Citalopram
Celexa
Ibogaine and Ondansetron
Also known as: Zofran
Dose-dependent QTc prolongation (>16mg IV especially). Commonly used for ibogaine nausea.
Severity
Moderate caution
Mechanism
QT-interval prolongation
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 Ondansetron.
May use at low doses (4mg) with QTc monitoring. Avoid IV bolus >16mg. Check QTc before and after.
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
May be used during treatment with monitoring.
Post-Treatment Restart
Restart at physician discretion once acute window closes.
The Pharmacology
How Ondansetron interacts with ibogaine: 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.
Same Mechanism
Other medications that interact via qt-interval prolongation.
Same Severity Tier
Other moderate caution medications (different mechanism).
Cardiac conduction (bradycardia / AV node)
Metoprolol
Lopressor, Toprol
Cardiac conduction (bradycardia / AV node)
Atenolol
Tenormin
Cardiac conduction (bradycardia / AV node)
Propranolol
Inderal
Cardiac conduction (bradycardia / AV node)
Carvedilol
Coreg
Cardiac conduction (bradycardia / AV node)
Verapamil
Calan, Verelan
Cardiac conduction (bradycardia / AV node)
Diltiazem
Cardizem, Tiazac
Common Questions
Ondansetron and ibogaine treatment.
Can I take ibogaine if I am on Ondansetron?
Moderate caution. Dose-dependent QTc prolongation (>16mg IV especially). Commonly used for ibogaine nausea. May use at low doses (4mg) with QTc monitoring. Avoid IV bolus >16mg. Check QTc before and after.
How long do I need to be off Ondansetron 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. May be used during treatment with monitoring.
What is the mechanism of the interaction?
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.
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 Ondansetron — 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