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Taking both these drugs should not be harmful. The effects of both drugs are likely to be reduced.

Combining these drugs should not be harmful. However, they will mask each other’s effects, which might increase the risk of overdosing either drug. This combination is also hard on the heart due to each drug’s opposing action (7).

The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually. Users have reported diminished experiences, thus care should be taken with dosage.

This combination carries a low risk. Aspirin and cannabis are unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Cannabis and DMT is not usually a harmful combination, but cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics so beware when mixing these drugs.

There is no evidence to date showing interactions between paracetamol and 2C-B.

This combination is unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Taking both these drugs together is likely to cause an effect stronger than taking them individually. If used with care they are unlikely to cause an adverse or undesirable reaction.

We strongly recommend you avoid taking these drugs together, reactions are highly unpredictable and can be fatal. You will likely come to some degree of harm even if you take strong precautions.

Taking the combined oral contraceptive pill and cocaine together is not usually any more harmful than taking them individually. The drugs are not known to interact with each other, each positively or negatively46,47.

Taking both of these drugs together is not usually any more harmful than taking them individually. The drugs are not known to interact with each other, each positively or negatively.

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

Be careful when mixing amphetamines and GHB. 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.

Avoid benzos if you are taking allergy medicines. benzos and allergy medicines such as Benadryl, Piriton and Clarityn are depressants and both slow down your central nervous system. This can produce heightened side effects such as drowsiness, sedation and poor concentration. In extreme cases, loss of consciousness and may occur.

These two drugs potentiate each other strongly and unpredictably which might lead to memory loss, blackout and respiratory depression.

Using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before mixing drugs.

Effects will be stronger than taking either drug alone, however, it’s unlikely that there will be any adverse health reactions to this combination.

The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually. Users have reported diminished experiences thus care should be taken with dosage.

There is no evidence to date showing interactions between contraceptive pills and cannabis and generally this combination carries a low risk. However, cannabis will often intensify and alter your mood. If your contraception is causing significant changes in your mood, it is advisable to avoid cannabis as it may intensify mood swings.

This combination carries a low risk. Paracetamol and cannabis are unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

There is no evidence to date showing interactions between paracetamol and LSD. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

There is no evidence to date showing interactions between allergy medicines and LSD. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

There is no evidence to date showing interactions between ibuprofen and 2C-B. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

There is no evidence to date showing interactions between ibuprofen and benzos. This combination is unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before mixing drugs.

The effects of these two drugs are similar and synergistic, therefore mixing MDMA with 2C-B may increase the intensity of the experience.

Combining kratom with such depressants is contraindicated.Depressants have the same general effects as opiates. Therefore, combining them with kratom can cause a synergy effect of severe sedation, which can feel like overdosing. More sedation and respiratory depression can occur as a result. Memory blackouts are also likely to occur.

_Users report that the two herbs go well with each other, however, moderation is important when combining them. Keeping both doses low helps ensuring that you derive the highest possible positive effects without crossing the line to negative side-effects. You should go particularly light on cannabis dosage. Although rarely, some users report mild effects, such as feeling nauseous, sick and uncomfortable. Stronger side effects include anxiety and dizziness._

Be careful when taking paracetamol and cocaine. Paracetamol may increase the harmful effects of cocaine on the liver4.

Taking both these drugs together may produce unpleasant effects such as physical discomfort or overstimulation. High doses put you at risk. If you mix, start low and go slow

_Kratom leaves produce complex opioid-like analgesic effects, which could be potentiated with the use of ibuprofen._

Amphetamines and DMT is not usually a harmful combination but stimulants generally increase anxiety levels and the risk of thought loops which can lead to negative experiences.

Tricyclics (Amitriptyline, Anafranil, Asendin, Aventyl, Elavil, Endep, Norfranil, Norpramin, Pamelor, Sinequan, Surmontil, Tipramine, Tofranil, and Vivactil) is consistently reported as being very bad in combination with LSD. People attempting this combination are unable to communicate with others, they go into a fugue state where they wander away from home and don't know how they got there, and they are generally in a terrible state psychologically. Life-threatening seizures and at least one death have been reported to be triggered by the combination of LSD and tricyclics. If you are prescribed tricyclics for mental health problems, it is not a good idea to try LSD outside of a supervised medical setting, as it might worsen the symptoms.

Effects are additive. The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually.

This drug can have anxiogenic (anxiety-creating) effects which may create an unpleasant thoughts and discomfort.

Using these drugs together can cause an effect stronger than desired though they aren't likely to cause a serious adverse reaction if used carefully. Additional research should always be done before mixing drugs.

Using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before mixing drugs.

