Oral DMT needs a a monoamine oxidase inhibitor (MAOI). The right MAOI can make all the difference.

The only clinically-available MAOIs in the United States have strict dietary requirements. Otherwise, these drugs can cause dangerously high blood pressure.

Reversible inhibitors of MAO-A (RIMAs) are selective for MAO-A versus MAO-B and are generally considered safer. Plant-sourced harmine and harmaline are RIMAs consumed alongside DMT in traditional ayahuasca ceremonies. However, harmine and harmaline exert off-target effects including gastrointenstinal distress and Parkinsonian-like tremors.

Moclobemide is a RIMA approved for clinical use in some countries, but it is not available in the United States. Moreover, it demonstrates relatively low potency at MAO-A and still exerts some degree of MAO-B inhibition. Low potency limits potential combination with DMT into a single formulation.

Remedi Therapeutics has identified a well-characterized, ultraselective, and potent MAOI that lacks hyperintensive risk, gastrointestinal symptoms, or tremors.