Mitragynine Pseudoindoxyl: Tablets, Withdrawal, Product Market & Federal Status (2026)
What the evidence actually shows
Evidence Strong opioid pharmacology; emerging human withdrawal evidence; no controlled therapeutic trialsDirect answer
Evidence-first August 2026 review of mitragynine pseudoindoxyl covering mu-opioid pharmacology, human withdrawal reports, commercial tablets and product marketing, DEA temporary-scheduling notice, labeling uncertainty, and the distinction from botanical kratom leaf. The page labels the overall evidence as Strong opioid pharmacology; emerging human withdrawal evidence; no controlled therapeutic trials and links 10 cited sources for verification.
Safety notice: Mitragynine pseudoindoxyl (MP) is a potent opioid-active compound with no FDA-approved medical use and no established safe consumer dose. This page is an evidence and public-health review, not a dosing, sourcing, preparation, withdrawal-treatment, or legal-evasion guide. Severe sedation, slowed or irregular breathing, blue lips, inability to awaken, or another suspected opioid emergency requires emergency medical care.
Bottom line
Mitragynine pseudoindoxyl is not ordinary kratom leaf in tablet form. It is a potent mu-opioid-receptor-active derivative related to 7-hydroxymitragynine (7-OH), and it has moved from laboratory pharmacology into a real commercial market.
As of August 22, 2026:
- strong preclinical and in-vitro evidence establishes opioid-receptor activity;
- 2025 market studies documented hundreds of 7-OH/MP products and dozens of MP-containing products sold in consumer-friendly formats;
- published 2026 case reports now describe severe opioid-like withdrawal after repeated MP-tablet use;
- DEA published a July 6, 2026 Notice of Intent to temporarily place mitragynine pseudoindoxyl, MGM-15, and MGM-16 in Schedule I;
- no controlled human efficacy trial establishes a therapeutic use, safe dose, long-term safety profile, or consumer dosing regimen.
The correct evidence grade is therefore not simply “very low.” Human efficacy evidence is absent, while opioid pharmacology and emerging human-harm evidence are substantially stronger.
Evidence at a glance
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| Question | Current evidence |
|---|---|
| Mu-opioid receptor activity | Strong preclinical/in-vitro evidence |
| Delta-opioid antagonist activity | Described preclinically; clinical significance uncertain |
| Human therapeutic trials | None identified |
| Human withdrawal evidence | Emerging direct evidence from 2026 case reports |
| Commercial tablet/product market | Documented in 2024–2026 surveillance and market studies |
| Product consistency | Poorly characterized; some products contain multiple potent derivatives |
| FDA-approved use | None |
| Federal CSA status on Aug. 22, 2026 | DEA has published a Notice of Intent to temporarily schedule MP, MGM-15, and MGM-16; no later effective temporary order was located in this review |
| Safe consumer dose | Not established |
What mitragynine pseudoindoxyl is
Mitragynine pseudoindoxyl is a rearranged opioid-active derivative associated with mitragynine/7-OH chemistry. Experimental work has also shown that 7-OH can rearrange to pseudoindoxyl under human-plasma conditions. PMID 33344889
That chemistry should not be confused with saying ordinary botanical kratom naturally contains consumer-tablet quantities of MP.
Evidence-transfer boundary
A study of:
- dried kratom leaf;
- mitragynine;
- 7-OH;
- mitragynine pseudoindoxyl;
- MGM-15;
- or a mixed commercial tablet
is not automatically evidence for the others.
These compounds can share structural lineage and opioid pharmacology while producing different exposures and product risks.
Pharmacology: opioid activity is established; human safety is not
Preclinical work describes mitragynine pseudoindoxyl as a potent mu-opioid receptor agonist with delta-opioid-receptor antagonism. Some assays also describe signaling bias. Varadi et al.
The most important interpretation rule is:
Receptor signaling bias is not proof of lower overdose, respiratory, dependence, or withdrawal risk in humans.
A compound can look mechanistically interesting in receptor assays and still lack the human clinical data needed to establish therapeutic safety.
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| Evidence domain | What is known | What remains unknown |
|---|---|---|
| MOR activity | Potent agonist activity in preclinical systems | Human exposure-response curve |
| Delta activity | Antagonism described in preclinical work | Clinical importance |
| Signaling bias | Assay-dependent mechanistic finding | Whether it reduces human respiratory or dependence risk |
| Human PK | No controlled consumer-style MP pharmacokinetic program identified | Onset, accumulation, interindividual variability |
| Long-term use | No controlled safety program | Cardiopulmonary, endocrine, cognitive, dependence and organ effects |
“Pseudoindoxyl tablets” are now a real market category
The commercial market is no longer hypothetical.
