Ibogaine and Hydroxychloroquine

Major risk. Recognised QT-prolonging agent, additive with ibogaine's hERG effect. Its terminal half-life is measured in WEEKS, so a washout of a few days achieves essentially nothing and a normal-looking gap since the last dose is not evidence of clearance. Usually prescribed for lupus or rheumatoid arthritis, where stopping it carries its own risk of a disease flare. Do not stop it on our initiative — the condition it treats usually outranks the interaction and a short hold would not clear it anyway. Assess readiness by ECG rather than by elapsed days: baseline QTc, and correct electrolytes to protocol target before dosing.

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.

QT-interval prolongation. Ibogaine and noribogaine block the cardiac hERG (IKr) potassium channel, which lengthens ventricular repolarisation and the QTc interval on a 12-lead EKG. Adding a second QT-prolonging drug compounds the effect and raises the risk of torsades de pointes — a polymorphic ventricular tachycardia that can be fatal. Every patient receives a baseline EKG, electrolyte panel, and continuous cardiac monitoring; medications in this class must be washed out long enough to return QTc into a safe range.

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 Hydroxychloroquine — contact us for an individual review.