Drug combinations

From TripSit wiki

WARNING! For educational purposes: We do not endorse any of these combinations. This page will always be 'work in progress'. It is extremely important to be safe at all times! See below the graphic for important information regarding specific combinations.

Combo 2.png

Overview[edit | edit source]

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Categorisations[edit | edit source]

Low Risk & Synergy - These drugs work together to cause an effect greater than the sum of its parts, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before combining drugs.

Low Risk & No Synergy - Effects are just additive. The combination is unlikely to cause any adverse or undesirable reaction beyond those that might ordinarily be expected from these drugs.

Caution - These combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Synergistic effects may be unpredictable. Care should be taken when choosing to use this combination.

Unsafe - There is considerable risk of physical harm when taking these combinations, they should be avoided where possible.

Dangerous - These combinations are considered extremely harmful and should always be avoided. Reactions to these drugs taken in combination are highly unpredictable and have a potential to cause death.

Chart versions[edit | edit source]

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Use & Attribution[edit | edit source]

Use of the data the combination chart and app are built upon is free-of-charge for non-commercial purposes. Distribution and display of the combination chart is also free for non-commercial purposes. In both cases, we only require that you link back to either this page, or [1]. This should be accompanied with a note citing TripSit as the source for the information wherever it appears. The presentation should also include a note that the information is only intended for a quick overview and reference, and that it is necessary for users to perform more individual research before making a decision.

Specific Combinations[edit | edit source]

cannabis & lsd[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

amphetamines & lsd[edit | edit source]

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

cocaine & lsd[edit | edit source]

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

tramadol & lsd[edit | edit source]

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

cannabis & mushrooms[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

amphetamines & mushrooms[edit | edit source]

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

cocaine & mushrooms[edit | edit source]

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

tramadol & mushrooms[edit | edit source]

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

cannabis & dmt[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

amphetamines & dmt[edit | edit source]

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

cocaine & dmt[edit | edit source]

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

tramadol & dmt[edit | edit source]

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

5-meo-xxt & mescaline[edit | edit source]

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions

cannabis & mescaline[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

amphetamines & mescaline[edit | edit source]

Status: Caution

Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

cocaine & mescaline[edit | edit source]

Status: Caution

Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

caffeine & mescaline[edit | edit source]

Status: Low Risk & No Synergy

Note: High doses of caffeine are uncomfortable and this will be magnified by psychedelics

tramadol & mescaline[edit | edit source]

Status: Unsafe

Note: This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

5-meo-xxt & dox[edit | edit source]

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

cannabis & dox[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

ketamine & dox[edit | edit source]

Status: Low Risk & Synergy

Note: Ketamine and psychedelics tend to potentiate each other - go slowly.

mxe & dox[edit | edit source]

Status: Caution

Note: As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense

dxm & dox[edit | edit source]

Status: Unsafe

Note: The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

pcp & dox[edit | edit source]

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

amphetamines & dox[edit | edit source]

Status: Unsafe

Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

mdma & dox[edit | edit source]

Status: Caution

Note: The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

cocaine & dox[edit | edit source]

Status: Unsafe

Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic

caffeine & dox[edit | edit source]

Status: Caution

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

alcohol & dox[edit | edit source]

Status: Low Risk & Decrease

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

opioids & dox[edit | edit source]

Status: Low Risk & No Synergy

Note: No unexpected interactions.

tramadol & dox[edit | edit source]

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

maois & dox[edit | edit source]

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

5-meo-xxt & nbomes[edit | edit source]

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided

cannabis & nbomes[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

mxe & nbomes[edit | edit source]

Status: Caution

Note: As an NMDA antagonist MXE potentiates NBOMes which can be unpleasantly intense

amphetamines & nbomes[edit | edit source]

Status: Unsafe

Note: Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

cocaine & nbomes[edit | edit source]

Status: Unsafe

Note: Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

caffeine & nbomes[edit | edit source]

Status: Caution

Note: Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping

tramadol & nbomes[edit | edit source]

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures

maois & nbomes[edit | edit source]

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

5-meo-xxt & 2c-x[edit | edit source]

Status: Caution

Note: The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics

cannabis & 2c-x[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

amphetamines & 2c-x[edit | edit source]

