MEDICAL AND SAFETY GUIDELINES FOR AYAHUASCA.

 Our priority is your safety and well-being, and to guide you towards personal healing and growth. During the booking process, you will be asked to complete an application form with your medical information. It is for your safety to be as open and detailed as possible when answering the questions. Failure to do so will put you and others at risk.

  • If the medical contraindications below are present – you may not participate in Ayahuasca ceremonies and retreats.
  • If there are possible medical contraindications, we make further enquiries to ensure your safety.
  • If the medical contraindications below are present and you withhold that information and we find out, you will be asked to leave the program without any refund, and you will be not allowed to participate at any other future Ayahuasca ceremonies and retreats with us.

By booking a ceremony or retreat, you certify that you have read and agree to our “Medical and Safety Guidelines for Ayahuasca”, that you are in a physical and mental condition suitable for the activities described in the ceremony or retreat programme, that you agree to participate at your own risk, and that we cannot accept liability for any accident or injury. We will provide the safest possible environment to work with Ayahuasca and ensure your well-being at all times to the best of its ability.

Working with Ayahuasca may involve health risks; it is imperative that you disclose any known physical and psychological conditions together with use of medication or psychoactive substances at the time of booking. 

PHYSICAL CONDITIONS 

Although the use of Ayahuasca under controlled conditions is generally considered safe, some medical conditions can have moderate to very serious complications when used with Ayahuasca. These include:

  • Heart/Cardiovascular conditions: If you have a chronic heart condition or high blood pressure, we advise against participating in drinking Ayahuasca because it can increase blood pressure, which can pose a serious and/or fatal risk for people with serious heart disease or high blood pressure. If you have a mild heart condition we may consider your case.
  • Epilepsy/seizures: If you or an immediate family member has a history of epilepsy and/or seizures, provide more details as possible. Use of Ayahuasca, if not properly managed and controlled, can induce a seizure if you have a history of epilepsy.
  • Diabetes: Guests with diabetes are at extra risk consuming Ayahuasca because using the MAO inhibitors (Monoamine oxidase inhibitors) can alter blood sugar levels via hypoglycemic effects. Moreover, MAOIs like Ayahuasca can alter the amount of insulin or oral anti-diabetic medication you need. People with severe, unstable diabetes are better off not taking Ayahuasca  because of this risk. People with less severe diabetes may discuss their specific case, including the possibility of a modified diet.
  • Liver and Kidney conditions: The liver and kidneys play a vital role in the metabolism of exogenous and endogenous chemicals, and using the MAOI can be stressful and impair their proper functioning.
  • Hypothyroidism: It is generally safe to partake in the use of Ayahuasca if you have a hypothyroidism condition, but we want to accurately monitor your dosage during your Ayahuasca. You may also continue taking your hypothyroid medication during your ceremony or retreat without complications.

 As also is not recommended on the following cases:

  • Glaucoma
  • retinal detachment
  • Fractures
  • recent surgeries
  • acute infectious diseases
  • Tuberculosis
  • certain cases of gastroduodenal ulcer or gastritis
  • digestive haemorrhage
  • Those who have difficulty vomiting should also avoid ingesting ayahuasca. 
  • Ayahuasca is not recommended for pregnant or lactating women.


  • If you suffer from a particular medical condition not covered below, you will have the possibility to provide further information during the screening process.

PSYCHOLOGICAL CONDITIONS: 

Ayahuasca is not indicated for people suffering from panic attacks, serious psychiatric disorders such as bipolar, schizophrenia, borderline personality, etc. If a person has a history of severe depression, suicide attempts or self-harm, it is essential that the work with ayahuasca is accompanied by adequate psychological supervision.

The right and appropriate use of ayahuasca has significant results supporting and improvement of psychological trauma and its resultant symptomatology. At the same time, potential guests with a close/strong family history of psychotic disorders such as bipolar, schizophrenia, borderline, or depersonalization should realise they are at an increased risk for the expression of these symptoms, and it is conceivable (although highly unlikely) that ayahuasca can unmask such symptoms in predisposed individuals. Consequently, If you have history of psychosis in your family, we would firstly need to ascertain that you:

  • Have no direct history of major issues of mania, psychosis, or depersonalization.
  • Have not previously taken any medication for these conditions
  • Are not currently taking any psychiatric medication

And those psychological conditions will be carefully reviewed:

  • panic attacks
  • severe depression
  • suicide attempts or self-harm

 

USE OF MEDICATIONS: 

In general, when taking Ayahuasca  or other medicinal plants, do not take any other substances or medicines, including herbal medicines, both for your safety and so as not to interfere with the efficacy of the plants or their energies. 

