Substance
What not to mix with MDMA
Empathogen
Also calledmolly, ecstasy, ecstacy, xtc, mandy, pills
Summary
MDMA is checked against 40 other substances — 6 dangerous, 4 unsafe and 12 caution.
Dangerous
6- MDMA and AMTHigh risk of death or life-changing injury. Do not combine.
- MDMA and DXMHigh risk of death or life-changing injury. Do not combine.
- MDMA and LithiumHigh risk of serotonin syndrome
- MDMA and MAOIsMAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with MDMA will lead to hypertensive crises.
- MDMA and MephedroneRisk of serotonin syndrome as both drugs raise serotonin levels. Stimulants also increase the neurotoxic effects of MDMA, in addition to concerns of…
- MDMA and TramadolTramadol and stimulants both increase the risk of seizures.
Unsafe
4- MDMA and DiphenhydramineDiphenhydramine is a strong anticholinergic: it suppresses sweating and impairs the body's ability to shed heat. MDMA already raises body temperature…
- MDMA and MethamphetamineBoth are releasers acting on the same neurons, and the neurotoxicity mechanisms are shared — serotonergic and dopaminergic terminals under oxidative…
- MDMA and PCPThis combination can easily lead to hypermanic states
- MDMA and PregabalinThere is a significant risk of seizures from this combination. Amphetamines increase respiration rate allowing for a higher dose of sedatives than…
Caution
12- MDMA and 2C-T-xCarries risk that is worth understanding before combining. Reduce doses and do not use alone.
- MDMA and 5-MeO-xxTSome of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care
- MDMA and AlcoholThe combination of MDMA and alcohol may increase strain on the cardiovascular system and lead to increased alcohol consumption. MDMA may also impair…
- MDMA and AmphetaminesThis combination of stimulants will increase strain on the heart, may cause some physical discomfort, and has the chance to cause cardiovascular…
- MDMA and CaffeineCaffeine is not really necessary with MDMA and increases any neurotoxic effects from MDMA
- MDMA and CocaineCocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.
- MDMA and DOxThe combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.
- MDMA and GHB / GBLLarge amounts of GHB/GBL may overwhelm the effects of MDMA on the comedown.
- MDMA and IbuprofenMDMA can cause hyperthermia, dehydration and, rarely, rhabdomyolysis — all of which stress the kidneys. NSAIDs reduce renal blood flow, so ibuprofen…
- MDMA and MXEThere have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience…
- MDMA and NBOMesCarries risk that is worth understanding before combining. Reduce doses and do not use alone.
- MDMA and NicotineAdditive cardiovascular strain on top of MDMA's own increase in heart rate, blood pressure and body temperature. Also expect heavily increased…
Low / synergy
8Low / decrease
2Low / no synergy
8Checking more than one?
This page rates MDMA 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 MDMA in the checkerEducational 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.