Ibogaine and Ketamine Therapy | Tovani Health
Tabernanthe iboga (Ibogaine) — Naturally-occurring psychoactive alkaloid (DEA Schedule I)
Verdict at Tovani Health
Schedule I and carries serious cardiac risk on its own; combination with ketamine adds too many unknowns.
Ibogaine is a DEA Schedule I controlled substance in the United States. Recreational and ceremonial use occurs internationally (Mexico, Costa Rica) primarily for opioid use disorder treatment, and the limited research interest is in supervised inpatient settings only. Two specific concerns matter: ibogaine causes documented QT prolongation and torsades de pointes, with multiple fatalities in published case series; and the long active duration (24-72 hours) plus serotonergic and NMDA-modulating activity means a long pharmacologic interaction window with ketamine. Patients who have used ibogaine recently are not candidates for at-home KAP until well into the recovery window.
If you take Tabernanthe iboga regularly and are considering at-home ketamine therapy, the combination is not currently a candidate. This page covers the brief pharmacologic context and what we do at intake.
How Tabernanthe iboga interacts with ketamine
Ibogaine is metabolized to noribogaine with a half-life of multiple days. Acts at NMDA, kappa-opioid, sigma-2, serotonin, and nicotinic receptors. Causes dose-dependent QT prolongation with documented torsades. Published case series report cardiac fatalities.
What we do at intake
Disclose any ibogaine use. We require at least 4 weeks of separation after any ibogaine experience before starting KAP, and a baseline EKG documenting normal QT before the first session.
Bottom line
Ibogaine is a DEA Schedule I controlled substance in the United States. Recreational and ceremonial use occurs internationally (Mexico, Costa Rica) primarily for opioid use disorder treatment, and the limited research interest is in supervised inpatient settings only. Two specific concerns matter: ibogaine causes documented QT prolongation and torsades de pointes, with multiple fatalities in published case series; and the long active duration (24-72 hours) plus serotonergic and NMDA-modulating activity means a long pharmacologic interaction window with ketamine. Patients who have used ibogaine recently are not candidates for at-home KAP until well into the recovery window.
What would change this answer
We don’t prescribe at-home ketamine in this scenario today, but the situation can change. Talk to your prescribing physician about whether the underlying clinical picture (medication change, dose taper, indication shift, or stabilization milestone) might make you eligible later. We’re happy to revisit if your circumstances change.
For immediate mental health support, the 988 Suicide & Crisis Lifeline is available 24/7 (call or text 988).
Sources
The verdict and clinical guidance on this page are based on the following peer-reviewed literature and FDA prescribing information.
- Psychedelics. Nichols DE. Pharmacological Reviews. 2016. PMID: 26841800
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 17, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.