Certain medications should be avoided with Ayahuasca as they can be potentially dangerous. This includes interaction with pharmaceutical drugs and medications, as well as some over-the-counter drugs and certain herbs. In particular, the combination with MAOIs and other serotonin agonists or precursors poses a serious risk of causing a life-threatening serotonin syndrome episode. It is essential to stop using the substances mentioned in this document and give your system enough time to remove them from the body before embarking on a ceremony or retreat. 

We suggest for best safety to stop taking those substances 2 months in advance.

Remember to consult your doctor before stopping taking any prescribed medication, and to tell your doctor specifically that you will be taking a reversible MAOI.

DRUGS TO BE AVOIDED WITH AYAHUASCA:

  • MAOIs
  • SSRIs (selective serotonin reuptake inhibitors)
  • Antihypertensive drugs/medication for high blood pressure
  • Appetite suppressants or diet pills
  • Medicines for asthma, bronchitis or other respiratory problems
  • Antihistamines
  • Medicines for colds, sinus problems, hay fever or allergies (all medicines containing dextromethorphan/DXM, or having DM, DX or Tuss in their name).
  • CNS (central nervous system) depressants (e.g. Xanax, Ativan)
  • Vasodilators
  • Antipsychotics
  • Barbiturates

VERY DANGEROUS PSYCHOACTIVE SUBSTANCES TO COMBINE WITH AYAHUASCA:

  • Cocaine, amphetamines and ephedrine
  • MDMA (Ecstasy), MDA, MDEA, PMA
  • Opiates (heroin, morphine, codeine, opium)
  • Dextromethorphan (DXM)
  • Nutmeg

Less but still dangerous:

  • Mescaline (elke fenethylamine)
  • Barbituraten
  • Alcohol
  • Kratom
  • Kava
  • 5-MEO-DMT

CONTRA-INDICATIONS: HERBAL MEDICINES AND SUPPLEMENTS.

  • St. John’s Wort
  • Kava
  • Kratom
  • Ephedra
  • Ginseng
  • Yohimbe
  • Sinicuichi
  • Rhodiola Rosea
  • Kanna
  • Boswellia
  • Nutmeg
  • Scotch Broom
  • Licorice root
  • Cannabis

 

(IN-DEPTH) CONTRA-INDICATIONS: DRUG AND MEDICINES

All drugs containing MAO inhibitors (MAOIs) are known to cause dangerous side effects when taken in combination with Ayahuasca  and should be suspended. Any medication that has an effect on the serotonin system, including Selective Serotonin Reuptake Inhibitors (SSRIs), can cause serotonin syndrome, with potentially fatal consequences when combined with Ayahuasca . We recommend discontinuing SSRI medications 6 weeks prior to a ceremony or retreat to allow the system to clear in time. Some of these medications can cause side effects when you stop taking them, so you should allow enough time for these to subside and always consult your doctor before changing your medication regimen.

DRUGS WITH A CONTRA-INDICATION:

  • Other MAOIs
  • SSRIs (selective serotonin reuptake inhibitors)
  • Asthma inhalers
  • Antihypertensives (medicines for high blood pressure)
  • Appetite suppressants (diet pills)
  • Medicines for asthma, bronchitis or other respiratory problems
  • Antihistamines, medicines for colds, sinus problems, hay fever or allergies (all cold, cough or flu medicines and all medicines with DM, DX or -tuss in the name).
  • CNS (central nervous system) depressants
  • Antipsychotics
  • Barbiturates
  • Sedatives
  • Sympathomimetic amines (including pseudoephedrine and ephedrine)
  • Alcohol
  • Amphetamines
  • Opiates
  • Mescaline (any phenethylamine)
  • Barbiturates

SPECIFIC CONTRA-INDICATED DRUGS:

