Pre-Ibogaine Flood Dose
A pre-ibogaine flood dose refers to a lower, preliminary dose of ibogaine administered before the full therapeutic "flood dose" - the flood dose itself being the high-dose ibogaine treatment (typically 10-15 mg/kg or 800-2000 mg total) used for substance use disorder treatment.
Understanding the Terminology
The term "flood dose" in ibogaine treatment refers to the full therapeutic dose administered to treat substance use disorders, particularly opioid dependence. Based on available evidence:
- Flood dose range: 10-15 mg/kg body weight, or approximately 800-2000 mg total for a 70 kg person 1, 2
- Pre-flood or "test" doses: Lower preliminary doses given to assess tolerance and cardiovascular response before the full flood dose
Clinical Context from Recent Evidence
In a 2026 case report of severe ketamine use disorder, the patient received an 800 mg ibogaine HCl flood dose (10.1 mg/kg), followed by two supplementary "booster doses" of 300 mg (3.8 mg/kg) 2. This demonstrates the flood dose as the primary therapeutic intervention.
A 2026 pilot study in alcohol use disorder used a sequential dose-escalation approach before reaching therapeutic levels: starting at 20/40/80 mg in one volunteer, then 80/160/240 mg in another, then 240/320 mg, before administering a single 400 mg dose to remaining participants 3. This sequential approach represents a safety-focused pre-flood dosing strategy.
Dosing Framework
The microdose range for ibogaine is 20 mg/70 kg according to systematic review data 1, while the intoxication threshold is 100-210 mg/70 kg, and the flood dose is 1000-2000 mg/70 kg.
A pre-flood dose would logically fall between the microdose and flood dose ranges - likely in the 100-400 mg range - serving as a cardiovascular and tolerance screening tool before administering the full therapeutic flood dose.
Critical Safety Considerations
Cardiovascular monitoring is mandatory - QTc prolongation occurs with ibogaine, and effects correlate more strongly with ibogaine plasma concentrations than its metabolite noribogaine 4. The 2026 alcohol study documented QTc alterations in five of nine patients, with two requiring medication for psychomotor agitation, insomnia, and hypertension 3.
CYP2D6 genotype profoundly affects ibogaine clearance - basic clearance is 0.82 L/h at CYP2D6 activity score of 0, increasing by 30.7 L/h for every point increase 4. Poor metabolizers face significantly higher exposure and toxicity risk.
Common Pitfall
Do not confuse microdosing (20 mg range) with pre-flood dosing (100-400 mg range) or flood dosing (800-2000 mg range). These represent distinct dosing paradigms with different purposes: microdosing for sub-perceptual effects, pre-flood for safety screening, and flood dose for acute addiction treatment.