Status: Caution

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

cocaine & 2c-x[edit | edit source]

Status: Caution

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

caffeine & 2c-x[edit | edit source]

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

tramadol & 2c-x[edit | edit source]

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

maois & 2c-x[edit | edit source]

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

5-meo-xxt & 2c-t-x[edit | edit source]

Status: Caution

Note: Both classes of compounds can be unpredictable alone

cannabis & 2c-t-x[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

amphetamines & 2c-t-x[edit | edit source]

Status: Unsafe

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences. In extreme cases, they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

cocaine & 2c-t-x[edit | edit source]

Status: Unsafe

Note: Cocaine and 2c-t-x both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

caffeine & 2c-t-x[edit | edit source]

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

alcohol & 2c-t-x[edit | edit source]

Status: Low Risk & Decrease

Note: Both these classes of compound can interact unpredictably. Caution should be exercised.

opioids & 2c-t-x[edit | edit source]

Status: Low Risk & No Synergy

Note: No expected interactions, some opioids have serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

maois & 2c-t-x[edit | edit source]

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably, which could be dangerous given the unpredictability of the 2C-T-x series

cannabis & amt[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics. Small amounts can reduce nausea with aMT but take care.

caffeine & amt[edit | edit source]

Status: Caution

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

alcohol & amt[edit | edit source]

Status: Caution

Note: aMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable

opioids & amt[edit | edit source]

Status: Low Risk & No Synergy

Note: No unexpected interactions

maois & amt[edit | edit source]

Status: Dangerous

Note: aMT is an MAOI on its own. Using enzyme inhibitors can greatly reduce predictability of effects.

mxe & 5-meo-xxt[edit | edit source]

Status: Low Risk & Synergy

Note: Little information exists about this combination.

dxm & 5-meo-xxt[edit | edit source]

Status: Unsafe

Note: Little information exists about this combination.

cannabis & 5-meo-xxt[edit | edit source]

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

amphetamines & 5-meo-xxt[edit | edit source]

Status: Unsafe

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

mdma & 5-meo-xxt[edit | edit source]

Status: Caution

Note: Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care

https://www.ncbi.nlm.nih.gov/pubmed/28677880 ; Just in case I forget.

cocaine & 5-meo-xxt[edit | edit source]

Status: Unsafe

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

caffeine & 5-meo-xxt[edit | edit source]

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

amphetamines & cannabis[edit | edit source]

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

mdma & cannabis[edit | edit source]

Status: Low Risk & Synergy

Note: Large amounts of either or both may cause strong and somewhat unpredictable experiences, which can be as intense as psychedelics. Consider rather Set and Setting are good, before you combine these. Cannabis should be saved for towards the end of the MDMA experience if possible, where the psychedelic alike effect won't come to play.

cocaine & cannabis[edit | edit source]

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

alcohol & cannabis[edit | edit source]

Status: Low Risk & Synergy

Note: In excess, this combination can cause nausea.

amphetamines & ketamine[edit | edit source]

Status: Caution

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

mdma & ketamine[edit | edit source]

Status: Low Risk & Synergy

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

cocaine & ketamine[edit | edit source]

Status: Caution

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

caffeine & ketamine[edit | edit source]

Status: Low Risk & No Synergy

Note: No unexpected interactions.

alcohol & ketamine[edit | edit source]

Status: Dangerous

Note: Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

ghb/gbl & ketamine[edit | edit source]

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

opioids & ketamine[edit | edit source]

Status: Dangerous

Note: Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

benzodiazepines & ketamine[edit | edit source]

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

maois & ketamine[edit | edit source]

Status: Caution

Note: MAO-B inhibitors appear to increase the potency of Ketamine. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available

pcp & mxe[edit | edit source]

Status: Caution

Note: There are no reports available about this combination

amphetamines & mxe[edit | edit source]

Status: Caution

Note: Risk of tachycardia, hypertension, and manic states

mdma & mxe[edit | edit source]

Status: Caution

Note: There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

cocaine & mxe[edit | edit source]

Status: Caution

Note: Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

caffeine & mxe[edit | edit source]

