Medical Guidelines

It is necessary and important that you agree to disclose, in confidence, any known medical conditions and/or use of any medication, at the time of booking.


By attending our ceremonies and spending time at our temple, you are declaring that you are mentally, emotionally, and physically healthy enough to attend our workshops, trainings, and programs; and agree that you participate at your own risk and that we cannot accept liability for any accident or injury on our grounds. You should seek professional medical advice on any preparations and pre-care which you might need for the journey and stay with us. We offer this advice and insist on these conditions in order to ensure your personal safety and the overall welfare of the group during your stay.

Certain drugs and medications have been found to not be compatible with ayahuasca. It is essential to stop taking the following substances, and give your system a sufficient amount of time to remove them from the body, before you attend a workshop. Please consult your doctor if you are in any doubt: you certainly should not suddenly stop taking prescribed medications (including antidepressants) without consulting your doctor.

  • Prescription Medications that contain Monoamine Oxidase Inhibitors (MAOI’s) – these are known to cause dangerous side effects when taken in conjunction with ayahuasca. It is critical that you stop taking these medications under the supervision of your primary care physician and allow plenty of time for your system to be cleared of these substances before working with ayahuasca.
  • Any medications that have an effect on the serotonin system, including Selective Serotonin Re-uptake Inhibitors (SSRIs) (i.e. antidepressants such as Wellbutrin, Prozac, Zoloft, Effexor, etc). Combining these medications with ayahuasca can induce serotonin syndrome – far more severely than with simply foods containing tyramine and tryptophan, and with potentially fatal results. We require guests discontinue taking SSRI medications under the care of their primary care physician BEFORE applying for a retreat to allow the body to completely detox. Some of these drugs can and often times do cause side effects when discontinued. Plenty of time should be allowed for these to withdrawal symptoms to subside and to be in a balanced state when attending our workshops. Do not abruptly stop taking any medication without discussing the matter with your doctor. Please note that the herbal antidepressant St. John’s Wort (hypericum perforatum) also must not be taken within 2 weeks of working with ayahuasca.
  • Other medications that must be discontinued are nasal and sinus decongestants, cold medications, allergy medications, antihistamines, sedatives, tranquilizers, amphetamines (including Adderall), some hypertensive medications, sympathomimetic amines (including pseudoephedrine and ephedrine), carbamazipine, methylphemidate (Ritalin), macromerine, phenelanine, tyrosine, tryptophan, asarone/calamus, some asthma inhalers, and other diet pills.
  • Although ayahuasca has not been found to cause psychosis or other psychiatric disturbances, it can be dangerous to those with a history of psychological problems. Please tell us if you have any history of mental health conditions so that we can adequately support you if your stay is approved.
  • If you are pregnant or have a heart condition and/or chronic high blood pressure, we will not be able to accommodate your stay.

  • In general, from an Indigenous healers’ traditional perspective, when a patient or an apprentice is working with medicinal plants, especially ayahuasca and some other important master plants like chiri-sanango, huayra-caspi, toé, brugmansia etc., it is necessary to not take any other substances or medicines, as it can cause confusion and interfere with the spirit of the plant and the energy can sometimes provoke unwanted reactions.
  • Several pharmaceutical treatments are absolutely contraindicated with ayahuasca and must not be taken in proximity to any workshop or program. We will provide more specific requirements upon receipt of your medical history, intake and application for a retreat.
  • Before applying to attend one of our programs, it is imperative that we have a full disclosure of all medications/drugs and the length of time taking them.
  • Guests/volunteers with hepatic conditions must first consult with us and provide more information about their condition. People with tuberculosis must not take ayahuasca.

DRUGS AND MEDS

Is it really dangerous to combine some pharmaceutical drugs with Ayahuasca?

YES. Unlike food interactions, whose consequences are usually unlikely to be serious, interaction with pharmaceutical drugs and meds (including some over-the-counter drugs and certain herbs) can be potentially life-threatening.. The combination of MAOIs and other serotonin agonists or precursors poses a particularly severe risk of a life-threatening serotonin syndrome episode.

