Omeprazole
Prilosec
Ibogaine and Esomeprazole
Also known as: Nexium
CYP2C19 substrate (S-enantiomer of omeprazole). Minor interaction.
Severity
Minor — monitor
Mechanism
CYP2D6 substrate competition
Protocol Status
Pre-arrival washout (under your prescribing physician)
Restart Delay
Physician discretion
What "Minor — monitor" Means
Generally safe. May require a hold on dosing day or post-treatment monitoring depending on individual response.
Clinical Action
What our medical team does for patients on Esomeprazole.
May continue. Switch to pantoprazole if concerned.
Where the Washout Happens
Pre-arrival washout (under your prescribing physician)
Discontinuation is completed before arrival, under the patient's own prescribing physician, with the medication-specific washout interval observed before the flood dose.
Pre-Treatment Washout Window
Hold on dosing day; physician-directed timing.
Post-Treatment Restart
Restart at physician discretion once acute window closes.
The Pharmacology
How Esomeprazole interacts with ibogaine: cyp2d6 substrate competition.
Both ibogaine and the co-administered drug compete for the same CYP2D6 enzyme. Levels of either substrate can rise unpredictably, making dose response harder to control and increasing the risk of side effects from the non-ibogaine medication.
Same Mechanism
Other medications that interact via cyp2d6 substrate competition.
Same Severity Tier
Other minor — monitor medications (different mechanism).
Common Questions
Esomeprazole and ibogaine treatment.
Can I take ibogaine if I am on Esomeprazole?
Minor — monitor. CYP2C19 substrate (S-enantiomer of omeprazole). Minor interaction. May continue. Switch to pantoprazole if concerned.
How long do I need to be off Esomeprazole before ibogaine treatment?
Pre-arrival washout (under your prescribing physician). Discontinuation is completed before arrival, under the patient's own prescribing physician, with the medication-specific washout interval observed before the flood dose. Hold on dosing day; physician-directed timing.
What is the mechanism of the interaction?
CYP2D6 substrate competition. Both ibogaine and the co-administered drug compete for the same CYP2D6 enzyme. Levels of either substrate can rise unpredictably, making dose response harder to control and increasing the risk of side effects from the non-ibogaine medication.
Can I switch to a different medication so I can have ibogaine treatment?
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 Esomeprazole — contact us for an individual review.
Checking more than one medication? Use the interactive Drug Interaction Checker to screen your full medication list at once.
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DA
Medically reviewed by Dr. Arellano, M.D.
Clinical Director, MindScape Retreat · Board-certified physician specializing in ibogaine-assisted detoxification with over 1,000 patients treated.
Last reviewed: May 2026 · See full medical team