Substance
What not to mix with Kratom
Opioid
Also calledmitragynine, mitragyna, mitragyna speciosa, krat
Partial agonist — a ceiling other opioids do not have
Summary
Kratom is checked against 40 other substances — 9 dangerous, 6 unsafe and 8 caution.
Dangerous
9- Kratom and BenzodiazepinesThe highest-risk kratom combination, ahead of alcohol. Benzodiazepines suppress breathing through GABA-A while kratom works the opioid receptor, and…
- Kratom and CocaineStimulants increase respiration rate allowing for a higher dose of opiates than normal. If the stimulant wears off first then the opiate may overcome…
- Kratom and FentanylFentanyl sets the risk here and kratom does nothing to blunt it. Kratom's ceiling protects against kratom, not against a full agonist dosed in…
- Kratom and GHB / GBLGHB's dose-response curve is steep enough to be dangerous on its own; an opioid on top removes the margin. Unrousable sedation with vomiting is the…
- Kratom and KetamineBoth substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit…
- Kratom and MAOIsMitragynine has monoamine activity and MAOIs block the breakdown of exactly what it releases. Hypertensive and serotonergic reactions are both…
- Kratom and MethadoneMethadone's effects outlast its own high by many hours, so kratom taken later in the day lands on top of methadone that is still fully active…
- Kratom and MXEThis combination can potentiate the effects of the opioid
- Kratom and OpioidsKratom is often taken to take the edge off between doses or to self-manage withdrawal, which puts it in the same window as a full agonist far more…
Unsafe
6- Kratom and AlcoholRated below heroin + alcohol, and the difference is real rather than cosmetic. Mitragynine is a partial mu-agonist that barely signals through the…
- Kratom and CodeineAdditive opioid effect with two unpredictable variables stacked: kratom products vary widely in alkaloid content between batches, and codeine's…
- Kratom and DiphenhydramineBoth substances are CNS depressants, potentiating each other strongly and unpredictably, raising the chances of memory loss, severe ataxia, and…
- Kratom and MethamphetamineA stimulant masking opioid sedation is how people miss the point at which they are overdosing. Methamphetamine's long duration means the opioid is…
- Kratom and PregabalinGabapentinoids potentiate opioid respiratory depression and carry an FDA warning for exactly this. The sedation arrives later than you expect and…
- Kratom and TramadolTramadol lowers the seizure threshold and inhibits serotonin reuptake on top of its opioid action; kratom adds opioid effect and mild serotonergic…
Caution
8- Kratom and AmphetaminesStimulants increase respiration rate, which can allow for a higher dose of opiates normal . If the stimulant wears off first then the opiate may…
- Kratom and BuprenorphineTwo partial agonists competing for the same receptor. Buprenorphine binds far more tightly, so it largely displaces kratom and you mostly get…
- Kratom and DXMBoth are serotonergic and both are sedating at the doses people take them recreationally. Additive nausea and dissociation, with serotonin toxicity…
- Kratom and LithiumNo direct pharmacokinetic interaction, but additive sedation and any dehydration or reduced kidney perfusion can raise lithium levels. Note that…
- Kratom and MephedroneStimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and…
- Kratom and Nitrous OxideBoth substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While…
- Kratom and PCPPCP can reduce opioid tolerance, increasing the risk of overdose
- Kratom and SSRIsTwo problems at once. Several SSRIs inhibit CYP2D6, which shifts how mitragynine is cleared and can raise levels from an unchanged dose. Kratom is…
Low / synergy
1Low / no synergy
16Checking more than one?
This page rates Kratom against one substance at a time. Combinations of three or more carry risks that no pair-by-pair list can show — the checker rates every pair at once and flags the whole-mix ones on top.
Open Kratom in the checkerOther opioids
All combinations →Educational information only, not medical advice. Absence of a documented interaction is not evidence of safety. Combination data from the TripSit drug combination chart, retrieved 2026-08-20.