304-product marketing study
A 2025 study identified 304 online products containing 7-OH and/or mitragynine pseudoindoxyl. Most were 7-OH-only, but combination 7-OH/MP products and MP-only products were also identified. Products were commonly sold as chewable or sublingual tablets, shots, gummies, and related formats, often with relaxation, focus, mood, or opioid-alternative marketing. PMID 40373645
51 MP-containing products
A separate 2025 descriptive assessment identified 51 unique products containing mitragynine pseudoindoxyl. Most contained MP plus 7-OH; some contained MP alone; others included additional hydroxymitragynine derivatives. The study also documented child-appealing flavors, bright packaging, food imagery, and other consumer-product features. PMID 40568898
Why this matters
A tablet described as “kratom,” “7-OH,” “botanical,” or “pseudo” may not represent one chemically simple exposure.
Product-level questions include:
- Is MP actually present?
- Is 7-OH present too?
- Are MGM-15 or other derivatives present?
- Does the label accurately describe the composition?
- Was the compound created or enriched during processing?
- Is there current independent analytical testing?
A brand name or front-label milligram number is not a substitute for validated chemical analysis.
Commercial assay uncertainty extends beyond MP
A 2026 analytical study of commercial kratom-related products found substantial inconsistencies between some labeled and measured 7-OH quantities and discussed 7-OH as a transient precursor related to pseudoindoxyl formation. PMID 41825819
That paper does not prove that every pseudoindoxyl label is inaccurate.
It does strengthen a broader conclusion: this emerging semi-synthetic market should not be treated as analytically equivalent to a standardized pharmaceutical supply chain.
Human evidence: severe withdrawal is now directly reported
The old statement “there are no human data” is no longer adequate.
There are still no controlled human efficacy trials, but 2026 case reports provide direct clinical evidence of dependence/withdrawal concerns.
Severe early-onset withdrawal case
A 2026 case report described a man who progressed from kratom to 7-OH tablets and then MP tablets and presented with severe opioid-like withdrawal, including autonomic and gastrointestinal symptoms and a high Clinical Opiate Withdrawal Scale score. PMID 41982589
This single case cannot estimate how frequently MP dependence occurs, define a threshold exposure, or establish a universal treatment approach.
It does show that severe clinically recognizable withdrawal can occur in the real-world MP tablet market.
A second 2026 case report also describes medically managed withdrawal associated with regular pseudoindoxyl use.
What case reports can and cannot prove
They support:
- clinical plausibility of opioid-like physical dependence;
- real-world exposure to MP-containing products;
- need for clinicians and poison/addiction specialists to recognize the compound.
They do not support:
- a safe dose;
- a typical withdrawal timeline;
- a self-treatment protocol;
- population-level incidence;
- comparative safety versus 7-OH or prescription opioids.
Safety and risk
Mitragynine pseudoindoxyl should be treated as a potent, poorly characterized opioid-active substance.
Important concerns include:
- opioid-like physical dependence and withdrawal;
- profound sedation;
- respiratory depression risk expected from potent MOR agonism and highlighted by DEA;
- unpredictable risk when products contain multiple active opioid derivatives;
- additive harm with alcohol, opioids, benzodiazepines, or other CNS depressants;
- uncertain long-term toxicity;
- labeling and quality-control uncertainty.
The earlier version of this page included advice such as “do not use alone.” That kind of language can be read as a use-optimization instruction and has been removed. The evidence purpose here is to explain risk—not to make an unapproved opioid product easier to use.
Federal status — updated August 22, 2026
On July 6, 2026, DEA published a Notice of Intent to temporarily place:
- mitragynine pseudoindoxyl;
- MGM-15 (dihydro-7-hydroxymitragynine);
- MGM-16
in Schedule I under the Controlled Substances Act. Federal Register 2026-13581
The notice states that HHS reported no current INDs or approved NDAs for the three substances and did not object to temporary placement.
DEA also documented the transition of MP and MGM-15 from research chemicals into commercially available powders, tablets, and liquid products and cited toxicology identification, misuse, and public-health risk.
Notice of Intent is not the same as an effective scheduling order
The July 6 Federal Register action is a Notice of Intent to issue a temporary scheduling order.
As of this August 22, 2026 review, no later Federal Register temporary order taking effect was located in the sources reviewed here. This page therefore does not state that MP is already federally Schedule I.
State law can be stricter and can change independently.
Why botanical-kratom evidence does not validate pseudoindoxyl tablets
Traditional kratom leaf contains a complex botanical alkaloid mixture dominated by mitragynine.
Commercial pseudoindoxyl tablets can instead deliver deliberately altered or enriched semi-synthetic opioid-active compounds.
