MDMA and Terbinafine (Lamisil)

[spephspeph]

I know this has been posted a fair bit, but I can't seem to find a definitive answer.

Terbinafine inhibits the CYP2D6 enzyme, one of those used to metabolise MDMA.

I was planning on taking MDMA tonight, however I've been on Terbinafine for the past month (and likely to be on it for the next 2-6 months, thank you fungal toenail).

As it inhibits, could I get away with taking smaller doses of MDMA - for instance pre-dosing 25-50mg into some capsules? Would this lessen any horrific effects?

 

[FormerBeagle]

There are multiple cyp isoforms that metabolize mdma. If one is inhibited, the others (3a4 and 1a2 in this case) can take over. I’d wager there will be little effect. In fact the 2d6 pathway is implicated in producing reactive metabolites of methylenedioxy compounds, and you may be better off with it inhibited.

 

[indigoaura]

I would not personally risk it. My friend had a grand mal seizure trying something similar.

 

[FormerBeagle]

That's actually much better advice. The real question here should not be how is the mdma going to affect the antiseizure med, not the other way around