Cocaine

Clinical contraindication: Relative; Substantial clinical concern; the literature treats it as a reason for caution or deferral.
Best available evidence: Mechanism only
Half-life: Not recorded

Named in state rules?

CONot named

ORNot named

NMPending

Cite asPsilodex: cocaine · v2026.10.02

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

01 Interaction with psilocybin

Sympathomimetic: BP, heart-rate and arrhythmia risk; some serotonergic activity.

Human data with psilocybin: None known: no published human data with psilocybin

Evidence types on this record

ThMechanism only (theoretical)

02 Pharmacology relevant to psilocybin

3 listed · counted on reports

Raises blood pressure or heart rate: Raises blood pressure or heart rate. Psilocybin raises both for several hours, so the effects can add. Sources [1]
Lowers seizure threshold or carries seizure risk: Makes a seizure more likely, or has been linked to seizures. Sources [2]
Serotonergic: Increases serotonin activity, for example by blocking its reuptake or releasing it. Psilocybin acts on serotonin receptors, so effects can add together. With antidepressant use, the psilocybin response can be weaker. Sources [3]

03 State rules

Official text governs

CO4 CCR 755-1

Not named

No provision names this medication or its class.

Colorado · checked 2026-09-30

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-09-30

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-09-30

04 Conditions to ask about

Screening items in state rules

This medication is usually taken for a condition. State rules screen for some conditions directly, so the medication is a prompt to ask about them. Confirm with the participant; never assume a condition from the medication.

Stimulant use disorder; cardiovascular riskCO 6.16(F)(1)

05 Sources

Preston CL (ed). Stockley’s Drug Interactions, 11th ed. Pharmaceutical Press, 2016., p. 112
Preston CL (ed). Stockley’s Drug Interactions, 11th ed. Pharmaceutical Press, 2016., p. 112
Han DD, Gu HH. Comparison of the monoamine transporters from human and mouse in their sensitivities to psychostimulant drugs. BMC Pharmacol 2006;6:6. — cocaine inhibits SERT, DAT and NET at similar concentrations (Ki 0.2–0.7 µM)

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