Ayahuasca interactions
Review the current reference classification for Ayahuasca paired with medications or other agents represented in the Arcametric reference library.
Reference information only. This resource summarizes information from external sources and isn't individualized medical advice or a determination of treatment suitability.
Interactors with a reference entry
Cardiovascular
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Ayahuasca and Propranolol Clinician Review
Ayahuasca contains MAO-A inhibiting harmala alkaloids. Propranolol FDA label explicitly notes that hypotensive effects of MAO inhibitors may be exacerbated when administered with beta-blockers. MAOI physiology creates complex BP dynamics that propranolol can worsen or mask.
Evidence: FDA label (Inderal) — MAOI interaction section + harmala alkaloid pharmacology
GLP-1/GIP Agonist
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Ayahuasca and Zepbound (tirzepatide) Strong Caution
Ayahuasca commonly causes vomiting (the "purge"). Zepbound's nausea/vomiting/diarrhea and dehydration-linked AKI warning create severe additive risk. Electrolyte derangements could compound cardiovascular vulnerability.
Evidence: FDA label (Zepbound 2025) + mechanistic
SSRI/SNRI
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Ayahuasca and Fluoxetine (Prozac) Absolute Contraindication
Severe to fatal serotonin syndrome from MAO-A inhibition combined with serotonin reuptake inhibition.
Evidence: Case report, Consensus Guideline
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Ayahuasca and Pristiq (desvenlafaxine) Absolute Contraindication
ABSOLUTE CONTRAINDICATION. Pristiq is contraindicated with MAOIs. Washout required: no MAOIs within 7 days of stopping Pristiq; no Pristiq within 14 days of stopping an MAOI. Ayahuasca harmala alkaloids (harmine, harmaline) inhibit MAO-A — treat as MAOI exposure. High risk of serotonin syndrome, hypertensive crisis, and death.
Evidence: FDA label (Pristiq 2017) — MAOI contraindication section + harmala alkaloid MAOI pharmacology
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