Lithium
Lithobid, Eskalith
Ibogaine and Flecainide
Also known as: Tambocor
Class Ic antiarrhythmic: potent sodium-channel blockade widening QRS, on top of ibogaine's potassium-channel (hERG) blockade. Combined conduction impairment is proarrhythmic.
Severity
Contraindicated
Mechanism
Cardiac conduction (bradycardia / AV node)
Protocol Status
Generally not eligible until alternative management is established
Restart Delay
Physician discretion
What "Contraindicated" Means
Absolute prohibition without an enforced washout. Treatment cannot proceed safely until the medication has been cleared from the body for the protocol's required interval.
Clinical Action
What our medical team does for patients on Flecainide.
Requires cardiology sign-off and an alternative rhythm strategy before treatment can be considered.
Where the Washout Happens
Generally not eligible until alternative management is established
Pharmacology (e.g., ultra-long half-life) makes safe washout impractical within any reasonable treatment window. Treatment generally cannot proceed until cardiology or the prescribing physician has established alternative management.
Post-Treatment Restart
Restart at physician discretion once acute window closes.
The Pharmacology
How Flecainide interacts with ibogaine: cardiac conduction (bradycardia / av node).
Ibogaine slows the sinus node and AV conduction. Beta-blockers, non-dihydropyridine calcium channel blockers, digoxin, and lithium can deepen bradycardia or generate higher-degree AV block. Heart-rate-slowing medications are typically held on dosing day with continuous telemetry monitoring.
Same Mechanism
Other medications that interact via cardiac conduction (bradycardia / av node).
Same Severity Tier
Other contraindicated medications (different mechanism).
Serotonergic activity (serotonin syndrome)
Fluoxetine
Prozac, Sarafem
Serotonergic activity (serotonin syndrome)
Sertraline
Zoloft
Serotonergic activity (serotonin syndrome)
Paroxetine
Paxil, Pexeva
QT-interval prolongation
Citalopram
Celexa
QT-interval prolongation
Escitalopram
Lexapro
Serotonergic activity (serotonin syndrome)
Fluvoxamine
Luvox
Common Questions
Flecainide and ibogaine treatment.
Can I take ibogaine if I am on Flecainide?
Contraindicated. Class Ic antiarrhythmic: potent sodium-channel blockade widening QRS, on top of ibogaine's potassium-channel (hERG) blockade. Combined conduction impairment is proarrhythmic. Requires cardiology sign-off and an alternative rhythm strategy before treatment can be considered.
How long do I need to be off Flecainide before ibogaine treatment?
Generally not eligible until alternative management is established. Pharmacology (e.g., ultra-long half-life) makes safe washout impractical within any reasonable treatment window. Treatment generally cannot proceed until cardiology or the prescribing physician has established alternative management.
What is the mechanism of the interaction?
Cardiac conduction (bradycardia / AV node). Ibogaine slows the sinus node and AV conduction. Beta-blockers, non-dihydropyridine calcium channel blockers, digoxin, and lithium can deepen bradycardia or generate higher-degree AV block. Heart-rate-slowing medications are typically held on dosing day with continuous telemetry monitoring.
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 Flecainide — 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