Status: Low Risk & No Synergy

Note: No likely interactions

alcohol & mxe[edit | edit source]

Status: Dangerous

Note: There is a high risk of memory loss, vomiting and severe ataxia from this combination.

ghb/gbl & mxe[edit | edit source]

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

opioids & mxe[edit | edit source]

Status: Dangerous

Note: This combination can potentiate the effects of the opioid

benzodiazepines & mxe[edit | edit source]

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

maois & mxe[edit | edit source]

Status: Unsafe

Note: MAO-B inhibitors appear to increase the potency of MXE. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available

ssris & mxe[edit | edit source]

Status: Caution

Note: Depending on the SSRI this combination can be unpredictable

amphetamines & dxm[edit | edit source]

Status: Unsafe

Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

cocaine & dxm[edit | edit source]

Status: Unsafe

Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues

caffeine & dxm[edit | edit source]

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

alcohol & dxm[edit | edit source]

Status: Dangerous

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

ghb/gbl & dxm[edit | edit source]

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict

opioids & dxm[edit | edit source]

Status: Dangerous

Note: CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

benzodiazepines & dxm[edit | edit source]

Status: Caution

Note: Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

maois & dxm[edit | edit source]

Status: Dangerous

Note: High risk of serotonin syndrome

ssris & dxm[edit | edit source]

Status: Dangerous

Note: High risk of serotonin syndrome.

amphetamines & pcp[edit | edit source]

Status: Unsafe

Note: This combination can easily lead to hypermanic states

mdma & pcp[edit | edit source]

Status: Unsafe

Note: This combination can easily lead to hypermanic states

cocaine & pcp[edit | edit source]

Status: Unsafe

Note: This combination can easily lead to hypermanic states

caffeine & pcp[edit | edit source]

Status: Caution

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

alcohol & pcp[edit | edit source]

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

ghb/gbl & pcp[edit | edit source]

Status: Dangerous

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

opioids & pcp[edit | edit source]

Status: Caution

Note: PCP can reduce opioid tolerance, increasing the risk of overdose

benzodiazepines & pcp[edit | edit source]

Status: Unsafe

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely

maois & pcp[edit | edit source]

Status: Dangerous

Note: This combination is very poorly explored

ssris & pcp[edit | edit source]

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

alcohol & nitrous[edit | edit source]

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

ghb/gbl & nitrous[edit | edit source]

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

opioids & nitrous[edit | edit source]

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

tramadol & nitrous[edit | edit source]

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

mdma & amphetamines[edit | edit source]

Status: Low Risk & Synergy

Note: Amphetamines increase the neurotoxic effects of MDMA

cocaine & amphetamines[edit | edit source]

Status: Caution

Note: This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine

caffeine & amphetamines[edit | edit source]

Status: Caution

Note: This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

alcohol & amphetamines[edit | edit source]

Status: Caution

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

ghb/gbl & amphetamines[edit | edit source]

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

opioids & amphetamines[edit | edit source]

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

tramadol & amphetamines[edit | edit source]

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

benzodiazepines & amphetamines[edit | edit source]

Status: Low Risk & Decrease

Note: Both can dull each other's effects, so if one wears off before the other it's possible to overdose due to the lack of counteraction

maois & amphetamines[edit | edit source]

Status: Dangerous

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with amphetamine can lead to hypertensive crises.

cocaine & mdma[edit | edit source]

Status: Caution

Note: Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

caffeine & mdma[edit | edit source]

Status: Caution

Note: Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA

alcohol & mdma[edit | edit source]

Status: Caution

Note: Both MDMA and alcohol cause dehydration. Approach this combination with caution, moderation and sufficient hydration. More than a small amount of alcohol will dull the euphoria of MDMA

ghb/gbl & mdma[edit | edit source]

Status: Caution

Note: Large amounts of GHB/GBL may overwhelm the effects of MDMA on the comedown.

tramadol & mdma[edit | edit source]

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

maois & mdma[edit | edit source]

Status: Dangerous

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with MDMA will lead to hypertensive crises.

caffeine & cocaine[edit | edit source]

Status: Caution

Note: Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.

alcohol & cocaine[edit | edit source]

Status: Unsafe

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

ghb/gbl & cocaine[edit | edit source]

