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 riskiest kratom combination: together they get past kratom's ceiling on slowed breathing, and kratom can peak late. Do not combine.
- Kratom and CocaineCocaine hides how much the opioid is slowing you down, so you take more; when the cocaine wears off first, breathing can stop. Do not combine. Keep…
- Kratom and FentanylKratom does nothing to blunt fentanyl; fentanyl sets the risk here. Do not combine. Never use alone, and keep naloxone nearby.
- Kratom and GHB / GBLGHB is steep enough on its own; an opioid removes the margin, and choking on vomit is how this kills. Do not combine. Put anyone who passes out on…
- Kratom and KetamineTogether they can cause vomiting and unconsciousness. Do not combine. Keep naloxone nearby, and put anyone who passes out on their side.
- Kratom and MAOIsMAOIs block the breakdown of what kratom releases, risking dangerous blood pressure and serotonin reactions. Do not combine, and that includes…
- Kratom and MethadoneMethadone is still fully active hours after you stop feeling it, so kratom lands on top of it. Do not combine. Keep naloxone nearby.
- Kratom and MXEMXE can make the opioid hit harder. Do not combine. Keep naloxone nearby.
- Kratom and OpioidsKratom's ceiling does not protect you once heroin or oxycodone is on board, and a second opioid is almost always found in kratom deaths. Do not…
Unsafe
6- Kratom and AlcoholKratom's ceiling on slowed breathing does not hold once alcohol is involved; heavy sedation and choking on vomit are the usual danger. Avoid this…
- Kratom and CodeineKratom varies between batches and codeine varies between people, so neither dose means what you think. Avoid this combination.
- Kratom and DiphenhydramineEach makes the other stronger, raising the risk of memory loss, collapse and unconsciousness. Avoid this combination. Keep naloxone nearby.
- Kratom and MethamphetamineMeth hides how much the opioid is slowing you, and when it fades, everything you redosed hits at once, often as you fall asleep. Avoid this…
- Kratom and PregabalinPregabalin makes opioid-type drugs slow breathing more, and its sedation comes late and lasts. Avoid this combination.
- Kratom and TramadolTogether they add sedation and raise the risk of a seizure. Avoid this combination.
Caution
8- Kratom and AmphetaminesThe stimulant hides how much the opioid is slowing you; if it wears off first, breathing can stop. Take less of each than usual, do not use alone…
- Kratom and BuprenorphineBuprenorphine mostly blocks kratom, sometimes with some withdrawal. Less an overdose risk than a wasted dose: on buprenorphine, kratom will not do…
- Kratom and DXMBoth act on serotonin and both sedate: expect more nausea and dissociation, and serotonin syndrome at higher doses. Take less of each than usual, and…
- Kratom and LithiumTogether they add sedation, and dehydration can push lithium levels up. Keep up water, and keep naloxone nearby.
- Kratom and MephedroneThe stimulant hides how much the opioid is slowing you; if it wears off first, breathing can stop. Take less of each than usual, do not use alone…
- Kratom and Nitrous OxideEach makes the other stronger, so you can lose balance or pass out without warning. Take less of each than usual, do not use alone, and keep naloxone…
- Kratom and PCPPCP can lower your opioid tolerance, making an overdose more likely. Take less opioid than usual, do not use alone, and keep naloxone nearby.
- Kratom and SSRIsSome SSRIs raise kratom levels, so your usual dose can hit harder, and serotonin syndrome is possible. Take less kratom than usual.
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.