Ibogaine and Apixaban

Moderate caution. Direct factor Xa inhibitor. CYP3A4 and P-gp substrate, so exposure shifts with interacting drugs. Anticoagulated: bleeding risk governs any invasive procedure or IV placement. Do NOT stop or hold on our initiative. Confirm the plan with the prescribing physician before any invasive procedure. Flag to the medical team on arrival.

Continues — any change is the prescribing physician's decision, made before arrival. This medication is not stopped on our initiative and there is no washout interval we can set: what governs it is a clinical judgement that belongs to the prescribing physician, not a waiting period we can count. It is documented, flagged to the medical team, and the plan is confirmed with the prescriber BEFORE any invasive procedure or IV placement. Stopping an anticoagulant or antiplatelet without that conversation carries its own risk, which is why the default here is to continue and confirm rather than to hold.

CYP3A4 metabolism overlap. CYP3A4 is the second major hepatic clearance pathway. Strong CYP3A4 inhibitors (some antifungals, macrolides, and protease inhibitors) extend the elimination of ibogaine and several co-medications, while strong inducers can cause sub-therapeutic exposure. Either direction destabilises a treatment that depends on tightly controlled plasma kinetics.

In many cases yes. Our medical team works with your prescribing physician to taper or substitute medications safely before treatment. The right substitution depends on the underlying condition you are treating with Apixaban — contact us for an individual review.