  • Actifed
  • Adderall
  • Alaproclaat
  • Albuterol (Proventil, Ventolin)
  • Amantadine hydrochloride (Symmetrel)
  • Amineptine
  • Amitriptaline
  • Amoxapine (Asendin)
  • Asaron/Calamus
  • Atomoxedine
  • Befloxeton
  • Benadryl
  • Benylin
  • Benzedrine
  • Benzfetamine (Didrex)
  • Bicifadine
  • Brasofensine
  • Brofaromine
  • Bromarest-DM of -DX
  • Bupropion (Wellbutrin)
  • Buspiron (BuSpar)
  • Butriptyline
  • Carbamazepine (Tegretol, Epitol)
  • Chloorfeniramine
  • Chlor Trimeton
  • Cimoxeton
  • Citalopram
  • Clomipramine (Anafranil)
  • Cocaïne
  • Codeïne
  • Compoz
  • Cyclobenzaprine (Flexeril)
  • Cyclizine (Marezine)
  • Dapoxotine
  • Desipramine (Pertofrane, Norpramin)
  • Desvenlafaxine
  • Dextroamfetamine (Dexedrine)
  • Dextromethorfan (DXM)
  • Dibenzepin
  • Dienolide kavapyrone desmethoxyyangonine
  • Diethylpropion
  • Dimetaan-DX
  • Disopyramide (Norpace)
  • Disulfiram (Antabuse)
  • Dopamine (Intropin)
  • Dosulepin
  • Doxepin (Sinequan)
  • Dristan Verkoudheid & Griep
  • Duloxetine
  • Emsam
  • Efedrine
  • Epinefrine (Adrenaline)
  • Escitalopram
  • Femoxitine
  • Fenfluramine (Pondimin)
  • Flavoxaathydrochloride (Urispas)
  • Fluoxetine (Prozac)
  • Fluvoxamine
  • Furazolidon (Furoxon)
  • Guanethedine
  • Guanadrel (Hylorel)
  • Guanethidine (Ismelin)
  • Hydralazine (Apresoline)
  • 5 Hydroxytryptofaan
  • Imipramine (T ofranil)
  • Iprindol
  • Iproniazide (Marsilid, Iprozid, Ipronid, Rivivol,
  • Propilniazida)
  • Iproclozide
  • Isocarboxazide (Marplan)
  • Isoniazid (Laniazid, Nydrazid)
  • Isoniazide rifampin (Rifamaat, Rimactane)
  • Isoproterenol (Isuprel)
  • L-dopa (Sinemet)
  • Levodopa (Dopar, Larodopa)
  • Linezolid (Zyvox, Zyvoxid)
  • Lithium (Eskalith)
  • Lofepramine
  • Loratadine (Claritin)
  • Macromerine
  • Maprotiline (Ludiomil)
  • MDA
  • MDEA
  • MDMA (Ecstasy)
  • Medifoxamine
  • Melitracen
  • Meperidine (Demerol)
  • Metaproterenol (Alupent, Metaprel)
  • Metaraminol (Aramine)
  • Methamfetamine (Desoxyn)
  • Methyldopa (Aidomet)
  • Methylfenidaat (Ritalin)
  • Mianserin
  • Milnacipran
  • Minaprine
  • Mirtazapine (Remeron)
  • Moclobemide
  • Montelukast (Singulair)
  • Nefazodon
  • Nialamide
  • Nisoxetine
  • Nomifensine
  • Norepinefrine (Levophed)
  • Nortriptyline (Aventyl)
  • Oxybutyninechloride (Ditropan)
  • Oxymetazoline (Afrin)
  • Orfenadrine (Norflex)
  • Pargyline (Eutonyl)
  • Parnate
  • Paroxetine (Paxil)
  • Pemoline (Cylert)
  • Percocet
  • Pethedine (Demerol)
  • Phendimetrazine (Plegiline)
  • Fenelanine
  • Fenergen
  • Fenmetrazine
  • Phentermine
  • Fenylefrine (Dimetane, Dristan decongestivum, Neo
  • Synephrine)
  • Fenylpropanolamine (in veel verkoudheidsmedicijnen)
  • Fenelzine (Nardil)
  • PMA
  • Procarbazine (Matulane)
  • Procainamide (Pronestyl)
  • Protriptyline (Vivactil)
  • Pseudo-efedrine
  • Oxymetazoline (Afrin)
  • Kinidine (Quinidex)
  • Rasagiline (Azilect)
  • Reboxetine
  • Reserpine (Serpasil)
  • Risperidon
  • Robitussin
  • Salbutemol
  • Salmeterol
  • Selegiline (Eldepryl)
  • Sertraline (Zoloft)
  • Sibutramine
  • Sumatriptan (Imitrex)
  • Terfenadine (Seldane D)
  • Tegretol
  • Temaril
  • Tesofensine
  • Theofylline (Theo Dur)
  • Tianeptine
  • Toloxatone
  • Tramidol
  • Tranylcypromine (Parnate)
  • Trazodon
  • Tricyclische antidepressiva (Amitriptyline, Elavil)
  • Trimipramine (Surmontil)
  • Triptanen
  • Tryptofaan
  • Tyrosine
  • Vanoxerine
  • Venlafaxine (Effexor)
  • Viloxezine
  • Vicks Formule 44-D
  • Yohimbine
  • Zimelidine
  • Ziprasidone (Geodon)
  • Using stimulants with MAOIs is particularly dangerous and can be fatal.
  • The use of cocaine, amphetamines or MDMA (Ecstasy) with MAOIs can cause a severe increase in blood pressure, increasing the risk of stroke and cerebral haemorrhage, and making an overdose of a relatively small amount of cocaine possible. (One death has been recorded with a combination of Peganum harmala and cocaine. Deaths from combining amphetamines with pharmaceutical MAOIs have been recorded in the medical literature).
