Health & Medical Safety Considerations

Existing 5-MeO-DMT studies have led early adopters to individually conclude that this psychedelic is non-addictive and sufficiently safe for their own occasional personal microdosing. It is up to each user to make this decision for themselves.

Based on general safety guidelines for vaping and for taking psychedelics, you should not be using the M-Pen:

  • If you are under 25
  • If you are not in a good state of mind
  • If you are not in good health
  • If you are pregnant or breastfeeding
  • If you have a current or past respiratory condition that is not well-controlled 
  • If you have allergies or past negative reactions to vape pen ingredients or related products
  • If you have any cardiac conditions
  • If you have had recent surgery for a respiratory or cardiac condition
  • If you have high blood pressure that is not well-controlled
  • If you have experienced liver or kidney failure
  • If you have experienced traumatic brain injury
  • If you have had any tumours in the central nervous system
  • If you are on certain medications (see below)

5-MeO-DMT and Interactions with Medicines

5-MeO-DMT can be dangerous when taken in combination with certain medicines, including those that affect the serotonin system in the brain. Serotonin is a neurotransmitter involved in regulating mood, appetite, and other functions. When 5-MeO-DMT is taken with medications that also impact serotonin levels, the medicine may be dampened and there may be a risk of serotonin syndrome, a potentially life-threatening condition.

Some medications that may interact with 5-MeO-DMT and increase the risk of serotonin syndrome include:

  1. Selective serotonin reuptake inhibitors (SSRIs), commonly prescribed for depression and anxiety (e.g., fluoxetine, sertraline, paroxetine).
  2. Serotonin-norepinephrine reuptake inhibitors (SNRIs), another class of antidepressants (e.g., venlafaxine, duloxetine).
  3. Monoamine oxidase inhibitors (MAOIs), an older class of antidepressants (e.g., phenelzine, tranylcypromine).
  4. Certain migraine medications known as triptans (e.g., sumatriptan, rizatriptan).
  5. Some pain medications, such as tramadol and meperidine.
  6. Certain allergy and sinus medications

Out of an abundance of caution, we have listed many medications and conditions at the end of this page. This information is intended as a reference only and should not be used as a sole basis for decision-making regarding medication interactions. 

Consulting with Experts

It is strongly recommended that individuals consult with a qualified medical professional or relevant specialist before making any decisions about the concurrent use of medications.An expert on medications and 5-MeO-DMT is Dr. Ben Malcolm, aka the Spirit Pharmacist. He was trained as a clinical psychiatric pharmacist and worked in academia for almost five years before dedicating himself to plant medicines where he provides psychopharmacology consulting, courses in psychedelic pharmacy, and a Member Program. You can learn more and book a consultation with the Spirit Pharmacist here
A trained Canadian expert is Dr. Trina Nguyen, aka the Dharmacist. Dr. Trina has two decades of formal pharmacy education and experience to facilitate new therapies that work. She can be consulted about pharmaceutical contraindications with 5-MeO-DMT, as well as other earth medicines. Dr. Trina operates solely on a donation-based model (Dāna), and can be contacted through her Dharmacist website

Mental Health History or Conditions

The following mental health history or conditions are reasons to avoid taking 5-MeO-DMT:

  • Past history of difficult psychedelic experiences
  • Personal or family history (first or second-degree relative) of psychosis or a psychotic disorder (e.g., schizophrenia, brief psychotic disorder, schizoaffective disorder, psychotic depression)
  • Personal or family history (first or second-degree relative)  of bipolar disorder 
  • Current suicidal ideation
  • Current plan or intent to harm yourself or to harm others
  • Current PTSD
  • Current trauma symptoms that are moderate to severe and/or not well-controlled
  • Past history of addiction and/or substance use issues
  • Past history of impulse control issues that cause difficulties in your life
  • Any other moderate to severe mental health or addiction issue that is not treated and/or well-controlled 

List of Contraindicated Medicines

Please note that the list of drug contraindications provided below has been derived from The Spiritpharmacist’s Five Guide and should not be considered exhaustive or definitive. This information is intended as a reference only and should not be used as a sole basis for decision-making regarding medication interactions. It is strongly recommended that individuals consult with a qualified medical professional or relevant specialist before making any decisions pertaining to the concurrent use of medications.

