Iboga and ibogaine can cause life-threatening complications, including death. Screening and clinical monitoring are essential—but neither makes treatment risk-free.
A discussion guide, not medical clearance or instructions for use.
Plant preparations and isolated ibogaine both carry serious risks. The strength and composition of plant products can vary, and a reassuring testimonial is not evidence of safety.
Ibogaine can prolong the heart’s QT interval and trigger dangerous abnormal rhythms, including cardiac arrest. It can also slow the heart rate.
Risk may be increased by existing heart conditions, some medicines, and electrolyte imbalances. A person can have an underlying problem without knowing it.
A normal ECG alone does not establish that treatment is safe. Risk can persist beyond the main psychoactive experience.
Prescription medicines, non-prescription products, supplements, alcohol and other drugs may affect heart rhythm, drug metabolism or mental state. Do not stop or adjust medicines to prepare on your own.
Seizures, impaired coordination, vomiting and aspiration are concerns. Liver disease and a history of severe mental illness may also affect risk and require specialist assessment.
Alcohol and benzodiazepine withdrawal can be life-threatening. Dependence and withdrawal must be medically assessed; ibogaine is not a substitute for supervised withdrawal care.
This is not a complete list of risks or contraindications. Evidence for benefits remains limited. Speak with a qualified clinician about established treatment options as well as uncertainties.
Speak openly with a qualified clinician before making arrangements. Leaving something out can change the risk assessment.
Do not self-administer. A questionnaire, online conversation or app cannot replace an appropriate medical assessment.
Build your preparation planInclude heart problems, fainting, seizures, liver conditions and mental health history. Mention unexplained sudden deaths or inherited heart conditions in your family.
Bring an accurate list of medicines, supplements and substances, including amounts and recent use. Include opioid treatments such as methadone or buprenorphine. Any changes need a clinician-led plan.
Ask about an ECG, electrolyte testing, liver function and any additional assessment your history requires. Results need clinical interpretation—not simply a tick in a box.
Discuss pregnancy or breastfeeding, recent illness, dehydration, withdrawal symptoms, and who can support you afterwards. Ask whether treatment should be deferred or avoided.
Use these questions to guide a conversation, not to certify a provider. Clear answers matter; so does an independent medical opinion.
Ask for the assessing clinician’s name, professional registration and relevant experience. Who reviews your ECG, blood results, medical history and medications? What findings would rule out or postpone treatment?
Look for: an individual clinical assessment and a willingness to decline treatment—not a promise that everyone is suitable.
Ask who is physically present, what cardiac monitoring is used, who interprets it, and how deterioration is recognised and managed. Ask how the observation period is decided, including after the main effects have passed.
Be cautious of: remote-only supervision, reliance on a consumer wearable, or an assumption that appearing awake means the danger is over.
Ask about on-site resuscitation equipment, staff training, emergency procedures and transfer to hospital. Who takes responsibility, and how quickly can higher-level care be reached?
Look for: a specific, practical response plan. “We have never had a problem” is not an emergency plan.
Ask who reviews every medicine and substance you use, and who manages any withdrawal or changes to prescribed treatment. The plan must account for your circumstances, not a standard stop-date for everyone.
Do not: stop medication, attempt a washout period or manage withdrawal yourself based on a provider’s general information or an online guide.
Ask how discharge readiness is assessed, who provides follow-up, and whom you can contact if physical or psychological symptoms develop. Discuss transport, ongoing addiction care, mental health support and an overdose prevention plan where relevant.
Look for: continuity of care, with clear responsibilities rather than an app or informal check-in as the only support.
Plan ongoing medical, psychological and practical support before treatment—not only if something goes wrong.
Explore the Treatment Companion App at ibogaine.org.nz as a supporting resource alongside preparation, clinical conversations and ongoing care.