  • The use of other serotonin agonists or precursors with an MAOI can lead to serotonin syndrome. The main symptom of serotonin syndrome may be severe and prolonged headache (same symptom as MAOI tryptamine interaction) and/or fever (up to 40 °C / 104 °F or more) Other symptoms of serotonin syndrome may include rapid heartbeat, shivering, sweating, dilated pupils, intermittent tremor or convulsions, overactive or overreacting reflexes, hyperactive bowel sounds, high blood pressure. Severe serotonin syndrome can cause shock, agitated delirium, muscle rigidity and high muscle tension. renal failure, seizures, and can be life-threatening.
  • Using tricyclic antidepressants within two weeks of using MAOIs can cause serious side effects, including sudden fever, extremely high blood pressure, convulsions and death.
  • Use of Fluoxetine (Prozac) within five weeks of using MAOIs can cause high fever, rigidity, high blood pressure, mental changes, confusion and hypomania.
  • The use of Benzedrine, Benzphetamine, Desipramine, Desoxyn, Dexedrine, Dopamine, Ephedrine (contained in Marax, Quadrinal, and other asthma drugs), Epinephrine, Guanadrel, Guanethidine, Hydralazine, Isoproterenol, L-dopa, Metaraminol, Methyldopa, Mirtazamine, Norepinephrine Oxymetazoline, Phendimetrazine, Phentermine, Phenylephrine, Phenylpropanolamine, Pseudoephedrine, Ritalin, or Venlafaxine with MAOIs can cause a hypertensive crisis (severe blood pressure spike).
  • Use of Adderall with MAOIs can lead to high body temperature, seizures and, in some cases, coma.
  • Use of Bupropion (Wellbutrin) within two weeks of using MAOIs can cause serious side effects, such as seizures.
  • The use of Buspiron (Buspar) with MAOIs can cause high blood pressure and increased sedative effects.
  • The use of carbamazepine (Tegretol) in combination with MAOIs may cause fever and increase seizures, especially in epileptics….
  • The use of clomipramine with MAOIs may cause high fever (hyperpyrexic crisis) and seizures.
  • The use of CNS depressants with MAOIs may potentiate depressive effects.
  • The use of desipramine (Norpramin, Pertofrane) with MAOIs may lead to a hypertensive crisis.
  • The use of Dextromethorphan with MAOIs may cause agitation, hypertension and fever, or brief episodes of psychosis.
  • The use of Fenfluramine with MAOIs may cause fever (hyperpyrexic crisis).
  • The use of Lithium with MAOIs may cause fever and serotonin syndrome.
  • Use of Meperidine (Demerol) with pharmaceutical MAOIs has led to deaths after a single dose.
  • Use of metaproterenol or other beta-adrenergic bronchodilators with MAOIs may cause blood pressure elevation and rapid heart rate.
  • Use of Mirtazapine (Remeron) with MAOIs may lead to hypertensive crisis.
  • The use of Nephazodone (Serzone) may lead to high fever.
  • Using Temaril with MAOIs may increase the risk of side effects.
  • The use of Terfenadine with MAOIs may cause an increase in MAOI blood levels.
  • The use of Theophylline with MAOIs may cause rapid heart rate and anxiety.
  • The use of Trazodone (Desyrel) with MAOIs may cause high fever.
  • The use of tryptophan or L-tryptophan with MAOIs may cause disorientation, confusion, amnesia, delirium, agitation, memory impairment, hypomania and chills.
  • Use of Venlafaxine (Effexor) with MAOIs can lead to a hypertensive crisis.
  • Use of Ziprasidone (Geodon) with MAOIs may cause serotonin syndrome.
  • Use of alcohol with MAOIs may cause side effects such as angina (chest pain) or headache. The headache may mask or be confused with a hypertensive crisis caused by the interaction with MAOIs. MAOIs can also enhance the sedative effect of alcohol.
  • The use of opiates with MAOIs carries a risk of respiratory depression.
  • The use of diuretics with MAOIs may cause a greater than normal drop in blood pressure and an increase in MAOI blood levels.
  • The use of anaesthetics with MAOIs may enhance the anaesthetic effect.
  • The use of sleeping pills, sedatives (major or minor) or barbiturates with MAOIs may enhance the sedative effect.

