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What is it?

MDMA, which is technically called methylenedioxymethamphetamine (yeah, try saying that ten times fast!!), is the primary ingredient in the drug that is sold under the common name of ‘ecstasy’. MDMA is an empathogen, which increases an individual’s feelings of empathy and kindness. Basically it gives us all the love feels! Ecstasy is notorious for being cut and filled with other chemicals that can range from poisonous household products to amphetamines.

MDMA is usually identified as a yellowish crystalline substance at the start, but is often crushed into powder form or made into pills with markings on them. It is also known as E, ekkies, pills, caps, XTC, pingers, bikkies, flippers, molly, and disco snacks.

MDMA is most often swallowed in pill form, but can also be snorted, injected, or absorbed rectally. With injecting, there is risk of contracting blood borne viruses, such as hepatitis B & C and HIV if needles are shared and the risk of infection at the injecting site.

What are the effects?

The short term effects of the drug can usually be felt 20 to 60 minutes after ingesting it, but may be sooner if snorted, injected or shafted (basically, up the butt). The effects of MDMA can vary depending on the ingredients used to make it.

  • Euphoria
  • Energetic and confident
  • Dilated pupils
  • Jaw clenching and teeth grinding
  • Heightened senses (sight, hearing and touch)
  • Excessive sweating and skin tingles
  • Muscle aches and pains
  • Reduced appetite
  • Fast heartbeat
  • Increased blood pressure
  • Dehydration
  • Heat stroke
  • Floating sensations
  • Perceptual changes, such as visual and auditory hallucinations
  • Out-of-character irrational behaviour
  • Anxiety
  • Irritability, paranoia and aggression
  • Vomiting
  • High body temperature
  • Racing heartbeat
  • Convulsion
  • Regular colds and flu
  • Depression
  • Needing to use more to get the same effect
  • Memory and concentration problems
  • Liver problems


Deaths experienced while using MDMA are usually attributed to other factors like cardiac arrest, stroke, kidney failure and overheating. But, if we take a large amount or get a really strong batch of MDMA, it’s possible to overdose. Knowing the signs of overdose helps keeps us and others safe, and when we might need to call an ambulance. Watch out for these symptoms and call 000 in an emergency:


Fast or irregular heart beat


High body temperature




Hypertension and difficult breathing


Passed out or passing out


Heart attack



It is also possible to drink too much water when we’re on MDMA – talk about feeling parched!! We’re probably going to be dancing and having a good time, but feeling extremely thirsty (and not that kind of thirsty, thank you very much!). Our body only needs to consume a particular amount of water and drinking too much is really bad! When taking MDMA, let’s take regular breaks from dancing or any activity that gets our heart rates pumping – and we only need to drink about 250-500 ml of water per hour.

Mixing with other drugs

The effects of mixing MDMA with other drugs – including over-the-counter or prescribed medications can be unpredictable and dangerous. Do not mix MDMA with the following medications because it may increase the risk of overdose, and even death:

  • Anti-depressant medications (specifically MAOIs)

There are a range of unsafe interactions to be cautious of when mixing MDMA and other drugs, and they can be found at TripSit.

HIV Medications

The interactions between MDMA and antiretroviral medications are not well known. There’s currently no evidence to suggest that MDMA use directly reduces the efficacy of antiretroviral medications. If some new research comes to light, then we’ll update this section and let you know.

We did find that at least two fatalities have been reported when antiretrovirals have been used alongside MDMA. One fatality involved a person taking Ritonavir and the other involved taking both Ritonavir and Saquinavir. Chat with an HIV specialist about MDMA use and the interactions with HIV medications.

The interactions between MDMA and PrEP and PEP are not well known. There’s currently no evidence to suggest that MDMA use directly interacts with these medications or reduces their efficacy. We’ll keep looking and update you if any new research comes to light.

To learn about the interactions between specific HIV medications and MDMA head to Liverpool HIV Drug Interactions Checker.


There’s currently no evidence to suggest that MDMA use directly reduces the efficacy of HRT. We’ll keep looking and update this information if something new comes to light.

Feminising hormones and anti-androgens can alter the experience of stimulants generally, including MDMA. It can result in experiencing amplified effects including excess sweating, rapid heart rate and dehydration, and this is more likely with low testosterone levels.

Fluctuations in Oestrogen and Progesterone can change how we respond to stimulants (although studies have been just with cisgender women), and it can affect our state of mind when taking MDMA.

Oestradiol can contribute to deep vein thrombosis, and cocaine use has been shown to increase thrombic risk, so best to chat with a healthcare professional to help manage and mitigate the risk.

Progesterone can cause us to feel tired, drowsy or sleepy a couple of hours after taking it, so it can help to schedule when to take it and when to take MDMA

As Spironolactone acts as a diuretic, we may need to be extra mindful of keeping our hydration levels up while using ecstasy/MDMA so that we don’t experience dehydration.

Testosterone can increase irritability, and restlessness and impact our emotions, so we may find changes in our response when taking MDMA, such as increased sweating and heart rate, and our experiences of irritability and mood swings.

Both Testosterone and MDMA use can contribute to a condition known as polycythaemia (a high concentration of red blood cells). This may feel like fatigue, weakness, dizziness, or shortness of breath. Chat with a doctor to keep an eye on any blood tests.

For more information about MDMA head to the Australian Drug Foundation or TripSit.

The information given on this page is not medical advice and should not be relied upon in that way.