This combination is relatively safe and is unlikely to cause any unwanted effects.

Stimulants should not be combined with kratom, as they further increase the level of stimulation provided by the kratom. This results in the development of potentially severe side effects: anxiety, heart palpitations, excessive sweating, and general agitation. More life-threatening side effects that may result include: increased blood pressure. The lowering of the seizure threshold may also be observed.

Cannabis and mushrooms is not usually a harmful combination, but cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics so beware when mixing these drugs.

The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually. Benzos lessen the effects of nitrous oxide due to both drugs acting on common receptors.

This combination carries a low risk. Ibuprofen and cannabis are unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Cannabis and LSD is not usually a harmful combination, but cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics so beware when mixing these drugs.

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. Be careful when mixing these drugs.

The effects of mixing these two drugs together can be unpredictable.

There is no evidence to date showing interactions between aspirin and benzos. This combination is unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

There is a low risk when drinking a moderate amount of alcohol when using the recommended dose of aspirin.

Avoid alcohol if you are taking aspirin for a headache. Alcohol is likely to make a headache worse as it causes dehydration.

2C-X and GHB is not usually a harmful combination, it will tend to decrease the effects of both drugs.

_Reactions and side effects are rare, but using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Kratom’s effects are due primarily to its interaction with mu-receptors in the brain, while SSRIs produce their effects by interacting with the serotonin receptors. It is hypothesized that, since both act on receptors that can sometimes be involved with each other in certain processes, an interaction may or may not occur. Interactions include risks such as_ [_serotonin syndrome_](https://www.mdedge.com/ccjm/article/120386/neurology/serotonin-syndrome-preventing-recognizing-and-treating-it)_. Additional research should always be done before mixing drugs._

[**Tramadol**](https://www.drugs.com/tramadol.html) can result in seizures when taken with LSD, as Tromadol lowers the seizure threshold.

There is no evidence to date showing interactions between ibuprofen and modafinil. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

Taking aspirin and cocaine together is not usually any more harmful than taking them individually. Aspirin is sometimes [used](https://www.the-hospitalist.org/hospitalist/article/125897/how-should-patient-cocaine-associated-chest-pain-be-treated) by doctors in response to cocaine associated chest pains51,52.

There is no evidence to date showing interactions between ibuprofen and ketamine. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

Caffeine and GHB have low risk and decreased synergy. Caffeine will mildly hide the depressant effects of GHB leading to a slightly increased risk of overdose.

Here are the most common effects, not everyone necessarily experiences all of them every time they consume the drug and other effects not listed might be felt. **The likelihood of experiencing negative effects is far greater at high doses.**

The effects are (from positive to negative):

>>> effects
++   Mood lift (mild to extreme)
++   Talkative and sociable
++   Increase in energy
++   Feelings of comfort and belonging
++   Increased empathy
++   Increased appreciation of music
++   Increased pleasure from the sense of touch==   Decreased appetite
==   Visual distortion: mild hallucinations
==   Rapid involuntary eye jiggling
==   Change in body temperature regulation
==   Unexpected emotions
==   Strong desire to take more MDMA when coming down
--   Mild to extreme jaw clenching, tongue and cheek chewing, and teeth grinding
--   Difficulty concentrating
--   Impaired ability to focus eyes/blurred vision
--   Inability to fall asleep when physically tired
--   Erectile dysfunction and difficulty reaching orgasm
--   Increase in body temperature, dehydration
--   Nausea and vomiting
<<<

 **Source:** [erowid.org](http://www.erowid.org/); [tripsit.me](https://tripsit.me/)

### How? How Much? When? For how Long?

As with any drug, the correct dose for you depends on factors such as weight, gender, metabolism, whether you have taken the drug recently or not, amongst many others.

**Read our section on dosing and tolerance in** [**ME**](/me) **for more information.**

### How you take MDMA matters...

#### Orally

MDMA usually comes in a powder or pill form, and is ingested orally.

#### Nasally

MDMA is also sometimes taken nasally. The effects take shorter to appear, but this is not recommended, as it decreases the length of the experience, cause nasal pain and can cause a more severe comedown. If you were to snort MDMA, make sure the powder/crystal is finely crushed. Clean your nostrils after snorting and alternate them if snorting more than once.

### How much MDMA?

- **Small/sensitive people/first timers:** 60-90mg
- **Recommended dose for most people:** 75-125mg
- **Large/less sensitive people:** 110-150mg
- **Strong dose:** 150-200mg
- **Heavy dose:** 200mg+

**Guideline by body weight:** 0.7mg per lb, or 1.54mg per kg

**Optional redose:** half of the original dose, 2–3 hours in.

[**Use a scale to measure**](https://www.reagent-tests.uk/product/a03-mg-balance/) the exact amount of MDMA you would like to take.