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind

opioids & cocaine[edit | edit source]

Status: Dangerous

Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

tramadol & cocaine[edit | edit source]

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

maois & cocaine[edit | edit source]

Status: Dangerous

Note: This combination is poorly explored

ssris & cocaine[edit | edit source]

Status: Low Risk & No Synergy

Note: May reduce each others' effectiveness. Cocaine can reduce mental stability and therefore exacerbate conditions which SSRIs are used to treat.

ghb/gbl & alcohol[edit | edit source]

Status: Dangerous

Note: Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

opioids & alcohol[edit | edit source]

Status: Dangerous

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely

tramadol & alcohol[edit | edit source]

Status: Dangerous

Note: Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

benzodiazepines & alcohol[edit | edit source]

Status: Dangerous

Note: Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

maois & alcohol[edit | edit source]

Status: Unsafe

Note: Tyramine found in many alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

ssris & alcohol[edit | edit source]

Status: Caution

Note: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

opioids & ghb/gbl[edit | edit source]

Status: Dangerous

Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position

tramadol & ghb/gbl[edit | edit source]

Status: Dangerous

Note: The sedative effects of this combination can lead to dangerous respiratory depression.

benzodiazepines & ghb/gbl[edit | edit source]

Status: Dangerous

Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

tramadol & opioids[edit | edit source]

Status: Dangerous

Note: Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present

benzodiazepines & opioids[edit | edit source]

Status: Dangerous

Note: Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely

maois & opioids[edit | edit source]

Status: Caution

Note: Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

ssris & opioids[edit | edit source]

Status: Low Risk & No Synergy

Note: There have been very infrequent reports of a risk of serotonin syndrome with this combination, though this should not be a practical concern.

benzodiazepines & tramadol[edit | edit source]

Status: Dangerous

Note: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.


--

LSD & Mushrooms[edit | edit source]

LSD & DMT[edit | edit source]

LSD & Mescaline[edit | edit source]

LSD & DOx[edit | edit source]

LSD & NBOMes[edit | edit source]

LSD & 2C-x[edit | edit source]

LSD & 2C-T-x[edit | edit source]

LSD & αMT[edit | edit source]

LSD & 5-MeO-xxT[edit | edit source]

LSD & Cannabis[edit | edit source]

LSD & Ketamine[edit | edit source]

LSD & MXE[edit | edit source]

LSD & DXM[edit | edit source]

LSD & Nitrous[edit | edit source]

LSD & Amphetamines[edit | edit source]

LSD & MDMA[edit | edit source]

LSD & Cocaine[edit | edit source]

LSD & Caffeine[edit | edit source]

LSD & Alcohol[edit | edit source]

LSD & GHB\GBL[edit | edit source]

LSD & Opioids[edit | edit source]

  • "Low doses antagonized the effects of both hallucinogens, whereas larger doses enhanced their effects."

LSD & Tramadol[edit | edit source]

LSD & Benzodiazepines[edit | edit source]

LSD & MAOIs[edit | edit source]

LSD & SSRIs[edit | edit source]

Mushrooms & DMT[edit | edit source]

Mushrooms & Mescaline[edit | edit source]

Mushrooms & DOx[edit | edit source]

Mushrooms & NBOMes[edit | edit source]

Mushrooms & 2C-x[edit | edit source]

Mushrooms & 2C-T-x[edit | edit source]

Mushrooms & αMT[edit | edit source]

Mushrooms & 5-MeO-xxT[edit | edit source]

Mushrooms & Cannabis[edit | edit source]

Mushrooms & Ketamine[edit | edit source]

Mushrooms & MXE[edit | edit source]

Mushrooms & DXM[edit | edit source]

Mushrooms & Nitrous[edit | edit source]

Mushrooms & Amphetamines[edit | edit source]

Mushrooms & MDMA[edit | edit source]

Mushrooms & Cocaine[edit | edit source]

Mushrooms & Caffeine[edit | edit source]

Mushrooms & Alcohol[edit | edit source]

Mushrooms & GHB\GBL[edit | edit source]

Mushrooms & Opioids[edit | edit source]

Mushrooms & Tramadol[edit | edit source]