See:
http://www.holistic-online.com/REMEDIES … s_MAOI.htm
http://www.pubmedcentral.nih.gov/articl … id=1898666
http://home.caregroup.org/clinical/altm … _Oxida.htm

Which drugs are dangerous with Ayahuasca?

These drugs and meds can be dangerous with MAOIs:

– other MAOIs
– SSRI’s (any selective serotonin reuptake inhibitor)
– antihypertensives (high blood pressure medicine)
– appetite suppressants (diet pills)
– medicine for asthma, bronchitis, or other breathing problems; antihistamines, medicines for colds, sinus problems, hay fever, or allergies (Actifed DM, Benadryl, Benylin, Chlor-Trimeton, Compoz, Bromarest DM or DX, Dimetane DX cough syrup, Dristan Cold & Flu, Phenergan with Dextromethorphan, Robitussin-DM, Vicks Formula 44-D, several Tylenol cold, cough, and flu preparations, and many others) — anything containing dextromethorphan/ DXM or with DM, DX or Tuss in its name, or anything containing pseudoephedrine.
– CNS (central nervous system) depressants
– vasodilators
– antipsychotics
– barbiturates
– alcohol

Illegal or recreational drugs that are VERY dangerous to combine with MAOIs:

– cocaine
– amphetamines (meth-, dex-, amphetamine), ephedrine, MDMA (Ecstasy), MDA, MDEA, PMA
– opiates (heroin, morphine, codeine, and especially opium)
– dextromethorphan (DXM)
– nutmeg
– 5-Meo-DMT

There are recorded fatalities from the combination of cocaine with MAOIs and 5-Meo-DMT with MAOIs.

Illegal or recreational drugs that can potentially be dangerous to combine with MAOIs:

– mescaline (any phenethylamine)
– barbiturates
– alcohol
– kratom
– kava

Some specific pharmaceutical drugs that should not be combined with MAOIs (some are mild risks, others serious):

