Research remains unclear on how psychedelics and antibiotics interact with each other. However, there are particular cases where the use of antibiotics has been effective with some types of psychedelics like MDMA, ayahuasca, psilocybin, and LSD.

For many years now, psilocybin and different psychedelic substances have grown in popularity. This is mainly for the amazing therapeutic effects they offer for a range of medical conditions. However, one big question is whether these substances can be mixed with antibiotics or not. What are the interactions between psychedelics and some common antibiotics? Are there any risks associated with the combination?

There are a range of risks that come with taking any medication. However, it’s also important to understand the interactions that take place when combining antibiotics with psychedelics. The need to understand this is important, especially for growing communities with people who decide to self-medicate. In this article, we’ll take you through what available research says about combining antibiotics and psychedelics.

What are Antibiotics?

These are medications that help to prevent the growth or kill bacteria in the body. They are mostly used in preventing and managing different bacterial infections. Antibiotics are taken in three ways; topically using sprays, ointments, or creams applied to the skin or ear/eye drops; orally using liquids, capsules, or pills; and injection for serious infections.

Side Effects

Antibiotics are associated with different side effects, which differ in their severity. Some of the common side effects are nausea, rash, yeast infections, diarrhea, antibiotic resistance infections, and severe and life-threatening allergic reactions.

What are Psychotropic Drugs?

Psychotropic drugs are drugs that act on the brain, with the ability to change behavior, perception, and mood. These substances include nicotine, caffeine, marijuana, alcohol, antidepressants, stimulants, anti-anxiety medications, mood stabilizers, some pain medicines, and antipsychotics. Schedule I psychedelic substances like MDMA, DMT, LSD, amphetamines, and psilocybin are also psychotropic substances.

Interactions Between Psychedelics and Antibiotics

There are many ways that psychotropic drugs and antibiotics interact. For example, the action of psychotropic drugs on the body can be affected by certain antibiotics, and this can cause some harmful side effects. According to the US National Institutes of Health (NIH), psychotropic and antibiotic drugs have some specific side effects and mechanisms of action. This makes the interactions between both substances have variations, which depend on the drugs involved.

Liver Damage

Taking the two substances concurrently could cause harm to the liver. Even though this is a rare occurrence, it’s worth noting that antibiotics can cause damage to the liver or liver failure. On the other hand, psychotropic drugs have the potential to increase liver enzymes, which could potentially cause liver damage.

The liver plays a major role in breaking down medications in the body. A combination of both substances could trigger different adverse reactions and liver damage. This is because they are both metabolized by liver enzymes, and the combination of both substances can go beyond the capacity of the liver.

Erythromycin and Clarithromycin

These are antibiotics that act on the liver enzymes responsible for breaking down LSD and MDMA. This interaction increases the level of the substance in the blood, thereby increasing the risk of liver damage. A 2019 study highlights that CYP 450 is the enzyme involved in the metabolism of MDMA. According to the study, clarithromycin and erythromycin block this enzyme, and this results in the accumulation of MDMA in the bloodstream.

Rifampin and Isoniazid

Using antibiotics like isoniazid and rifampin can cause harm to the liver, especially when taken a lot. Together with psychedelic substances, the risk becomes higher. A 2017 study in the Journal of Clinical and Diagnostic Research highlights the potential harm caused by these antibiotics, as seen in a patient treated for tuberculosis. Even though the report doesn’t highlight the impact of psychedelic substances, it shows the potential risk of liver damage when taking antibiotics with psychedelic drugs.

The use of antibiotics and psychedelics is mostly as prescribed by a physical, even though the risk of liver damage is low in most people. However, it’s important to recognize that the combination can increase the risk of damage.


There is evidence showing that taking some antibiotics can affect the way the body processes psychotropic drugs, and this can trigger high toxicity levels. A report titled “Drug interactions with monoamine oxidase inhibitor: Ayahuasca, LSD, and Mescaline” provided a deeper understanding. The report highlights that Linezolid (an antibiotic) can prevent the enzymes that break down ayahuasca. This can ultimately lead to the accumulation of the psychedelic drug in the body.

Despite this finding, it’s worth noting that there are only a few data on the risks of the combination. This shows a gap that should be addressed immediately. Another thing to note is that drug interactions differ based on overall health and genetic factors. Therefore, the best thing is to consult with a physician before combining drugs or medications.

Antibiotics To Avoid Mixing with Psychedelics

As mentioned above, some antibiotics can alter how the body processes psychedelic drugs. This can trigger high levels of the drug in the body, which ultimately causes toxicity. Some of the antibiotics to avoid mixing with psychedelics include the following:


This is an antimicrobial agent used in treating infections caused by gram-positive bacteria. It is an approved treatment option for skin and skin structure infections, infections caused by VRE bacteria, and bacterial pneumonia. Linezolid is a type of MAOI, implying that it has the potential to change the levels of some neurotransmitters in the brain through interaction with certain drugs. This includes MDMA, psilocybin, and LSD, all of which can change serotonin levels. The interaction can also lead to serotonin syndrome, which is a life-threatening condition.


This antibiotic is mostly used for managing respiratory tract infections and other conditions caused by bacteria. This includes Legionnaire’s disease, pneumonia, bronchitis, diphtheria, syphilis, urinary tract infection, skin infections, gynecological and intestinal infections. However, the study also shows that the drug can alter the metabolism of some psychotropic drugs like alprazolam, diazepam, and amitriptyline. This interaction can trigger elevated levels of the drugs in the body, thereby leading to side effects like drowsiness, sedation, and more.


This is a type of antibiotic that is used in treating infections like cellulitis, pneumonia, and ear infections. It is also used in treating Helicobacter pylori, which is known to cause stomach ulcers. Like erythromycin, the antibiotic has an impact on the enzymes that mediate the metabolism of drugs like LSD and MDMA.

Rifampin and Isoniazid

These antibiotics are used in treating tuberculosis. Tuberculosis is a severe infection that affects the lungs and other parts of the body. Rifampin is also effective in managing Neisseria meningitides infections, which is a bacterium that causes meningitis. As mentioned earlier, the drugs have the potential to cause liver damage, especially when used with psychedelics.


With everything above, the big question remains whether you can mix antibiotics and psychedelics. For emphasis, it’s risky to use antibiotics and psychedelics together. If you’re thinking of exploring psychedelic-assisted therapy while on an antibiotic, it’s advisable to wait for your recovery before you start the psychedelic therapy. Also consult with a health professional to discuss the potential harm and further guarantee your safety when on the drug.

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