Mushrooms & Benzodiazepines[edit | edit source]

Mushrooms & MAOIs[edit | edit source]

Mushrooms & SSRIs[edit | edit source]

DMT & Mescaline[edit | edit source]

DMT & DOx[edit | edit source]

DMT & NBOMes[edit | edit source]

DMT & 2C-x[edit | edit source]

DMT & 2C-T-x[edit | edit source]

DMT & αMT[edit | edit source]

DMT & 5-MeO-xxT[edit | edit source]

DMT & Cannabis[edit | edit source]

DMT & Ketamine[edit | edit source]

DMT & MXE[edit | edit source]

DMT & DXM[edit | edit source]

DMT & Nitrous[edit | edit source]

DMT & Amphetamines[edit | edit source]

DMT & MDMA[edit | edit source]

DMT & Cocaine[edit | edit source]

DMT & Caffeine[edit | edit source]

DMT & Alcohol[edit | edit source]

DMT & GHB\GBL[edit | edit source]

DMT & Opioids[edit | edit source]

DMT & Tramadol[edit | edit source]

DMT & Benzodiazepines[edit | edit source]

DMT & MAOIs[edit | edit source]

DMT & SSRIs[edit | edit source]

Mescaline & DOx[edit | edit source]

Mescaline & NBOMes[edit | edit source]

Mescaline & 2C-x[edit | edit source]

Mescaline & 2C-T-x[edit | edit source]

Mescaline & αMT[edit | edit source]

Mescaline & 5-MeO-xxT[edit | edit source]

  • The 5-MeO class of tryptamines can be unpredictable in their interactions.

Mescaline & Cannabis[edit | edit source]

Mescaline & Ketamine[edit | edit source]

Mescaline & MXE[edit | edit source]

Mescaline & DXM[edit | edit source]

Mescaline & Nitrous[edit | edit source]

Mescaline & Amphetamines[edit | edit source]

  • The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

Mescaline & MDMA[edit | edit source]

Mescaline & Cocaine[edit | edit source]

  • The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

Mescaline & Caffeine[edit | edit source]

  • High doses of caffeine are uncomfortable and this will be magnified by psychedelics.

Mescaline & Alcohol[edit | edit source]

Mescaline & GHB\GBL[edit | edit source]

Mescaline & Opioids[edit | edit source]

Mescaline & Tramadol[edit | edit source]

  • This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

Mescaline & Benzodiazepines[edit | edit source]

Mescaline & MAOIs[edit | edit source]

Mescaline & SSRIs[edit | edit source]

DOx & NBOMes[edit | edit source]

DOx & 2C-x[edit | edit source]

DOx & 2C-T-x[edit | edit source]

DOx & αMT[edit | edit source]

DOx & 5-MeO-xxT[edit | edit source]

  • The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

DOx & Cannabis[edit | edit source]

DOx & Ketamine[edit | edit source]

  • Ketamine and psychedelics tend to potentiate each other - go slowly.

DOx & MXE[edit | edit source]

  • As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense.

DOx & DXM[edit | edit source]

  • The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

DOx & Nitrous[edit | edit source]

DOx & Amphetamines[edit | edit source]

  • The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

DOx & MDMA[edit | edit source]

  • The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

DOx & Cocaine[edit | edit source]

  • The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic.

DOx & Caffeine[edit | edit source]

  • High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

DOx & Alcohol[edit | edit source]

  • Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

DOx & GHB\GBL[edit | edit source]

DOx & Opioids[edit | edit source]

  • No unexpected interactions.

DOx & Tramadol[edit | edit source]

  • Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

DOx & Benzodiazepines[edit | edit source]

DOx & MAOIs[edit | edit source]

DOx & SSRIs[edit | edit source]

NBOMes & 2C-x[edit | edit source]

NBOMes & 2C-T-x[edit | edit source]

NBOMes & αMT[edit | edit source]

NBOMes & 5-MeO-xxT[edit | edit source]

  • The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided.

