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A recent study evaluated its effects on healthy volunteers at doses of 3–60 mg, finding no tolerability issues.[4] A slow half-life of 28–49 hours was seen with large volume of distribution.
Recently, noribogaine has been determined to act as a biased agonist of the κ-opioid receptor (KOR).[11] It activates the G-protein (GDP-GTP exchange) signaling pathway with 75% the efficacy of dynorphin A (EC50 = 9 μM), but it is only 12% as efficacious at activating the β-arrestin pathway.[11] Moreover, due to its very low efficacy on the β-arrestin pathway, noribogaine blocked dynorphin A activation of the pathway (IC50 = 1 μM) and hence functioned as an antagonist of it.[11] The β-arrestin pathway is thought to be responsible for the dysphoric and aversive effects of KOR activation,[12] and its lack of activation by noribogaine may be the reason for the lack of dysphoric effects of the drug.[11] This biased agonist/antagonist action of noribogaine at the KOR is unique to it relative to other iboga alkaloids and related compounds such as ibogaine and 18-methoxycoronaridine (18-MC).[11] Moreover, it has been hypothesized that it may give noribogaine unique properties such that it may have the analgesic and antiaddictive effects of KOR agonists without the anxiogenic, dysphoric, or anhedonic effects that are typical of them.[11]
^Glick SD, Maisonneuve IS (May 1998). "Mechanisms of antiaddictive actions of ibogaine". Annals of the New York Academy of Sciences. 844: 214–26. doi:10.1111/j.1749-6632.1998.tb08237.x. PMID9668680.
^Baumann MH, Pablo J, Ali SF, Rothman RB, Mash DC (2001). "Comparative neuropharmacology of ibogaine and its O-desmethyl metabolite, noribogaine". The Alkaloids: Chemistry and Biology. 56: 79–113. doi:10.1016/S0099-9598(01)56009-5. PMID11705118.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Kubiliene A, Marksiene R, Kazlauskas S, Sadauskiene I, Razukas A, Ivanov L (2008). "Acute toxicity of ibogaine and noribogaine". Medicina (Kaunas, Lithuania). 44 (12): 984–8. PMID19142057.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^"Ascending-dose study of noribogaine in healthy volunteers: Pharmacokinetics, pharmacodynamics, safety, and tolerability". The Journal of Clinical Pharmacology. 55: 189–94. Oct 3, 2014. doi:10.1002/jcph.404. PMID25279818.
^ abcdefMaillet EL, Milon N, Heghinian MD, Fishback J, Schürer SC, Garamszegi N, Mash DC (2015). "Noribogaine is a G-protein biased κ-opioid receptor agonist". Neuropharmacology. 99: 675–88. doi:10.1016/j.neuropharm.2015.08.032. PMID26302653.