Lithium
Lithobid, Eskalith
Ibogaine and Guanfacine
Also known as: Intuniv, Tenex
Alpha-2 agonist of the same class as clonidine, less sedating but with the same bradycardia and hypotension profile, additive with ibogaine's.
Severity
Moderate caution
Mechanism
Cardiac conduction (bradycardia / AV node)
Protocol Status
Continue as prescribed — cleared by a measured lab value, not a waiting period
Restart Delay
Physician discretion
What "Moderate caution" Means
Use with caution. Often requires a brief hold, dose reduction, or enhanced monitoring rather than full discontinuation.
Clinical Action
What our medical team does for patients on Guanfacine.
Do not stop abruptly. Expect a lower baseline heart rate and record raw QT with the rate so QTc can be corrected.
Where the Washout Happens
Continue as prescribed — cleared by a measured lab value, not a waiting period
This medication is not stopped for treatment, and should not be stopped on our initiative — the condition it treats usually outranks the interaction. What it changes is monitoring: serum potassium and magnesium are measured before the flood dose and corrected to target, and the dose is deferred until those numbers are right rather than until a number of days have passed. Any change to the prescription belongs to the prescribing physician.
Post-Treatment Restart
Restart at physician discretion once acute window closes.
The Pharmacology
How Guanfacine 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 moderate caution medications (different mechanism).
Common Questions
Guanfacine and ibogaine treatment.
Can I take ibogaine if I am on Guanfacine?
Moderate caution. Alpha-2 agonist of the same class as clonidine, less sedating but with the same bradycardia and hypotension profile, additive with ibogaine's. Do not stop abruptly. Expect a lower baseline heart rate and record raw QT with the rate so QTc can be corrected.
How long do I need to be off Guanfacine before ibogaine treatment?
Continue as prescribed — cleared by a measured lab value, not a waiting period. This medication is not stopped for treatment, and should not be stopped on our initiative — the condition it treats usually outranks the interaction. What it changes is monitoring: serum potassium and magnesium are measured before the flood dose and corrected to target, and the dose is deferred until those numbers are right rather than until a number of days have passed. Any change to the prescription belongs to the prescribing physician.
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 Guanfacine — contact us for an individual review.
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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