**Sources:** [www.erowid.org](https://www.erowid.org/chemicals/mdma/mdma_dose.shtml); [rollsafe.org](http://www.rollsafe.org/)

### When do the effects of MDMA kick in and for how long?

The **START** time below is when you will usually begin to feel the effects of MDMA from the time when you first take it. **DURATION** is roughly the length of time you will experience the effects, after which the effects will start to wear off and you might start to feel the comedown effects.

- **Onset:** 20–70 minutes (depending on the form of the MDMA and how much food you have eaten)
- **Duration:** 3–5 hours
- **Normal after-effects:** up to 24 hours after

**Source:** [www.erowid.org](https://www.erowid.org/chemicals/mdma/mdma_effects.shtml)

**WARNING:** pills in the UK and Europe contain a very high concentration of MDMA. This can lead to accidental overdoses. We recommend that you **try half a pill first** as it might have much more MDMA than you expect.

### How often can I take MDMA?

#### The Three Month Rule

MDMA works by causing large amounts of serotonin to be released, along with other neurotransmitters like dopamine. After using MDMA, your serotonin levels are lowered, and it takes [**a long time**](https://dancesafe.org/drug-information/ecstasy-slideshow/) for your brain to build more serotonin. If you take ecstasy [**on a regular basis**](http://www.reddit.com/r/Drugs/comments/xihdo/rdrugs_ama_series_mdma_aka_ecstasy_e_x_molly/), you may be releasing and depleting your serotonin before it has a chance to fully replenish itself. This means you will be operating on lower-than-normal serotonin levels most of the time, and this can [**lead to depression**](http://www.bmj.com/content/350/bmj.h1771) or worsen depressive symptoms. It is recommended that you leave **at the very least 1–2 months** between uses, **ideally 3**. Save MDMA for special occasions or events only, and use it very sparingly.

#### Tolerance and loss of effectiveness

[**Consuming MDMA too often**](https://www.globaldrugsurvey.com/dosing-for-pleasure-and-why-less-is-often-more/) decreases the potency of this drug on your body. This may lead to consuming larger amounts of MDMA. Again, save MDMA for special occasions or events only, and use it very sparingly.

There are certain precautions you should take before doing MDMA. The advice below helps you to be physically and mentally prepared before doing it. Furthermore, we want you to be safe, and just in case you have a bad experience or some of the unwanted side effects associated with MDMA, we have also provided information on how to take care of yourself when you are in full swing. Finally, there are those uncomfortable or undesirable effects after the high have worn out, we will provide you with some practical tips on how to have a better calm down and help you to reduce the harm done to your body and brain.

>>> tabs
# Before

### Test it

MDMA and ecstasy are often mixed with other chemicals, from caffeine to methamphetamine. We recommend that you always test your pills using a drug testing kit. Depending on the country you're in, there are places where you can [**send samples of your pills**](https://www.ecstasydata.org/send_sample.php) to be tested. Another recommended source is [**Pill Reports**](http://www.pillreports.net/), where you can search for an ecstasy pill by its stamp and appearance. However, this is not a foolproof way to making sure that your pills are safe.

Accidental deaths have occurred due to ingesting compounds such as [**PMMA in a pill that was thought to be MDMA**](http://www.theguardian.com/society/shortcuts/2013/jul/22/pma-not-another-drug-scare-story). We know some people cannot be bothered to test, but it is becoming increasingly important to do this in order to stay safe.  

### Check the interactions

Check our drug interaction chart above!  

### Get some supplements

There's some science out there that supports certain vitamins as being neuroprotective and helping to reduce the side-effects of taking MDMA. [RollSafe](https://rollsafe.org/mdma-supplements/) has an extensive guide on this and you can purchase a kit at [Roll Kit](https://rollkit.net/). 20% of Roll Kit's proceeds will be going to MAPS to aid psychedelic research.

# During 

### Drink water (but not too much!)

Drink around 500 ml of water (2-3 glasses of water) per hour to avoid overheating and dehydration. Excessive water decreases salts in the body, so be careful not to drink too much.

### Take a break from dancing

MDMA can change your body temperature regulation, while dancing increases your body temperature. These combined can lead to heat stroke, so take a break from dancing from time to time to cool down.

### Avoid re-dosing

A common mistake which can lead to a bad experience (or even to hospitalisation) is taking another dose of MDMA because the first one did not have an effect. This leads to ‘coming up’ twice as hard, which is very dangerous. MDMA takes a long time to digest and absorb, so be patient, and wait for it to kick in. After a certain point during the comedown, taking more will not lead to positive effects. It only worsens the hangover. We recommend that you abstain from redosing at the end of the night.