– Actifed
– Adderall
– Alaproclate
– Albuterol (Proventil, Ventolin)
– Amantadine hydrochloride (Symmetrel)
– Amiflamine
– Amineptine
– Amitriptaline
– Amoxapine (Asendin)
– Atomoxedine
– Bazinaprine
– Befloxetone’
– Befol
– Benadryl
– Benmoxinb (Nerusil, Neuralex)
– Benylin
– Benzedrine
– Benzphetamine (Didrex)
– Bicifadine
– Brasofensine
– Brofaromine (Consonar)
– Buprenorphine
– Bupropion (Wellbutrin)
– Buspirone (BuSpar)
– Butriptyline
– Carbamazepine (Tegretol, Epitol)
– Chlorpheniramine
– Chlor-Trimeton
– Cimoxetone
– Citalopram (Celexa)
– Clomipramine (Anafranil)
– Clorgyline
– Codeine
– Cyclobenzaprine (Flexeril)
– Cyclizine (Marezine)
– D-deprenyl
– Dapoxotine
– Desipramine (Pertofrane, Norpramin)
– Desvenlafaxine
– Dextroamphetamine (Dexedrine)
– Dextromethorphan (DXM)
– Dibenzepin
– Dienolide kavapyrone desmethoxyyangonin
– Diethylpropion
– Disopyramide (Norpace)
– Disulfiram (Antabuse)
– Dobutamine
– Dopamine (Intropin)
– Dosulepin
– Doxepin (Sinequan)
– Duloxetine (Cymbalta)
– Emsam
– Entacapone
– Ephedrine
– Epinephrine (Adrenalin)
– Escitalopram (Lexapro)
– Esuprone
– Etorphine
– Femoxitine
– Fenfluramine (Pondimin)
– Flavoxate Hydrochloride (Urispas)
– Fluoxetine (Prozac)
– Fluvoxamine
– Furazolidone (Furoxone)
– Gabapentin
– Guanethedine
– Guanadrel (Hylorel)
– Guanethidine (Ismelin)
– Hydralazine (Apresoline)
– Hydrazine
– 5-Hydroxytryptophan
– Imipramine (Tofranil)
– Iprindole
– Iproniazid (Marsilid, Iprozid, Ipronid, Rivivol, Propilniazida)
– Iproclozide (Sursum)
– Isocarboxazid (Marplan)
– Isoniazid (Laniazid, Nydrazid)
– Isoniazid rifampin (Rifamate, Rimactane)
– Isoproterenol (Isuprel)
– L-dopa (Sinemet)
– Ladostigil
– Lazabemide (Pakio, Tempium)
– Levodopa (Dopar, Larodopa)
– Linezolid (Zyvox, Zyvoxid)
– Lithium (Eskalith)
– Lofepramine
– Loratadine (Claritin)
– Maprotiline (Ludiomil)
– Mebanazine (Actomol)
– Medifoxamine
– Melitracen
– Meperidine (Demerol)
– Metaproterenol (Alupent, Metaprel)
– Metaraminol (Aramine)
– Metfendrazine (Inkazan)
– Methamphetamine (Desoxyn)
– Methyldopa (Aidomet)
– Methylphenidate (Ritalin)
– Metralindole
– Mianserin
– Milacimide
– Milnacipran
– Minaprine (Cantor)
– Mirtazapine (Remeron)
– Mofegeline
– Moclobemide (Aurorix, Manerix)
– Monomethylhydrazine
– Montelukast (Singulair)
– Nalbufrine
– Naloxone
– Naltrexone
– Nefazodone
– Nialamide (Niamid)
– Nisoxetine
– Nomifensine
– Norepinephrine (Levophed)
– Nortriptyline (Aventyl)
– Octamoxin (Ximaol, Nimaol)
– Oxybutynin chloride (Ditropan)
– Oxycodone
– Oxymetazoline (Afrin, Dimetapp)
– Oxymorphone
– Orphenadrine (Norflex)
– Pargyline (Eutonyl)
– Parnate
– Paroxetine (Paxil)
– Pemoline (Cylert)
– Percocet
– Pethedine (Demerol)
– Phendimetrazine (Plegiline)
– Phenelzine (Nardil)
– Phenergen
– Phenelzine (Nardil, Nardelzine)
– Pheniprazine (Catron)
– Phenmetrazine
– Phenoxypropazine (Drazine)
– Phentermine
– Phenylephrine (Dimetane, Dristan decongestant, Neo-Synephrine)
– Phenylhydrazine
– Phenylpropanolamine (found in many cold medicines)
– Phenelzine (Nardil)
– Pirlindole (Pirazidol)
– Procarbazine (Matulane)
– Procainamide (Pronestyl)
– Protriptyline (Vivactil)
– Pseudoephedrine
– Oxymetazoline (Afrin)
– Quinidine (Quinidex)
– Rasagiline (Azilect)
– Reboxetine
– Reserpine (Serpasil)
– Risperidone
– Salbutemol
– Salmeterol
– Selegiline (Eldepryl, Emsam, Zelapar)
– Sercloramine
– Sertraline (Zoloft)
– Sibutramine
– Sumatriptan (Imitrex)
– Terfenadine (Seldane-D)
– Tegretol
– Temaril
– Tesofensine
– Tetrindole
– Theophylline (Theo-Dur)
– Thesbutiaint
– Thioridazine (Mellaril)
– Tianeptine
– Tolcapone
– Toloxatone (Humoryl)
– Tramadol
– Tranylcypromine (Parnate)
– Trazodone
– Tricyclic antidepressants (Amitriptyline, Elavil)
– Trimipramine (Surmontil)
– Triptans
– Tyrima
– Vanoxerine
– Venlafaxine (Effexor)
– Viloxezine
– Yohimbine
– Zimelidine
– Ziprasidone (Geodon)


Known interactions and contraindications

Using stimulants with MAOIs is particularly dangerous and can be potentially fatal. Using cocaine, amphetamines or MDMA (Ecstasy) with MAOIs may cause a severe increase in blood pressure, increasing the chances for stroke and cerebral hemorrhage. MAOIs may make it possible to overdose on a relatively small amount of cocaine. (A fatality has been recorded involving combination of Peganum harmala and cocaine. Fatalities resulting from combining amphetamines with pharmaceutical MAOIs are recorded in the medical literature.)