NBOMes & Cannabis[edit | edit source]

NBOMes & Ketamine[edit | edit source]

NBOMes & MXE[edit | edit source]

NBOMes & DXM[edit | edit source]

NBOMes & Nitrous[edit | edit source]

NBOMes & Amphetamines[edit | edit source]

  • Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

NBOMes & MDMA[edit | edit source]

NBOMes & Cocaine[edit | edit source]

  • Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

NBOMes & Caffeine[edit | edit source]

  • Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping.

NBOMes & Alcohol[edit | edit source]

NBOMes & GHB\GBL[edit | edit source]

NBOMes & Opioids[edit | edit source]

NBOMes & Tramadol[edit | edit source]

  • Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures.

NBOMes & Benzodiazepines[edit | edit source]

NBOMes & MAOIs[edit | edit source]

NBOMes & SSRIs[edit | edit source]

2C-x & 2C-T-x[edit | edit source]

2C-x & αMT[edit | edit source]

2C-x & 5-MeO-xxT[edit | edit source]

  • The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics.

2C-x & Cannabis[edit | edit source]

2C-x & Ketamine[edit | edit source]

2C-x & MXE[edit | edit source]

2C-x & DXM[edit | edit source]

2C-x & Nitrous[edit | edit source]

2C-x & Amphetamines[edit | edit source]

  • The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

2C-x & MDMA[edit | edit source]

2C-x & Cocaine[edit | edit source]

  • The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

2C-x & Caffeine[edit | edit source]

  • High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

2C-x & Alcohol[edit | edit source]

2C-x & GHB\GBL[edit | edit source]

2C-x & Opioids[edit | edit source]

2C-x & Tramadol[edit | edit source]

  • Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

2C-x & Benzodiazepines[edit | edit source]

2C-x & MAOIs[edit | edit source]

2C-x & SSRIs[edit | edit source]

2C-T-x & αMT[edit | edit source]

2C-T-x & 5-MeO-xxT[edit | edit source]

2C-T-x & Cannabis[edit | edit source]

2C-T-x & Ketamine[edit | edit source]

2C-T-x & MXE[edit | edit source]

2C-T-x & DXM[edit | edit source]

2C-T-x & Nitrous[edit | edit source]

2C-T-x & Amphetamines[edit | edit source]

2C-T-x & MDMA[edit | edit source]

2C-T-x & Cocaine[edit | edit source]

2C-T-x & Caffeine[edit | edit source]

  • High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

2C-T-x & Alcohol[edit | edit source]

  • Both these classes of compound can interact unpredictably. Caution should be exercised.

2C-T-x & GHB\GBL[edit | edit source]

2C-T-x & Opioids[edit | edit source]

  • No expected interactions, some Opioids have Serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

2C-T-x & Tramadol[edit | edit source]

2C-T-x & Benzodiazepines[edit | edit source]

2C-T-x & MAOIs[edit | edit source]

2C-T-x & SSRIs[edit | edit source]

αMT & 5-MeO-xxT[edit | edit source]

αMT & Cannabis[edit | edit source]

αMT & Ketamine[edit | edit source]

αMT & MXE[edit | edit source]

αMT & DXM[edit | edit source]

αMT & Nitrous[edit | edit source]

αMT & Amphetamines[edit | edit source]

αMT & MDMA[edit | edit source]

αMT & Cocaine[edit | edit source]

αMT & Caffeine[edit | edit source]

  • High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

αMT & Alcohol[edit | edit source]

  • αMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable.

αMT & GHB\GBL[edit | edit source]

αMT & Opioids[edit | edit source]

  • No unexpected interactions

αMT & Tramadol[edit | edit source]

αMT & Benzodiazepines[edit | edit source]

αMT & MAOIs[edit | edit source]

αMT & SSRIs[edit | edit source]

5-MeO-xxT & Cannabis[edit | edit source]

5-MeO-xxT & Ketamine[edit | edit source]

5-MeO-xxT & MXE[edit | edit source]

5-MeO-xxT & DXM[edit | edit source]

5-MeO-xxT & Nitrous[edit | edit source]

5-MeO-xxT & Amphetamines[edit | edit source]

  • The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

5-MeO-xxT & MDMA[edit | edit source]

  • Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care.

