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Combining Cocaine with other Drugs – Interactions

The risks and effects of mixing Cocaine with other drugs varies. We’ve divided the risk factors into what we believe are three appropriate categories: “dangerous”, “unsafe”, and “caution”.


  • αMT
  • Opioids: Stimulants (like cocaine) increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.
  • Tramadol: Tramadol and stimulants both increase the risk of seizures.
  • MAOIs: This combination is poorly explored.


  • Alcohol: Drinking while on stimulants (like cocaine) is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. Stimulants allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide combine, set an intake limit of how much you will drink each hour. Remember! You will feel the alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.
  • Dox: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic.
  • NBOMes and 2C-T-x: Cocaine and NBOMes/2C-T-x, both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.
  • PCP: This combination can easily lead to hypermanic states.
  • 5-MeO-xxT: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.
  • DXM: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.


  • Mushrooms, LSD, DMT, 2C-x and Mescaline: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.
  • Cannabis: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences.
  • Ketamine: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.
  • Amphetamines: This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine.
  • MDMA: Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.
  • Caffeine: Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.
  • GHB/GBL: Stimulants (like cocaine) increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise GHB/GBL can wear off and leave a dangerous concentration of cocaine behind.
  • MXE: Stimulants (like cocaine) taken with MXE can lead to hypermanic states much more easily, especially if sleep deprived.
  • Dealers don’t always sell what they say they’re selling. The chances of a dangerous side effects or overdose/overamping is increased when substances are misrepresented.

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Cocaine Cut: Ephedrine

Ephedrine-Induced Priapism: (Prolonged erected penis)

What is Ephedrine?

Ephedrine comes from the plant Ephedra sinica, which can be found in Asia. For centuries this herb has been used in China for its medical properties. Famously helpful to break a fever and induce sweating.

Ephedrine is categorized as a stimulant it is similar structurally to amphetamines. However, the effects of ephedrine are much weaker than amphetamines.

Short History:

Products that contain the herb ephedra have been promoted and used in the United States since the 1980s.

This herb has been advertised as a weight loss aid and enhancer of athletic performance.

However, there is no or very little research backing up these claims. An overwhelming amount of complaints in the 1990s lead to its prohibition.


Ephedrine is currently banned by:

  1. Food and Drug Administration (FDA)
  2. National Collegiate Athletic Association (NCAA)
  3. International Olympic Committee (IOC)
  4. National Football League (NFL).

Reports of adverse effects included serious side effects and, in some cases, death. Many of those reports were coming from healthy young customers and professional athletes.

Ephedrine as a stimulant:

The ephedrine alkaloids are stimulants, and so ephedrine can:

  • Increase heart rate
  • Increase blood pressure
  • Relax bronchial tissue
  • Ease shortness of breath
  • Decrease appetite
  • Increase alertness
  • Increase productivity
  • Improve mood
  • Decrease fatigue

At higher doses, it can promote anxiety, restlessness and insomnia.

Ephedrine and Cocaine:

Ephedrine has been commonly used as a cut for cocaine. Is not only cheaper than cocaine, but it also provides a kick of its own. Ephedrine is a stimulant, so, it has the ability to speed up the nervous system. This can lead to serious side effects:

  • High blood pressure
  • Heart attacks
  • Seizures
  • Strokes
  • Irregular heartbeat
  • Death

Cocaine and Ephedrine-Induced Priapism: (Prolonged erected penis)

Drugs that facilitate, potentiate, or mimic the action of sympathetic nerves have been associated with priapism.

Cocaine inhibits norepinephrine (NE) reuptake, in other words, cocaine increases the amount of NE. Ephedrine has a more varied method of action, but it mostly works by increasing the amount of adrenaline and/or norepinephrine (NE).

In theory, ephedrine should not induce priapism. However, in animal and case studies, the combination of ephedrine and cocaine was shown to induce priapism.

More research is needed to reach a concrete answer. However, chronic use of cocaine and ephedrine increases the risk of developing priapism.

Testing Cocaine For Cuts

It is possible to test cocaine for a variety of cuts.

Get your test kit for Ephedrine and other Cocaine Cuts.

You may also like to view:

Cocaine Test Kits ».

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Cocaine Cut: Levamisole (Livestock Dewormer)

What’s Levamisole?

Levamisole was first synthesized in 1966. It was intended to be use as an anthelminthic (anti-parasitic drugs) and as an immunomodulatory agent for inflammatory conditions. However, in 2000, it was withdrawn from the US market due to side effects and is currently used only for veterinary purposes.
Over the last decade, levamisole has been increasingly encountered as an additive in both powder and crack cocaine.

What’s Levamisole role in Cocaine?

Levamisole has become an “excellent” cut for cocaine, as its cheaper for producers and it resembles to cocaine physically and chemically.

Levisamole once consumed is metabolized to aminorex, a compound with amphetamine-like psychostimulatory properties and a long half-life. These characteristics permits levamisole to enhance the effects of cocaine.

Still, a much higher dose of levamisole is required to affect monoamine reuptake in a way similar to cocaine. Users of drugs containing a high levamisole-to-cocaine ratio are likely to consume significant amounts in order to achieve the desired effects, putting them at higher risks of severe side effects from the adulterant.

Effects of Levamisole:

As use of cocaine cut with levamisole becomes more prevalent, complications directly attributable to the chemical are increasingly being recognized.

Levamisole use can present with a number of adverse effects:

  • Nausea and vomiting
  • Headache
  • Fatigue
  • Fever
  • Diarrhea
  • Myalgia
  • Dizziness
  • Confusion
  • Rash

Serious complications include:

  • Agranulocytosis
  • Leukopenia
  • Thrombocytopenia
  • Vasculopathy and vasculitis
  • Dermal necrosis
  • Leukoencephalopathy
  • Psychosis
  • Pulmonary hypertension and hemorrhage
  • Glomerulonephritis
  • Emboli
  • Arthritis
  • CAD
  • Collapse

Product Placement: Levamisole and other cuts can be detected with our Cocaine Cuts Test Kit.