[Solved] Can MDMA therapy be done with Mirabegron?

Combining MDMA and mirabegron (Betmiga®) is not recommended. Both substances have a stimulating effect on the heart and blood vessels: they increase blood pressure and heart rate, thereby increasing the risk of hypertension, cardiac arrhythmias, and other cardiovascular complications.

In addition, there is an important metabolic interaction. Mirabegron is a strong inhibitor of the enzyme CYP2D6, whereas MDMA is partially broken down by this enzyme. This means that MDMA is broken down more slowly and can therefore have a stronger and longer-lasting effect than normal. The consequence is an increased risk of overstimulation, serotonin syndrome, neurotoxicity, and severe side effects such as nausea, anxiety, or confusion.

Because mirabegron a long half-life of approximately 50 hours has, the substance remains in the body for a long time. It takes about 10 days (5× the half-life) before it is fully spent.

Conclusion

The use of MDMA in combination with mirabegron is unsafe and can lead to dangerous cardiovascular and neurochemical effects. For therapeutic or recreational MDMA sessions Mirabegron is recommended not combinable and possibly (temporarily) stop only in consultation with a doctor, taking into account the long onset of action. It can also be examined whether a truffle therapy would fit.