### Find some chewing gum

Use chewing gum to avoid teeth grinding and try magnesium tablets to reduce clenching

### Friends

If you are feeling unwell after taking MDMA in a party, look for your friends. They will help you feeling better. Tell them how you feel and ask them for anything that might make you feel better such as water.

### Overdose

How to know if someone took an overdose:

- Vomiting
- Headaches
- Dizziness
- **Serotonin syndrome**: increased heart rate, shivering, twitching, over-responsive reflexes, extremely high temperatures

Do not doubt to call a paramedic if you feel any of these symptoms. You will not get into trouble.

# After 

### Hangover

The MDMA hangover, or comedown, varies from person to person and is dependent on the amount taken. The effects can also last from 1 up to 14 days after use.

The after-effects include:

- Fuzzy memory
- Decrease in attention or difficulty concentrating
- Some people feel happier in general and more focused.
- Mild to strong depression

Some people experience a ‘loss of magic’ after using MDMA after a couple of uses, meaning the drug doesn’t feel as good as the first few times. However, this does not happen to all people. If MDMA is taken on successive days or weeks, then the negative and comedown effects are worsened.

### Sleep, eat, and hydrate

After the sesh, get plenty of sleep as exhaustion will leave you feeling like garbage. Make sure to eat plenty of nutritious food full of protein and to drink plenty of water throughout the day (2-3L total with 1-2 glasses per hour max).
<<<

### Short-term

#### Heatstroke

MDMA causes raise in body temperature and deregulates the body’s natural thermoregulation. This adds up to other factors such as dehydration and dancing in hot settings during hours. Keep hydrated and take regular breaks to avoid overheating.

#### Dehydration or hyperhydration

Many [MDMA-related injuries](http://www.reddit.com/r/Drugs/comments/xihdordrugs_ama_series_mdma_aka_ecstasy_e_x_molly/) are due to dehydration. Dehydration contributes to heatstrokes. Make sure to drink water during the night, but not too much as too much water can lead to health risks of its own.

### Long-term use

#### Brain toxicity

There are studies that indicate brain toxicity can occur after MDMA use[^1]. However, there is little or no knowledge of what the consequences are.

#### Addiction

MDMA is not as addictive as other stimulants or depressants[^2]. However, like any other drug, it is possible to become dependant if it becomes a habit. Please read our information on dependence in our [**ME**](https://drugsand.me/en/me/addiction/) page for more information.

### Europe

- **UK**: Illegal. Class A drug. Penalties include a maximum of seven years and/or unlimited fine for possession; life and/ or unlimited fine for production or trafficking.
- **Germany:** Illegal
- **France:** Illegal
- **Netherlands:** Illegal
- **Spain:** Illegal
- **Russia:** Illegal
- **Czech Republic:** [**Posession of less than 5 pills is not a serious criminal offense**](https://www.loc.gov/law/help/decriminalization-of-narcotics/czechrepublic.php)
- **Portugal:** Decriminalised up to 1g.
- **Rest of Europe:** Illegal in all countries

### America

- **USA**: Illegal, Schedule I section D 1995.
- **Canada:** Schedule III
- **Mexico:** Illegal

### Asia and Australia

- **Australia:** Illegal
- **New Zealand:** Illegal
- **Singapore:** Illegal
- **Hong Kong:** Illegal
- **Israel:** Illegal

### Africa

- **South Africa:** Illegal

To learn more about why MDMA is illegal, check out this video.

### FAQs

#### I have a heart problem. Can I take MDMA?

It depends on your condition, however, stimulants can increase your heart rate considerably, so if you want to be on the safe side, it is better to not take it.

### Bibliography

[^1]: Kalant, H., 2001. [The pharmacology and toxicology of “ecstasy” and related drugs.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81503/) _Cmaj_, _165_(7), pp.917-928.
[^2]: Nutt, D., King, L.A., Saulsbury, W. and Blakemore, C., 2007. [Development of a rational scale to assess the harm of drugs of potential misuse.](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60464-4/fulltext) _The Lancet_, _369_(9566), pp.1047-1053.

The same pill/powder may take 30 minutes to have and effect for one person and 3 hours for another. Avoid re-dosing before you feel the effects.

Spread out re-doses

Stay hydrated, but don't drink too much. 250–500ml (one or two standard glasses) per hour is recommended.

Drink water

MDMA affects your body temperature. Take a break: go outside or sit down from time to time to cool down.

MDMA

{Mandy, Molly, Ecstasy, X, XTC}

Spread out re-doses

1

Drink water

2

Take breaks

3