That creates a major evidence mismatch:
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| Botanical evidence | Cannot automatically answer |
|---|---|
| Kratom leaf pharmacokinetics | MP-tablet pharmacokinetics |
| Traditional-use surveys | Safety of concentrated MP |
| Leaf alkaloid composition | Composition of a branded tablet |
| Mitragynine effects | Pseudoindoxyl dose-response |
| Kratom dependence literature | Incidence/severity of MP-specific dependence |
“Derived from kratom chemistry” is not the same as “equivalent to kratom leaf.”
What the evidence does not justify
Current evidence does not justify:
- a recreational or therapeutic pseudoindoxyl dose;
- a tablet-strength ranking;
- a product recommendation;
- a conversion from 7-OH to MP exposure;
- instructions for maximizing effect;
- a withdrawal self-treatment plan;
- a claim that signaling bias makes MP safer than conventional opioids;
- a claim that a product is lawful merely because it is sold openly.
FAQ
What are pseudoindoxyl tablets?
They are retail products marketed as containing mitragynine pseudoindoxyl, sometimes alone and often alongside 7-OH or other related derivatives. Market studies confirm that tablets and other consumer formats are widely sold, but product composition is not standardized like an approved medicine.
Is mitragynine pseudoindoxyl the same as 7-OH?
No. They are related but distinct compounds. 7-OH can rearrange to pseudoindoxyl under some experimental conditions, and commercial products may contain both.
Is pseudoindoxyl stronger than kratom?
That comparison is too vague to be scientifically useful. MP has potent MOR activity in preclinical studies, while botanical kratom leaf contains a different alkaloid matrix and exposure profile. There is no controlled human head-to-head trial establishing a simple potency conversion.
Can pseudoindoxyl cause withdrawal?
Yes, published 2026 case reports now describe severe opioid-like withdrawal associated with repeated MP-tablet use. Case reports cannot define incidence or a universal timeline.
Are pseudoindoxyl tablets federally Schedule I?
DEA published a July 6, 2026 Notice of Intent to temporarily schedule mitragynine pseudoindoxyl, MGM-15, and MGM-16. As of the August 22 review date, this page did not locate a later effective temporary scheduling order. State law may differ.
Why is there no dosing section?
Because no controlled human trial establishes a safe consumer dose, products can contain multiple potent derivatives, severe withdrawal has been reported, and the purpose of the article is evidence and safety—not use optimization.
Final verdict
Mitragynine pseudoindoxyl has crossed an important threshold in the evidence base.
It is no longer merely a potent laboratory derivative with theoretical human risk. Commercial tablets and other products are documented, and severe opioid-like withdrawal has been reported in human cases. DEA has also formally initiated the temporary-scheduling process.
At the same time, controlled human pharmacokinetics, therapeutic efficacy, long-term safety, product standardization, and dose-response remain absent or inadequate.
The most defensible description in August 2026 is:
A potent semi-synthetic opioid-active kratom derivative with emerging direct human harm evidence, an established commercial product market, and no validated consumer or medical use.
Related Content
Source ledger
References
10 sources
- 01Mitragynine/Corynantheidine Pseudoindoxyls As Opioid Analgesics with Mu Agonism and Delta Antagonism Varadi A, et al. · 2016 Source →
- 02Metabolism of a Kratom Alkaloid Metabolite in Human Plasma Increases Its Opioid Potency and Efficacy Kamble SH, et al. · 2020 Source →
- 03De facto opioids: Characterization of novel 7-hydroxymitragynine and mitragynine pseudoindoxyl product marketing Hill R, Boyer EW, et al. · 2025 PubMed →
- 04A Descriptive Assessment of Products Containing the Opioid Receptor Stimulator Mitragynine Pseudoindoxyl Product-market study authors · 2025 PubMed →
- 05Severe Early-Onset Withdrawal Following Intentional Use of Mitragynine Pseudoindoxyl Stanciu CN · 2026 PubMed →
- 06Mitragynine Pseudoindoxyl Withdrawal Treated with Macro-Dosed Buprenorphine Case report authors · 2026 Source →
- 07Quantitative analysis of 7-hydroxymitragynine in commercial kratom products and its stability under chemical and physiological conditions Avula B, et al. · 2026 PubMed →
- 08Schedules of Controlled Substances: Temporary Placement of Mitragynine Pseudoindoxyl, MGM-15, and MGM-16 in Schedule I — Notice of Intent U.S. Drug Enforcement Administration · 2026 Source →
- 09Emergence of potent kratom-related products containing 7-hydroxymitragynine and/or mitragynine pseudoindoxyl United Nations Office on Drugs and Crime · 2025 Source →
- 10Mitragynine Pseudoindoxyl Center for Forensic Science Research and Education · 2025 Source →