Ayahuasca has a better physical safety profile for healthy individuals without medication contraindications. In the Global Ayahuasca Survey, 2.3% of 10,836 respondents required medical attention. Ibogaine carries documented cardiac risk: 19 deaths were reported between 1990 and 2008, six involving cardiac complications (Alper et al., 2012). Ibogaine’s hERG channel blockade can cause QT prolongation and fatal arrhythmia. CYP2D6 genotyping and ECG are required before treatment (Knuijver et al., 2024). Noribogaine’s half-life of 24 to 49 hours means cardiac monitoring extends days past the psychoactive phase (Glue et al., 2015, 2016). Neither is safe without professional screening and supervision.