Contraindications & Safety
Medical Guidelines & Your Safety
Ayahuasca is a powerful sacrament that can be dangerous when combined with certain medications, conditions, and substances. Your honesty is the single most important thing that keeps you safe.
Before you apply
Although ayahuasca is generally considered safe for most people, it is not suitable for everyone. It contains a potent MAO inhibitor (harmala alkaloids) plus a psychedelic (DMT) — a combination that can interact dangerously with many medications, substances, and health conditions.
If you take any of the medications listed below, please consult your prescribing physician to safely taper off before applying. Clearance times vary widely — from a couple of days to eight weeks or more — so your body needs ample time. We review every person individually and, in many cases, we can help you prepare safely. The lists below are not exhaustive; if your medication isn't shown, contact us.
Disclose everything — even things you consider minor
Failure to fully clear medications and substances can result in serious adverse reactions, injury, or death. Full, honest disclosure of your medical history, medications, supplements, and recent substance use is what allows us to evaluate whether ayahuasca is safe for you.
How to read the risk labels:
1. Contraindicated medical conditions
Individual risk varies by severity, stability, medications, and supervision. Please disclose your full medical history and consult your physician before applying.
- Coronary artery disease, recent heart attack, or unstable angina— risk of ischemia, arrhythmia
- Uncontrolled high blood pressure— risk of hypertensive crisis, stroke
- Significant arrhythmias or conduction disorders
- Moderate-to-severe heart failure
- Cerebrovascular disease, prior stroke or TIA
- Autonomic dysfunction (severe orthostatic hypotension, dysautonomia)
Ayahuasca temporarily raises blood pressure and heart rate, so your cardiovascular history matters.
- Epilepsy or a poorly controlled seizure disorder— lowered seizure threshold
- Recent significant head injury or intracranial hypertension
- Bipolar disorder (especially type I) or a history of mania— risk of precipitating mania
- Schizophrenia, schizoaffective disorder, or a strong family history of psychosis
- Severe major depression with psychotic features, or active suicidal ideation
- Severe psychiatric instability (recent hospitalization, inability to care for self)
- Cognitive impairment preventing informed consent or safe participation
If any of these apply, please don't rule yourself out silently — talk to us so we can navigate it together with your care team.
- Severe liver disease— impaired metabolism, prolonged effects
- Severe kidney impairment or end-stage renal disease
- Severe pulmonary disease (advanced COPD, severe asthma)
- Severe anemia or unstable hemoglobinopathies
- Uncontrolled endocrine conditions (untreated hyperthyroidism, pheochromocytoma)
- Severe GI disease with high aspiration risk (vomiting is common with ayahuasca)
- Acute infection with high fever, dehydration, or major electrolyte disturbance
- Known allergy or hypersensitivity to ayahuasca components
- Pregnancy— potential fetal harm; unknown safety
- Breastfeeding— risk to infant via milk
2. Contraindicated medications
Combining ayahuasca with these can cause serotonin syndrome, hypertensive crisis, severe agitation, seizures, or respiratory depression. Categories are ordered most dangerous first. This is not exhaustive — consult a clinician or pharmacist.
SSRIs Very high
Greatly increase synaptic serotonin; with DMT + MAOI can cause fatal serotonin syndrome.
SNRIs & mixed serotonergic High
Raise serotonin and/or norepinephrine; same serotonin/adrenergic dangers.
Tricyclic antidepressants (TCAs) High
Serotonergic plus cardiotoxic/anticholinergic; MAOI interaction worsens cardiac risk.
Prescription MAO inhibitors Very high
Potent MAO inhibition; severe hypertensive-crisis and serotonin-syndrome risk.
Serotonergic opioids & analgesics High
Raise serotonin or lower seizure threshold; risk of serotonin syndrome and respiratory depression.
Triptans (migraine) High
With MAOI/DMT can precipitate serotonin syndrome.
Sympathomimetics & stimulants High
Plus MAOI/DMT raise blood pressure, heart rate, and arrhythmia risk; can trigger hypertensive crisis or stroke.
Antipsychotics & mood stabilizers High
Cardiac, seizure, and interaction risks; some lower the seizure threshold.
Lithium with serotonergic psychedelics is linked to severe neurotoxicity and encephalopathy.
Benzodiazepines & sedative-hypnotics Caution
CNS depressants can increase respiratory depression and may blunt the experience.
Cardiovascular drugs Caution
Unpredictable effects on blood pressure/heart rate with MAOI/sympathomimetics — review with your prescriber.
Over-the-counter medications Caution
Everyday remedies can interact — please disclose these too.
Clearing medications safely
- All non-essential medications should be cleared before ceremony. Timing varies by medication — from a few days to eight weeks or more.
- Fluoxetine (Prozac) is a key exception: because it stays in the body a long time, it typically needs about 5–6 weeks.
- We'll confirm the exact, safe timing for your specific medications with you — always alongside your prescribing physician. Never taper on your own.
3. Contraindicated recreational drugs
Please abstain from recreational substances well before ceremony and disclose any recent use. Some combinations can be fatal.
Strong overlap with serotonergic and sympathomimetic effects — mixing can be fatal (serotonin syndrome, hypertensive crisis, malignant hyperthermia).
Recreational opioids & illicit supplies High
Respiratory depression plus unpredictable adulterants; some are serotonergic.
Psychedelics & dissociatives High
May amplify intensity or precipitate prolonged psychosis, agitation, or seizures.
Alcohol & marijuana Avoid
Alcohol: CNS depression, hypertensive-crisis and physical-illness risk. Marijuana: incompatible; may cause adverse psychological reactions or blunt the experience.
4. Supplements & foods
Some supplements and high-tyramine foods interact with ayahuasca's MAOI components.
Many are serotonergic or have MAOI-like / pressor effects — stop with your clinician's guidance.
Ayahuasca's MAOI components can interact with high-tyramine foods, causing hypertensive crises.
See our Diet & Preparation page for the full dieta and food guidance.
Our screening process
You are never on your own with this. Here's how we work together to keep participation safe:
Review
Read this page and our Diet & Preparation guidance, and self-check against the conditions and substances above.
Apply
Submit your application with an honest health and medication history.
Disclose
Tell us everything — conditions, prescriptions, supplements, and recent substance use.
Additional screening (when needed)
For flagged answers we may ask follow-up questions or ask you to coordinate a safe taper with your prescriber.
Decide together
A go / not-yet / conditional decision made with you — never a silent rejection.
Prepare
If we proceed, we'll guide your personalized washout and dieta timeline right up to ceremony.
Not sure about a medication or condition?
Reach out before you apply. We consider every person case by case, and we're glad to help you understand whether — and when — this is safe for you.
This page is for general education and is not medical advice. It does not replace guidance from your own healthcare provider, and you should never stop a prescribed medication without consulting your doctor. See our full Disclaimer and Terms of Service for details.