Lithium
Lithobid, Eskalith
Ibogaine and Metoprolol
Also known as: Lopressor, Toprol
CYP2D6 substrate + beta-blocker. Additive bradycardia with ibogaine.
Severity
Moderate caution
Mechanism
Cardiac conduction (bradycardia / AV node)
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 Metoprolol.
Reduce dose or hold on treatment day. Monitor heart rate closely. CYP2D6 inhibition by ibogaine will increase metoprolol levels.
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 Metoprolol 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
Metoprolol and ibogaine treatment.
Can I take ibogaine if I am on Metoprolol?
Moderate caution. CYP2D6 substrate + beta-blocker. Additive bradycardia with ibogaine. Reduce dose or hold on treatment day. Monitor heart rate closely. CYP2D6 inhibition by ibogaine will increase metoprolol levels.
How long do I need to be off Metoprolol 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?
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 Metoprolol — 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