Can I take psilocybin while using blood pressure medication?

If you use blood pressure medication, it makes sense to wonder how psilocybin might affect your body. The short answer is that psilocybin and blood pressure have a clear, short-term relationship, and psilocybin safety depends a lot on your baseline health, your medications, and the setting.

Clinical studies show that during a psilocybin session many people experience temporary increases in heart rate and blood pressure, then values return to normal as the experience resolves. Understanding that time window is key to making informed choices about hypertension and about psilocybin safety. In other words, most healthy participants tolerate these changes, but those with untreated hypertension or cardiac disease need extra caution.

What the science says about psilocybin and blood pressure

Multiple controlled human studies report transient, often modest, elevations in blood pressure and heart rate during the first one to two hours after dosing. A classic dose-response study in healthy adults observed a moderate increase in mean arterial pressure around the 60-minute mark, with no concerning ECG changes. More recent safety reviews echo this pattern, noting that psilocybin safety signals are generally favorable when people are screened and monitored.

Newer data continue to align with that picture. A 2024 safety pharmacology analysis found significant but short-lived increases in systolic and diastolic pressure, and did not observe severe hypertension in their sample. Early 2025 clinical reports similarly describe transient elevations that normalized by the end of the dosing day. These studies reinforce the importance of active monitoring during the acute effects, especially for anyone managing hypertension. 

Do blood pressure meds like ACE inhibitors or beta-blockers interact with psilocybin?

There is still limited direct evidence about drug–drug interactions between psilocybin and common antihypertensives like lisinopril, losartan, or metoprolol. Systematic reviews of interactions with classic psychedelics find very few serious interaction signals overall, and most of the interaction literature focuses on psychiatric medicines such as SSRIs rather than blood pressure drugs. That means we do not have strong evidence of harmful interactions with ACE inhibitors or beta-blockers, and we also do not have definitive proof of zero interaction across all scenarios. When data are limited, psilocybin safety practice leans on careful screening and monitoring. 

A notable exception to highlight for anyone reading about “enhancers” online is the combination of psilocybin with monoamine oxidase inhibitors, for example harmaline or harmine. A 2024 case report described a hypertensive emergency after psilocybin mushrooms were taken alongside an MAOI. This is not the same as taking standard hypertension medicines. It does show why people should avoid stacking psilocybin with MAOIs or “ayahuasca-like” compounds outside of clinical oversight. For hypertension and psilocybin safety, this is one interaction to clearly avoid.

Why psilocybin raises blood pressure temporarily

Psilocybin is converted to psilocin in the body. Psilocin acts on serotonin receptors and is metabolized mainly by glucuronidation pathways, which do not directly overlap with how ACE inhibitors or many beta-blockers are processed. Even so, psilocybin’s acute effects on arousal and autonomic tone can nudge blood pressure and heart rate upward, especially early in a session. Understanding these mechanisms helps explain why psilocybin and blood pressure often go hand in hand during the acute window, even when there is no direct clash with blood pressure meds. 

How clinical trials handle hypertension

Modern trials typically measure resting blood pressure multiple times before dosing, and many exclude people with uncontrolled hypertension. Some protocols set thresholds, for example, excluding resting pressures above about 140/90 unless values can be stabilized. During dosing, staff routinely recheck vitals and have plans for outlier readings. These guardrails are part of psilocybin safety, and they matter even more for participants who live with hypertension. 

Long-term lens, what about population-level links to hypertension?

Interesting observational work links lifetime classic psychedelic use to lower odds of having hypertension in the past year. Researchers suggest possible pathways, like stress reduction, behavior change, and anti-inflammatory effects. These studies cannot prove cause and effect, but they raise useful questions for future research on hypertension, psilocybin safety, and whole-person health. 

Practical takeaways if you use blood pressure medication

• Talk with a clinician who understands your specific meds and history. Share details about your hypertension and any cardiac history so they can weigh psilocybin safety for you personally. FDA guidance encourages robust cardiovascular monitoring during psychedelic investigations for a reason.
• Avoid combining psilocybin with monoamine oxidase inhibitors. This is a known risk for severe blood pressure spikes. This is separate from standard antihypertensives like lisinopril or metoprolol.
• If you are cleared and choose to proceed, favor a setting with medical screening, measured dosing, and blood pressure monitoring for the first several hours, since psilocybin and blood pressure spikes usually appear early then resolve.
• If your hypertension is uncontrolled, or you have significant cardiac disease, the safest option is to wait until your condition is well managed. That is consistent with how clinical trials screen participants.

Now what?

There is no strong evidence of harmful interactions between psilocybin and common antihypertensives like ACE inhibitors or beta-blockers, based on the limited research we have. However, psilocybin and blood pressure are linked in the short term, with predictable, temporary increases during the acute experience. For most healthy participants under supervision, psilocybin safety has been acceptable. For people with hypertension, the safest path is careful screening, stable baseline control, and active monitoring. Avoid MAOI combinations. If you keep those pieces in place, you reduce risk while the field continues to learn more. 

If you’re looking for personalized guidance and support before or after a psychedelic experience, the Unlimited Sciences Psychedelic Info Line offers free, 1:1 support for answering questions about psychedelic safety, integration, and emotional processing.