Using other serotonin agonists (SSRIs) or precursors with an MAOI can lead to serotonin syndrome.Serotinin syndrome is rare, but can be fatal. The main symptom of serotonin syndrome may be a severe and long-lasting headache (the same symptom as MAOI tyramine interaction) and/or fever (as high as 40 °C / 104 °F or more) Other symptoms of serotonin syndrome may include rapid heartbeat, shivering, sweating, dilated pupils, intermittent tremor or twitching, overactive or overresponsive reflexes, hyperactive bowel sounds, high blood pressure. Severe serotonin syndrome may lead to shock, agitated delirium, muscular rigidity and high muscular tension, abnormal blood clotting and bleeding, respiratory failure, renal failure, and seizures, and can be life-threatening. This interaction can happen even if weeks have passed between stopping the SSRI and taking the MAOI. For further information on serotonin syndrome see this web page: http://www.psychotropical.com/

Using other MAOIs with Ayahuasca may result in hypertensive crisis, convulsive seizures, fever, marked sweating, excitation, delirium, tremor, coma and circulatory collapse.

Using 5-MEO-DMT with Ayahuasca or Ayahuasca analogs can be fatal. There is a documented case of fatality combining 5-MeO-DMT with Ayahuasca and another documented case of fatality combining 5-MeO-DMT with an Ayahuasca analog.

Using opiates (opium, heroin, morphine, codeine) or barbiturates with MAOIs can cause interactions or an increase to the sedative effect and result in respiratory depression. Using MAOIs with heroin or morphine can theoretically push a normal dose to the overdose threshold. Opium (whether smoked or drunk as tea) is especially dangerous to combine with MAOIs, because it contains not only morphine and codeine, but another active alkaloid called thebaine, which can cause convulsions when combined with MAOIs, and which is also a stimulant (see above paragraph on stimulants). Painkillers synthesized from thebaine (buprenorphine, etorphine, oxycodone, oxymorphone, nalbuphine, naloxone, naltrexone) should also be regarded as highly dangerous to combine with MAOIs.

Using alcohol with MAOIs may cause side effects like angina (chest pain) or headaches. The headache may mask or be mistaken for hypertensive crisis caused by MAOI interaction. MAOIs can also increase the sedative effect of alcohol.

Using diuretics with MAOIs may cause a greater drop in blood pressure than normal and increase in MAOI blood levels.

Using anesthetics with MAOIs may potentiate or increase the anesthetic effect.

Using sleeping pills or tranquilizers (major or minor) with MAOIs may increase the sedative effect.

Using nutmeg (at psychoactive levels) with MAOIs can cause hypotensive crisis (extremely low blood pressure), rapid heartbeat, unconsciousness and potentially death.

Using cowhage (Mucuna pruriens) with MAOIs may result in high blood pressure, although there are unverified reports of this plant (of African and Asian origin) being used in some Ayahuasca preparations because of its minor DMT and 5-MeO-DMT content.

Using vasodilators with Ayahuasca may cause fainting (which carries the slight risk of choking on vomit) and increases the chances of having an experience in which one believes one is dying. Using vasodilators immediately after an Ayahuasca session also carries the risk of fainting or passing out.

Using Tricyclic antidepressants within two weeks of taking MAOIs may cause serious side effects including sudden fever, extremely high blood pressure, convulsions, and death.

Using Fluoxetine (Prozac) within five weeks of taking MAOIs may cause high fever, rigidity, high blood pressure, mental changes, confusion and hypomania.

Using Amitryptamine or Amoxipine with MAOIs may cause hyperpyretic crises, disseminated intravascular coagulation, convulsions, and death.

