QT-interval prolongation
Ondansetron
Zofran
Ibogaine and Kava
Also known as: Kava Kava, Piper Methysticum, Kavalactones
Hepatotoxicity (idiosyncratic and dose-related) plus CNS depression. Adds hepatic stress on top of ibogaine's hepatic metabolism and compounds sedation.
Severity
Moderate caution
Mechanism
Hepatic stress
Protocol Status
Pre-arrival washout (under your prescribing physician)
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 Kava.
Discontinue minimum 14 days before treatment. Pre-treatment LFTs required.
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
14 days minimum before treatment.
Post-Treatment Restart
Restart at physician discretion once acute window closes.
The Pharmacology
How Kava interacts with ibogaine: hepatic stress.
Ibogaine is metabolised in the liver. Adding hepatotoxic drugs (alcohol, high-dose acetaminophen, certain antifungals, anabolic steroids) raises the risk of transaminase elevation and impaired clearance. Liver function tests are part of every pre-treatment workup.
Same Severity Tier
Other moderate caution medications (different mechanism).
Common Questions
Kava and ibogaine treatment.
Can I take ibogaine if I am on Kava?
Moderate caution. Hepatotoxicity (idiosyncratic and dose-related) plus CNS depression. Adds hepatic stress on top of ibogaine's hepatic metabolism and compounds sedation. Discontinue minimum 14 days before treatment. Pre-treatment LFTs required.
How long do I need to be off Kava 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. 14 days minimum before treatment.
What is the mechanism of the interaction?
Hepatic stress. Ibogaine is metabolised in the liver. Adding hepatotoxic drugs (alcohol, high-dose acetaminophen, certain antifungals, anabolic steroids) raises the risk of transaminase elevation and impaired clearance. Liver function tests are part of every pre-treatment workup.
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 Kava — 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 900 patients treated.
Last reviewed: May 2026 · See full medical team