Hello!

does anyone have any interaction information/experience (not seeking medical advice) with sryrian rue and lisinopril and amlodipine? I've read searched and there doesn't appear to be any negative information and what little info there was no negative reactions were mentioned, the only thing that makes me question is when reading this thread it mentions antihypertensives (high blood pressure medicine).

(I understand that DMT itself can and will raise BP)

Thanks in advance!

Harmala's in their own right act as antihypertensive and vasorelaxant drugs lowering blood pressure and even causing other cardiovascular effects like bradycardia. DMT on the other hand can dose dependently increase blood pressure and heart rate significantly and should therefore be used with extreme caution in people with preexisting heart conditions, high blood pressure and anything related.

The way I see it harmalas and amlodapine could either interact negatively making your blood pressure so low that you could be at an increased risk of fainting / blacking out or it may be fine to consume together, I don't know. I know you said you didn't want medical advice but given the nature of the question it is impossible for me to avoid it. The interaction of harmalas with blood pressure medication like amlodapine is a question for your doctor and not people on the internet who either don't care about your health and wellbeing or won't be liable to take responsibility for it if it does go bad. Please contact your doctor and ask him / her the question you just asked here.

Hello and welcome!

Sound words from King Tryptamine there. Here's what I've found by having a look at some readily available data, plus a bit of background knowledge:

Amlodipine clearance may be decreased through a Cyp450 interaction, leading to increased levels of amlodipine:
"Interactions
Several drugs interact with amlodipine to increase its levels in the body. CYP3A inhibitors, by nature of inhibiting the enzyme that metabolizes amlodipine, CYP3A4, are one such class of drugs. Others include the calcium-channel blocker diltiazem, the antibiotic clarithromycin, and possibly some antifungals. Amlodipine causes several drugs to increase in levels, including cyclosporine, simvastatin, and tacrolimus (the increase in the last one being more likely in people with CYP3A5*3 genetic polymorphisms)."

Harmala alkaloids have more of an effect on CYP2D6 though, so the interaction is likely to be minor except at high dose levels. However, this in no way indicates that the combination would be safe (or dangerous) as it is merely an observation on my part, and I am not a medical practitioner. Lisinopril is not metabolised in this way and is instead entirely excreted via the kidneys due to its solubility in water.

"amlodipine overdose toxicity can result in widening of blood vessels, severe low blood pressure, and fast heart rate.[28] Toxicity is generally managed with fluid replacement[29] monitoring ECG results, vital signs, respiratory system function, glucose levels, kidney function, electrolyte levels, and urine output. Vasopressors [emphasis added] are also administered when low blood pressure is not alleviated by fluid resuscitation."

If harmala alkaloids led to an amlodipine overdose then they would also potentially complicate treatment with vasopressors. Harmala alkaloids also act as vasodilators (and lisinopril and amlodipine are both vasodilators in some sense) so there would be a risk of postural hypotension. As a worst-case scenario, this suggests to me the possibly fatal combination of unconsciousness and vomiting. This is also mentioned in the thread that you linked to, under "vasodilators". If you decide to proceed with using Syrian rue having a qualified medic as a sitter would be strongly recommended.

One possible ROA to consider is sublingual doses of extracted harmine, starting really low, like 1mg or less. Ideally, get your vitals monitored even while doing this - but equally you would want to stay calm and peaceful.

Above all else, King Tryptamine's advice still stands - speak to your doctor. Indeed, this is one of the foundations of the Nexus attitude.

I appreciate the information and will have a conversation with my doctor, I am sure it will be an interesting one.

Out of interest, are there known cases of people suffering serious heart related problems while using DMT? I mean in theory this makes sense and we all know how unbelievably fast the heart actually can beat on DMT, but has this ever caused serious problems in practice, like have people suffered heart attacks or the like?

PS: I am in no way intending to encourage using DMT with heart issues, in case my comment is formulated ambiguously.

A forum member's mother had a stroke directly after vaping DMT due to the blood pressure spike (she made a recovery) so adverse cardiovascular effects from DMT aren't unheard of. That is an entirely different question from the potential interactions between harmalas and blood pressure meds of course.

Combining harmalas with DMT arguably reduces the cardiovascular risk (for the most part!) on account of the vasodilatory effects. I just think it's best to keep it simple and avoid mixing medications without proper medical advice.