[Solved] Can psilocybin be taken together with mirabegron?

Combining psilocybin (truffles) of mirabegron (Betmiga®) has no direct metabolic interaction, as psilocybin is mainly broken down by MAO-A and glucuronidation is broken down and does not involve the liver enzymes on which mirabegron acts. There is therefore no enzyme interaction as strong as that seen with MDMA in combination with mirabegron.

However, there is a combined effect on the heart and blood vessels. Psilocybin can temporarily cause a increase in blood pressure and heart rate, and mirabegron has this same effect due to its mechanism of action as β3-adrenergic receptor agonist. Taken together, this can place additional strain on the cardiovascular system, leading to symptoms such as headaches, palpitations, anxiety or high blood pressure. However, this effect is shorter-lasting and less intense than with MDMA. If the heart and blood vessels are in good condition, there is no immediate need to taper off the medication. If, however, there are heart problems or blood pressure issues, care should be taken with this combination and it is strongly recommended that you seek medical advice. 

Because mirabegron a long half-life of approximately 50 hours takes, it takes about 10 days before the drug has been completely eliminated from the body. This is useful to know if you want to rule out any potential interactions.

Conclusion

The use of psilocybin in combination with mirabegron is not necessarily dangerous due to metabolic interactions, but However, it may pose a risk to the heart and blood vessels in some people. In healthy people with no heart or blood pressure problems, it may, in theory, be less risky than combining it with MDMA, but it is still wise to exercise caution. For most therapeutic sessions, however, it is usually recommended to use mirabegron not combinable containing psilocybin, and only to start with a truffle session once the medicine (in consultation with a doctor) has taken full effect.