Pseudoephedrine-containing products, including:

Benylin All-In-One Cold and
Flu Caplets
Claritin Allergy + Sinus
Extra Strength Tablets
Dimetapp Cold & Cough
NeoCitran Sinus Nighttime
Robax Platinum
Sudafed Nasal
Decongestant Tablets and
Liquid Gels

Medications that inhibit enzyme CYP2D6 including:

Paroxetine (Paxil)
Bupropion (Wellbutrin,
Quinidine (Quinidex)
Cinacalcet (Sensipar)
Fluoxetine (Prozac)
Terbinafine (Lamisil)
Duloxetine (Cymbalta)
Celecoxib (Celebrex)
Cobicistat (Tybost)
Clobazam (Frisium)
Mirabegron (Myrbetriq)
Abiraterone (Zytiga)
Lorcaserin (Belviq)
Amiodarone (Cordarone)
Cimetidine (Tagamet)
Escitalopram (Cipralex)
Fluvoxamine (Luvox)
Sertraline (Zoloft)
Labetalol (Trandate)
Ritonavir (Norvir)
Vemurafenib (Zelboraf)

Monoamine Oxidase Inhibitors (MAOIs) including:

Beta-carbolines (harmala
alkaloids), including
harmine, harmaline,
ayahuasca, syrian rue
Moclobemide (Manerix)
Tranylcypromine (Parnate)
Phenelzine (Nardil)
Isocarboxazid (Marplan)
Selegiline (Emsam)
Methylene blue
Linezolid (Zyvox
Lithium (Carbolith) 

Selective Serotonin Reuptake Inhibitors (SSRIs) including:

Fluoxetine (Prozac)
Paroxetine (Paxil)
Escitalopram (Cipralex)
Fluvoxamine (Luvox)
Sertraline (Zoloft)
Citalopram (Celexa)

Selective Serotonin Reuptake Inhibitors (SNRIs) including:

Duloxetine (Cymbalta)
Venlafaxine (Effexor)
Desvenlafaxine (Pristiq)

Serotonin Partial Agonist Reuptake Inhibitor (SPARIs) including:

Vortioxetine (Brintellix)
Vilazodone (Viibryd
Buspirone (BuSpar)
Mirtazapine (Remeron)
Trazodone (Desyrel)
Nefazodone (Serzone)

Antipsychotics including:

Chlorpromazine (Largactil)
Aripiprazole (Abilify)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Risperidone (Risperdal)
Ziprasidone (Geodon)

Tricyclic Antidepressants (TCAs) including:

Clomipramine (Anafranil)
Desipramine (Norpramin)
Maprotiline (Ludiomil)
Amoxapine (Asendin)
Imipramine (Tofranil)
Amitriptyline (Elavil)
Nortriptyline (Pamelor)
Nefazodone (Serzone)
Desipramine (Norpramin)
St. John’s Wort

Weight loss agents, including:

Phentermine (Adipex-P)
Diethylpropion (Tenuate)
Benzphetamine (Didrex)
Phendimetrazine (Bontril)
Mazindol (Mazanor,

Triptans (Migraine medications) including

Sumatriptan (Imitrex)
Rizatriptan (Maxalt)

Ergotamines (Migraine medications) including

Dihydroergotamine (Migranal)

Serotonin 3 receptor antagonists (Anti-nausea medications) including

Ondansetron (Zofran)
Granisetron (Kytril)
Dolasetron (Anzemet)

Analgesics (Pain Relievers) including

Meperidine (Demerol)
Methadone (Dolophin)