypertensive crisis and serotonin syndrome.
Opioids (Critical Distinction): It is crucial to distinguish between different types of opioids:
Serotonergic Opioids (e.g., Tramadol, Tapentadol, Meperidine/Demerol, Fentanyl): These are EXTREMELY DANGEROUS to combine with Ayahuasca. They affect serotonin levels and carry a high risk of life-threatening serotonin syndrome.
Kratom: this plant contains opioid drugs, stimulant drugs (depending on the “vein color”), benzo-type drugs, and more. Red vein kratom seems to be fairly safe with ayahuasca but can make trips darker. Stimulating white and green vein kratoms should be avoided as with other stimulants.
Classical Opioids (e.g., Morphine, Hydrocodone, Oxycodone, Codeine): These opioids do not primarily act on the serotonin system and do not carry the same risk of serotonin syndrome. While not considered directly dangerous from a serotonin toxicity standpoint, their use with ayahuasca is under-researched. Anecdotally, they might cause psychologically challenging or "darker" trips, particularly if they have been used to suppress negative emotions. Caution is still advised.
First-Generation Antihistamines (e.g., Benadryl/Diphenhydramine): These carry a risk of serotonin syndrome and should be avoided. Second-generation antihistamines like loratadine, cetirizine, should be ok.
Medications Requiring Caution
Hypothyroid Medications (e.g., Synthroid/levothyroxine): Ayahuasca can increase thyroid function. This means combining it with hypothyroid medication could theoretically lead to a thyroid storm. While low doses are often fine, caution is strongly advised, and consultation with a doctor is essential.
Certain Antipsychotics (especially ziprasidone): May interact adversely, increasing the risk of serotonin syndrome or thyroid disruption. Even if no dangerous interactions they could block effects.
NSAIDs and steroid medications: these drugs destroy the microvilli of the intestinal lining and should never be used except in real emergencies. When your intestines are inflamed, ayahuasca can cause significant intestinal pain.
Dimethylsulfoxide (DMSO): While DMSO is safe and good to use with ayahuasca, it should not be taken exactly at the same time as, and definitely not mixed into the rue or caapi (harmala plants), as this can cause hyper rapid harmala absorption which can lead to rapid body temperature decrease. It’s ok to take with the Acacia confusa.
Other Drug Interactions
Alcohol: Alcohol is dangerous to combine with any drug, especially psychedelics. Beyond the risk of tyramine in some alcoholic drinks causing a spike in blood pressure with MAOIs, alcohol itself can unpredictably intensify or alter the psychedelic experience, impair judgment, and increase psychological distress.
Cannabis and other Relaxing Herbs: These substances can often dull or block the effects of Ayahuasca, preventing the full experience. THC itself is neurotoxic and can cause paranoia and false memories if not sufficiently balanced with CBD, CBG, or palmitoylethanolamide.
Iboga: Male iboga especially, but even female iboga can increase the effects of ayahuasca and loveyhuasca. There can be some nice synergy at low doses, but it is risky to play with. 2g iboga was a very challenging experience for me with a medium dose of ayahuasca. Iboga does, however, synergize very well with smokable ayahuasca (especially chrunga, which is synthetic pure DMT infused into syrian rue seed powder at 1:3 ratio).
LSD: Taking LSD with ayahuasca (or just with harmalas like in Syrian rue or B. caapi) can greatly increase the power of the LSD (and make it feel more like ayahuasca), but at the expense of much greater body load/discomfort. Make sure to use very pure LSD if you try this. Very pure LSD is relaxing, not stimulating.
Herb and Supplement Interactions
Cinnamon: Cinnamon can be a powerful synergistic ally to Ayahuasca, but it can feel overwhelming except at very low doses. Reports suggest it can lead to profound, surgery-like dopamine detox-type experiences and unmatched deep PTSD healing. However, its intensity means it should be used with extreme caution; never combining with a high dose of ayahuasca.
Mixing Mimosa hostilis with Acacia confusa: This is a dangerous ayahuasca admixture combination which I have played around with numerous times. I did get it to work well with my ultimate psychedelic recipe, but I would never recommend anyone risk it, as it is highly destabilizing and challenging.
Syrian rue itself: some people (probably less than 1%) get headaches when using Syrian rue as the harmala source for their ayahuasca analog. B. caapi vine is preferred by these people, and some people also find it to feel better than rue. Probably most people can’t tell the difference.