Using Benzedrine, Benzphetamine, Desipramine, Desoxyn, Dexedrine, Dopamine, Ephedrine (contained in Marax, Quadrinal, and other asthma drugs), Epinephrine, Guanadrel, Guanethidine, Hydralazine, Isoproterenol, L-dopa, Metaraminol, Methyldopa, Mirtazamine, Norepinephrine Oxymetazoline, Phendimetrazine, Phentermine, Phenylephrine, Phenylpropanolamine, Pseudoephedrine, Ritalin, or Venlafaxine with MAOIs may cause a hypertensive crisis (severe spike in blood pressure) which can lead to brain hemorrhage or stroke.

Using Adderall with MAOIs can result in high body temperature (hyperpyrexic crisis), severe increase in blood pressure (hypertensive crisis), seizures, and coma. (see paragraph above on stimulants)

Using Bupropion (Wellbutrin) within two weeks of taking MAOIs may cause serious side effects such as seizures.

Using Buspirone (Buspar) with MAOIs may cause high blood pressure and increased sedative effects.

Using Carbamazepine (Tegretol) with MAOIs may result in fever (hyperpyrexic crisis) and may cause seizures, or increase seizures in epileptics.

Using Citalopram with MAOIs may result in severe and sometimes fatal reactions involving elevations in blood pressure, hyperthermia, rigidity, and autonomic instability. This drug should be ceased a minimum of two weeks before taking Ayahuasca.

Using Clomipramine with MAOIs may cause high fever (hyperpyrexic crisis), seizures, disseminated intravascular coagulation, and death.

Using CNS depressants with MAOIs may increase the depressant effects.

Using Desipramine (Norpramin, Pertofrane) with MAOIs may result in hypertensive crisis, hyperpyretic crises, disseminated intravascular coagulation, convulsions, and death.

Using Dextromethorphan (DXM) at psychoactive levels with MAOIs may cause serotonin syndrome, extremely high blood pressure (hypertensive crisis), high body temperature (hyperpyrexic crisis), episodes of psychosis, and in high doses can potentially be fatal.

Using Dobutamine with MAOIs may precipitate severe hypertensive reaction.

Using Doxepin with MAOIs may cause hyperpyretic crises, disseminated intravascular coagulation, convulsions, and death.

Using Entacapone with MAOIs can stop the catalyst enzyme catechol-O-methyltransferase (COMT) from metabolizing levodopa to 3-O-methyldopa in the periphery, and in the brain.

Using Fenfluramine with MAOIs may result in fever (hyperpyrexic crisis).

Using Fluoxedine or Fluvaoxamine with MAOIs may result in severe and sometimes fatal reactions involving elevations in blood pressure, hyperthermia, rigidity, and autonomic instability. This drug should be ceased a minimum of two weeks before taking Ayahuasca.

Using Gabapentin with MAOIs may result in increased blood pressure, rapid heartbeat, and/or seizures.

Using Horny Goat Weed with MAOIs may result in hypotensive crisis (severe blood pressure drop).

Using Imipramine with MAOIs may cause hyperpyretic crises, disseminated intravascular coagulation, convulsions, and death.

Using Isoproterenol with MAOIs may precipitate severe hypertensive crisis.

Using Kava with MAOIs may result in hypotensive crisis (severe blood pressure drop).

Using Levodopa with MAOIs can stop the catalyst enzyme catechol-O-methyltransferase (COMT) from metabolizing levodopa to 3-O-methyldopa in the periphery, and in the brain.

Using Linezolid with MAOIs can cause serotonin syndrome.

Using Lithium with MAOIs may cause fever (hyperpyrexic crisis) and serotonin syndrome (see serotonin syndrome above).

Using Meperidine (Demerol) with pharmaceutical MAOIs has resulted in deaths from a single dose. Immediate onset of sweating, rigidity and hypertension can occur.

Using Metaproterenol or other beta-adrenergic bronchodilators with MAOIs may cause blood pressure elevation and rapid heartbeat.

