Recently the use of the secretions of by the Bufo Alvarius toad (correct name Incilius alvarius) has become popular in various ritual settings. This popularization has meant that its use is becoming common in retreats where ayahuasca is also being consumed. While the separate use of each of these preparations is quite safe from a physiological perspective, combining these two substances is dangerous and can be deadly. There are at least two cases of deaths documented in the medical literature related to the combination of the active principles of Bufo alvarius with harmalines, compounds that are present in ayahuasca.