5-MeO-xxT & Cocaine[edit | edit source]

  • The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

5-MeO-xxT & Caffeine[edit | edit source]

5-MeO-xxT & Alcohol[edit | edit source]

5-MeO-xxT & GHB\GBL[edit | edit source]

5-MeO-xxT & Opioids[edit | edit source]

5-MeO-xxT & Tramadol[edit | edit source]

5-MeO-xxT & Benzodiazepines[edit | edit source]

5-MeO-xxT & MAOIs[edit | edit source]

5-MeO-xxT & SSRIs[edit | edit source]

Cannabis & Ketamine[edit | edit source]

Cannabis & MXE[edit | edit source]

Cannabis & DXM[edit | edit source]

Cannabis & Nitrous[edit | edit source]

Cannabis & Amphetamines[edit | edit source]

Cannabis & MDMA[edit | edit source]

Cannabis & Cocaine[edit | edit source]

Cannabis & Caffeine[edit | edit source]

Cannabis & Alcohol[edit | edit source]

Cannabis & GHB\GBL[edit | edit source]

Cannabis & Opioids[edit | edit source]

Cannabis & Tramadol[edit | edit source]

Cannabis & Benzodiazepines[edit | edit source]

Cannabis & MAOIs[edit | edit source]

Cannabis & SSRIs[edit | edit source]

Ketamine & MXE[edit | edit source]

Ketamine & DXM[edit | edit source]

Ketamine & Nitrous[edit | edit source]

Ketamine & Amphetamines[edit | edit source]

  • Amphetamine worsens Ketamines ataxia.

Ketamine & MDMA[edit | edit source]

Ketamine & Cocaine[edit | edit source]

Ketamine & Caffeine[edit | edit source]

  • No unexpected interactions.

Ketamine & Alcohol[edit | edit source]

  • Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

Ketamine & GHB\GBL[edit | edit source]

  • Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

Ketamine & Opioids[edit | edit source]

  • Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

Ketamine & Tramadol[edit | edit source]

  • No unexpected interactions.

Ketamine & Benzodiazepines[edit | edit source]

  • Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

Ketamine & MAOIs[edit | edit source]

Ketamine & SSRIs[edit | edit source]

MXE & DXM[edit | edit source]

MXE & Nitrous[edit | edit source]

MXE & Amphetamines[edit | edit source]

  • Risk of tachycardia, hypertension, and manic states.

MXE & MDMA[edit | edit source]

  • There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

MXE & Cocaine[edit | edit source]

  • Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

MXE & Caffeine[edit | edit source]

  • No likely interactions.

MXE & Alcohol[edit | edit source]

  • There is a high risk of memory loss, vomiting and severe ataxia from this combination.

MXE & GHB\GBL[edit | edit source]

  • Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

MXE & Opioids[edit | edit source]

  • This combination can potentiate the effects of the opioid.

MXE & Tramadol[edit | edit source]

MXE & Benzodiazepines[edit | edit source]

  • Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

MXE & MAOIs[edit | edit source]

MXE & SSRIs[edit | edit source]

  • Depending on the SSRI this combination can be unpredictable.

DXM & Nitrous[edit | edit source]

DXM & Amphetamines[edit | edit source]

  • Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

DXM & MDMA[edit | edit source]

DXM & Cocaine[edit | edit source]

  • Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

DXM & Caffeine[edit | edit source]

  • High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

DXM & Alcohol[edit | edit source]

  • Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

DXM & GHB\GBL[edit | edit source]

  • Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict.

DXM & Opioids[edit | edit source]

  • CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally, there is a reverse cross tolerance between opiates/dxm. I.E. if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

DXM & Tramadol[edit | edit source]

DXM & Benzodiazepines[edit | edit source]

  • Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

DXM & MAOIs[edit | edit source]

  • High risk of serotonin syndrome.

DXM & SSRIs[edit | edit source]

  • High risk of serotonin syndrome.

Nitrous & Amphetamines[edit | edit source]

Nitrous & MDMA[edit | edit source]

Nitrous & Cocaine[edit | edit source]

Nitrous & Caffeine[edit | edit source]

Nitrous & Alcohol[edit | edit source]

  • This combination can lead to vomiting.

