Iâve never liked raves
Drugs metabolized through the same liver enzyme as MDMA
Some drugs are metabolized (broken down) through the same liver enzyme as MDMA, known as the CYP2D6 enzyme (pronounced âsip-two-dee-sixâ). If you take MDMA along with another drug that is metabolized by the CYP2D6 enzyme, they will both be metabolized much more slowly, as the same enzymes struggle to break down two drugs at the same time. It is like taking a higher dose of both drugs, and this can be dangerous, especially if the other drug has a low overdose threshold.
Ritonivar, for example, is a protease inhibitor used in the treatment of HIV that is metabolized by the CYP2D6 enzyme. At least one person has died from taking MDMA while on Ritonivar. Other drugs metabolized by CYP2D6 include codeine and other opiate derivatives, as well as DXM, an ingredient found in many over-the counter cough medications.
Be especially careful about DXM, because it is commonly found in fake ecstasy tablets. Donât combine different brands of E. Accidentally getting DXM is bad enough, but accidentally combining it with real Ecstasy is even worse.
Note: Prozac is also metabolized by the CYP2D6 enzyme. Taking E while on Prozac will inhibit the breakdown of both the Prozac and the E. However, Prozac also prevents users from experiencing the desired effects. The unique relationship between MDMA and Prozac deserves special consideration. See our neurotoxicity page as well as our Ecstasy Slideshow for more information.