Kanna (Sceletium tortuosum): Dangerous to combine with Ayahuasca. Kanna has SRI (serotonin reuptake inhibitor) activity and presents a high risk of serotonin syndrome.
Iodine: Dangerous: High doses of iodine (like in kelp) can cause Thyroid Storm when used with ayahuasca or loveyhuasca (not just with MAOi in general tho).
St. John’s Wort, Ginseng: Dangerous due to MAOI and serotonergic activity, which can lead to serotonin syndrome.
Ginseng, Yohimbe: Dangerous due to stimulant properties, could cause cardiac risk or hypertensive crisis.
Kava: lowers blood pressure while increasing pulmonary blood pressure. Toxic to liver.
Guayusa, Rapé, Tobacco: Generally considered low risk in traditional contexts, but caution is advised with blends containing other psychoactive plants.
How long to wait?
In general, look up the half life of the drug, including its active metabolites. Wait 4-5 half lives after you stop taking the drug before it is considered mostly out of your system. Amphetamines and serotonergic drugs like antidepressants are usually out within a few weeks, although Prozac takes 4-5 weeks. With iboga, I have found it to be fine to take ayahuasca the day after taking iboga, but it may be more prudent to wait longer.
Diet, not dieta
I highly recommend eating only organic, paleo, without industrial junk in your diet, and without wheat. Look at what our closest primate cousins, the semi-lovey Bonobos eat!
Some people (30% or so) might need to avoid large amounts of foods high in tyramine, such as: aged cheeses, cured meats, fermented foods, overripe fruits, and yeast extracts on the day of ayahuasca or loveyhuasca, in order to avoid a mild blood pressure spike that can cause headache (or worse if your BP is already chronically high). A little bit of fermented beet juice should be fine.
I prefer to take my loveyhuasca in the morning on a nearly empty stomach. If your stomach is too full that can also feel like a heavy weight or it could even prevent you from absorbing your dose. This way you don’t really need to worry about any particular “dieta.” In some native traditions there is a specific “dieta” done for days or even weeks beforehand, but this is really overkill and more like a psychological ritual than a medical necessity.
On the other hand, after taking my acacia dose, sometimes a light fatty snack helps to activate digestion. ZHoly2O also seems to help with activating the loveyhuasca.
General Precautions
Avoid Uncertainty: If you are not absolutely sure that a medication or herb is safe to combine with Ayahuasca, do not take it. If you are not sure how much ayahuasca or loveyhuasca you can handle, go low and start slow, because it does not have a tolerance effect like many other drugs. You can keep taking little doses every hour or 2 to build up your dose gradually.
Consult Professionals: Always consult with a qualified healthcare professional before combining Ayahuasca with any medication or supplement, but make sure first that they are really knowledgeable about ayahuasca (they should understand it’s not just MAOi interactions).
Full Disclosure: Disclose all medications, herbs, and supplements you are taking to your ceremony facilitator to prevent dangerous interactions.
Emergency Measures
If you go to the hospital with serotonin syndrome, you will be given benzodiazepines to control symptoms, as well as cyproheptadine and antipsychotic drugs to antagonize the serotonin receptors directly. But here are some psychological tips, and here are some effective at-home remedies for overdoses:
ZHoly2O is my favorite, because it really maximizes the benefits while minimizing the side effects.
DMSO is proven to reverse all kinds of brain damage, and can turn bad trips good instantly, just mix 15mL into some juice and drink (both also work by touching to some extent). Fermented beet (or veggie or apple juice in general to some degree) also helps, but only with certain drugs.
Morning glory leaf (related to shankhapushpi) is unique in its ability to block nausea extremely effectively at a very low dose (even starting with 100mg). Taking a little more will cancel the trip itself. With certain drugs, especially loveyhuasca and ayahuasca, it can convert the trip energy into a super deep relaxation experience.
CBD or palmitoylethanolamide are also very calming, by restoring balance to your endocannabinoid system.
Epsom salt water is also great to bathe in since magnesium is calming and whenever you are stressed, your magnesium levels are depleted. If you don’t have a bathtub just keep splashing epsom salt water on your armpits (head is nice, too). It does not absorb so well on most of the skin.
Niacin (a form of vitamin B-3) is another natural substance that can kill trips, but it also causes an itchy heat rash and can be uncomfortable.