[Solved] Can I combine bisoprolol/bisohexal with MDMA?

Can I combine bisoprolol/bisohexal with MDMA?

It is advised against combining bisoprolol (Bisohexal) with MDMA. MDMA increases heart rate and blood pressure and can trigger cardiac arrhythmias; a beta-blocker can partially dampen the increase in heart rate, but the increase in blood pressure may (actually) persist, meaning the risk may be less “perceptible” while the cardiovascular strain continues. Additionally, the combination can have unpredictable consequences due to conflicting signals (stimulus versus inhibition), with a risk of blood pressure spikes, dizziness, fainting, and arrhythmias, particularly in people using bisoprolol for hypertension, angina, or rhythm problems.

If you are considering “stopping to avoid interaction”: bisoprolol has a half-life of approximately 10–12 hours and typically works for about 24 hours per dose; pharmacologically, the majority has worn off after about 48 hours, but medically speaking, abrupt (temporary) stopping actually poses a risk due to rebound (faster heart rate, higher blood pressure, angina/arrhythmias). Therefore, “stopping for a week and seeing if blood pressure normalizes” is not a reliable strategy: normalization of blood pressure says little about rebound susceptibility, underlying cardiac vulnerability, and the acute effects of MDMA. If tapering is even considered, it is usually done gradually (often over 1–2 weeks or according to a physician's plan), and the core question remains whether MDMA is justifiable for your indication at all; that is almost always a medical 'no' or at the very least ‘only after explicit physician advice’.

More: MDMA info | MDMA session | Combining drugs with medication

Can psilocybin be used with bisoprolol/bisohexal?

Psilocybin affects blood pressure to a lesser extent than MDMA and can be a 'safer' option. Caution is advised with this combination as well. All psychedelics are discouraged in cases of severe heart conditions or blood pressure problems, including psilocybin, ayahuasca, LSD, and MDMA. Although psilocybin appears to be the safest option among the mentioned psychedelics, it is important to know that it can often slightly increase blood pressure at the beginning of a session. After the effects of psilocybin wear off, blood pressure may be lower than normal. The lowered blood pressure immediately after the psilocybin session and the following day can lead to fainting and fainting in the event of lowered blood pressure caused by the effects of the psilocybin session and the combined effects of the medication used.

Therefore, always seek advice from a treating physician. This doctor has more insight into the severity of the underlying issues and can assess with you whether you can safely taper off the medication and then have the psychedelic session a week after tapering.