Nitrous & GHB\GBL[edit | edit source]

Nitrous & Opioids[edit | edit source]

Nitrous & Tramadol[edit | edit source]

Nitrous & Benzodiazepines[edit | edit source]

Nitrous & MAOIs[edit | edit source]

Nitrous & SSRIs[edit | edit source]

Amphetamines & MDMA[edit | edit source]

  • Amphetamines increase the neurotoxic effects of MDMA.

Amphetamines & Cocaine[edit | edit source]

  • This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine.

Amphetamines & Caffeine[edit | edit source]

  • This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

Amphetamines & Alcohol[edit | edit source]

  • Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

Amphetamines & GHB\GBL[edit | edit source]

  • Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

Amphetamines & Opioids[edit | edit source]

  • Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

Amphetamines & Tramadol[edit | edit source]

  • Tramadol and stimulants both increase the risk of seizures.

Amphetamines & Benzodiazepines[edit | edit source]

Amphetamines & MAOIs[edit | edit source]

Amphetamines & SSRIs[edit | edit source]

MDMA & Cocaine[edit | edit source]

  • Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

MDMA & Caffeine[edit | edit source]

  • Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA.

MDMA & Alcohol[edit | edit source]

  • Both MDMA and alcohol cause severe dehydration. Approach this combination with caution, moderation and sufficient hydration.

MDMA & GHB\GBL[edit | edit source]

MDMA & Opioids[edit | edit source]

MDMA & Tramadol[edit | edit source]

  • Tramadol and stimulants both increase the risk of seizures.

MDMA & Benzodiazepines[edit | edit source]

MDMA & MAOIs[edit | edit source]

MDMA & SSRIs[edit | edit source]

Cocaine & Caffeine[edit | edit source]

  • Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.

Cocaine & Alcohol[edit | edit source]

  • Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel he alcohol less. Cocaine is potentiated somewhat by alcohol by reduction of cocaine breakdown which results in increased risk to the heart.

Cocaine & GHB\GBL[edit | edit source]

  • Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind.

Cocaine & Opioids[edit | edit source]

  • Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

Cocaine & Tramadol[edit | edit source]

  • Tramadol and stimulants both increase the risk of seizures.

Cocaine & Benzodiazepines[edit | edit source]

Cocaine & MAOIs[edit | edit source]

Cocaine & SSRIs[edit | edit source]

  • Risk of serotonin syndrome, Likely to make the SSRI's innefective with regular cocaine use. The SSRIs may also make the cocaine less effective. Mental stability and cocaine don't go together.

Caffeine & Alcohol[edit | edit source]

Caffeine & GHB\GBL[edit | edit source]

Caffeine & Opioids[edit | edit source]

Caffeine & Tramadol[edit | edit source]

Caffeine & Benzodiazepines[edit | edit source]

Caffeine & MAOIs[edit | edit source]

Caffeine & SSRIs[edit | edit source]

Alcohol & GHB\GBL[edit | edit source]

  • Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

Alcohol & Opioids[edit | edit source]

  • Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

Alcohol & Tramadol[edit | edit source]

  • Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

Alcohol & Benzodiazepines[edit | edit source]

  • Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

Alcohol & MAOIs[edit | edit source]

  • The chemical tyramine in alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

Alcohol & SSRIs[edit | edit source]

  • Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

GHB\GBL & Opioids[edit | edit source]

  • The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

GHB\GBL & Tramadol[edit | edit source]

  • The sedative effects of this combination can lead to dangerous respiratory depression.

GHB\GBL & Benzodiazepines[edit | edit source]

  • The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

GHB\GBL & MAOIs[edit | edit source]

  • No study, but MAO B inhibitors should enhance the effects, no interaction with MAO A.

GHB\GBL & SSRIs[edit | edit source]

Opioids & Tramadol[edit | edit source]

  • Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present.

Opioids & Benzodiazepines[edit | edit source]

  • Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely.

Opioids & MAOIs[edit | edit source]

  • Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

Opioids & SSRIs[edit | edit source]

Tramadol & Benzodiazepines[edit | edit source]

  • Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

Tramadol & MAOIs[edit | edit source]

Tramadol & SSRIs[edit | edit source]

Benzodiazepines & MAOIs[edit | edit source]

Benzodiazepines & SSRIs[edit | edit source]

MAOIs & SSRIs[edit | edit source]