Using Mirtazapine (Remeron) with MAOIs may result in hypertensive crisis.

Using Nefazodone (Serzone) may result in high fever (hyperpyrexic crisis).

Using Paroxitine (Paxil) with MAOIs may result in severe and sometimes fatal reactions involving elevations in blood pressure, hyperthermia, rigidity, and autonomic instability. This drug should be ceased a minimum of two weeks before taking Ayahuasca.

Using Sertraline with MAOIs may result in severe and sometimes fatal reactions involving elevations in blood pressure, hyperthermia, rigidity, and autonomic instability. This drug should be ceased a minimum of two weeks before taking Ayahuasca.

Using Temaril with MAOIs may increase chance of side effects.

Using Terfenadine with MAOIs may cause an increase in MAOI blood levels.

Using Theophylline with MAOIs may cause rapid heartbeat and anxiety.

Using Tolcapone with MAOIs can stop the catalyst enzyme catechol-O-methyltransferase (COMT) from metabolizing levodopa to 3-O-methyldopa in the periphery, and in the brain.

Using Trazodone (Desyrel) with MAOIs may result in high fever (hyperpyrexic crisis).

Using Tryptophan or L-tryptophan with MAOIs may cause disorientation, confusion, amnesia, delirium agitation, memory impairment, hypomanic signs, shivering.

Using Venlafaxine (Effexor) with MAOIs may result in hypertensive crisis or serotonin syndrome.

Using Ziprasidone (Geodon) with MAOIs may cause serotonin syndrome.

Using Zoloft (Sertraline) with MAOIs has produced fatal cases of serotonin syndrome, and can also result in fever, muscle rigidity, instability of the autonomic nervous system, delirium, and coma.

Special note to diabetics: MAOIs may change the amount of insulin or oral antidiabetic medication that you need. Notes on Diabetes and Ayahuasca.

Ayahuasca forum Threads discussing specific meds:

antibiotics
antihistamines
asthma inhalers
SSRIs
Acetominophen
Codeine
Diazepam
Elavil
Kava
Kava
Klonopin
Klonopin
Losartan (Cozaar)
Methadone
MDMA
Oxycodone
Paxil
Percocet
Prozac
Risperdal
Stratera
St Johns Wort
Vicodin
Wellbutrin
Zoloft

If your meds are not listed here, you could post an inquiry in the Information forum, but people in the forum don’t necessarily know about every med so there may not be an answer to your question. Before asking, it is suggested that you do a web search on the name of the drug + MAOI; and you should also ask your doctor about whether your drug is contraindicated with MAOIs. (It is not necessary to mention Ayahuasca to your doctor in order to ask the question about MAOIs.)

If you find out such information about a drug that is not mentioned here, it could be a service to others if you posted what you learned in the Information forum.

How long do you have to stay off contraindicated drugs before and after an Ayahuasca ceremony?

Depends on the drug. May be 24 hours, may be six months. For over the counter drugs (like antihistamines), 48 hours before and after is more than enough. For prescription drugs, two to six weeks is typical, but do not guess. Find out for sure from your doctor. Your doctor may be unfamiliar with Ayahuasca specifically, but tell him or her that you are planning to take a reversible MAOI. . Some people who plan to drink Ayahuasca in a country where it is not legal are concerned that the doctor will ask questions about the source of the MAOI and learn about an illegal activity. Doctors are bound by doctor-patient confidentiality and they would prefer to know about anything their patients are taking, legal or not. But if your doctor feels that he or she needs more information about Ayahuasca, you could refer him or her to this thread and other informational resources in this forum.

Medical consultation is especially important if you are taking Prozac, Paxil, Wellbutrin, Effexor, Zoloft or other antidepressants that shares interactions with serotonin levels, i.e. serotonin selective re-uptake inhibitors (SSRI), because these substances must be reduced gradually. Fluoxetine (Prozac) requires 8 weeks (56 days) and most other SSRIs five weeks (35 days) to clear the system.