BELOW ARE MORE SPECIFIC GUIDELINES ON THESE MEDICATIONS THAT SHOULD BE AVOIDED WITH AYAHUASCA .

MONOAMINE OXIDASE INHIBITORS (MAOIS): STOP USING THEM 4 TO 6 WEEKS BEFORE.

Ayahuasca is a very potent, natural MAOI, and should not be used in combination with other MAOIs. Combining MAOIs can lead to complications in the regulation of neurotransmitters and digestion, such as hypertensive crisis, convulsive seizures, fever, delirium, coma, and circulatory collapse. Withdrawal symptoms are possible when discontinuing prescribed MAOIs, so it is important to consult a doctor about how to taper off the dosage.

SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS): 6 OR 8 WEEKS PRIOR AND AT LEAST 4 WEEKS AFTER.

The combination of Ayahuasca  and an SSRI is potentially life-threatening. The combination of these two substances can cause SSRIs to induce serotonin syndrome when used in combination with Ayahuasca , which is an excess and/or overload of serotonergic activity in the central nervous system and peripheral serotonin receptors. With most SSRIs you should stop 6 weeks before the ceremony, but with Prozac you should stop 8 weeks before drinking Ayahuasca because of its longer half-life. To avoid side effects, it is important to give yourself time to get used to not taking any medication before participating in an Ayahuasca  ceremony.

OTHER ANTI-DEPRESSANTS: DISCONTINUE USE 6 WEEKS BEFORE, AND FOR AT LEAST 4 WEEKS AFTER.

Antidepressants other than SSRIs can cause serious complications when combined with drinking Ayahuasca . These antidepressants include serotonin-norepinephrine inhibitors (SNRI), serotonin antagonist and reuptake inhibitors (SARI), norepinephrine inhibitors (NRI), norepinephrine-dopamine reuptake inhibitors (NDRI), tricyclic antidepressants (TCA), tetracyclic antidepressants (TeCA), noradrenergic and specific serotonergic antidepressants (NaSSA), and serotonin modulators and stimulators (SMS). As with all medications, it is important to give antidepressants ample time to leave your system to avoid unwanted side effects.

BENZODIAZEPINES, CENTRAL NERVOUS SYSTEM DRUGS AND SLEEPING PILLS: DO NOT TAKE THEM 3 TO 4 WEEKS IN ADVANCE.

Drugs that suppress the central nervous system (CNS), such as certain anti-anxiety drugs and sleeping pills, should not be used in combination with Ayahuasca , as they pose a serious health risk. Taking Ayahuasca  can intensify the effects of these drugs, leading to slower brain activity, heart rhythm and labored breathing. CNS depressants include benzodiazepines, sedatives and barbiturates. Dependence on CNS depressants can develop easily, so withdrawal symptoms may occur when discontinuing the medication.

*Consult your doctor for help before stopping your medication*.

ANTI-HYPERTENSIVE DRUGS: STOP USE 2 TO 6 WEEKS IN ADVANCE, DEPENDING ON THE MEDICATION AND CONSULT WITH THE DOCTOR.

There are many types of blood pressure-lowering drugs that lower blood pressure in different ways; among the most important and widely used are thiazide diuretics, ACE inhibitors, calcium channel blockers, beta blockers and angiotensin II receptor antagonists.

*Consult your doctor before discontinuing your medication*.

ALL OTHER DRUGS: DISCONTINUE USE FOR AT LEAST 1 WEEK PRIOR, AND FOR AT LEAST 1 WEEK AFTERWARDS.

  • Medications such as Valium, Xanax and similar benzodiazepines.
  • Antibiotics, antihistamines, systemic vasoconstrictors or decongestants, cold and flu medicines, asthma inhalers and medicines with high caffeine content.
  • Narcotics, sedatives and tranquillisers
  • Antihypertensive drugs for the treatment of high blood pressure
  • Painkillers
  • Medicines to treat heart disease
  • Neurological or anti-seizure drugs
  • Hormonal therapy and sympathomimetic drugs, including amphetamines and tyrosine

If you have any questions about the above policy regarding contraindications to the use of most medications in combination with Ayahuasca , or would like to discuss your specific health condition(s), please contact us at bookings@pachamamatemple.org.