Cusco, Peru · 11,150 feet · Optional · No extra charge
Kambo in Cusco
One session of twenty to forty minutes, held in daylight on a rest day, one practitioner to one guest who does not leave the room. It is not psychedelic and you are awake and yourself for every minute of it. Cleared separately from ayahuasca, never in the first half of the week, and never suggested to a guest who did not ask.
The short answer
Kambo is the dried skin secretion of Phyllomedusa bicolor, the giant monkey frog of the western Amazon. A practitioner lifts the top layer of skin at three to five small burned points and places the secretion on them. Within a minute the face flushes and the heart rate climbs, most people vomit, and twenty to forty minutes later it is finished.
It is not psychoactive. There are no visions, no altered state to come down from, and no part of it you will not remember clearly. At this house it is one optional daytime session, one to one, on a rest day in the second half of the week, included in the $5,800 seven night week for guests the physician clears for it separately.
The dangerous part of kambo is not the frog. It is the water, and almost nobody selling kambo will tell you that. Section 03.
One session, in daylight, over before lunch.
One practitioner, one guest, the whole time.
The altitude that changes how we run it.
Extra charge. Included, or declined, never sold.
00 · What kambo is
A frog secretion, a burn the size of a match head, and forty minutes
Phyllomedusa bicolor lives in the canopy of the western Amazon. It is not a poison dart frog and what it produces is not venom, so nothing bites or stings you. The frog is held on strings while the secretion is scraped from its back with a stick, dried onto wood, and stored. The frog is released.
In a session the practitioner touches a glowing point to the surface of your skin, usually on the shoulder or the outside of the calf, and lifts the top layer away at three to five points each smaller than a match head. The secretion is moistened and placed on them. It is absorbed through the lymphatic system rather than swallowed or injected, which is why it takes hold in under a minute and why it is over so fast.
What is actually in it is not a mystery. The peptides have been isolated and measured. The table below gives the approximate quantities in a standard five point dose, from the most complete review of the human pharmacology published to date.
| Peptide | Per dose | What it does in the body |
|---|---|---|
| Phyllocaerulein | 1,600 mcg | Lowers blood pressure, drives nausea, vomiting, gastric and bile secretion, bowel movement |
| Phyllomedusin | 1,100 mcg | Dilates blood vessels. This is the heat, the red face and the facial swelling |
| Phyllokinin | 900 mcg | Also vasodilatory, and more potent than the body’s own bradykinin |
| Deltorphins | 265 mcg | Opioid peptide. Pain reduction and behavioural change |
| Sauvagine | 150 mcg | Hypotensive and gastrointestinal. Also reduces emotional reactivity and appetite |
| Dermorphins | 15 mcg | Opioid peptide, analgesic at forty to a thousand times the potency of morphine by weight |
| Dermaseptins | trace | Antimicrobial in laboratory assays. Present too briefly and too dilute to assume the same in you |
Why the response is so physical
Two of those peptides drop your blood pressure while two more dilate your vessels and your heart rate climbs to compensate. That combination, arriving inside sixty seconds, is the whole experience. Everything you have read described as spiritual is that cascade being felt.
What it is not
Not a psychedelic. Not a warm up for ayahuasca. Not a detox in the sense the internet uses that word, because your liver and kidneys were already doing that and no study has shown kambo removes anything from you.
What is actually known
No controlled trial of kambo in humans has ever been run, for any outcome. Everything published is a case report, a laboratory assay or an anecdote. We will describe the forty minutes in as much detail as you want. We will not tell you what it does to your health, because nobody knows.
01 · The session
What forty minutes actually looks like
Written from the sessions we run, not from a brochure. Times are the shape of a typical morning and your own will vary by a few minutes in either direction.
The night beforeOne light dinner, then nothing after ten
There is no fast. You eat normally, lightly, and stop at ten. Water is measured from that point rather than encouraged. Blood pressure and oxygen saturation are taken in the evening and again in the morning, and if anything has moved the session moves with it. Nobody is talked into a session because it was on the schedule.
8:00 amA measured cup, and it is written down
You drink a specific measured volume of water. Not the two to four litres a great many practitioners ask for, and the reason for that difference is the whole of section 03. The practitioner records what you drank and when, before anything is applied.
8:15 amThe points
Three to five points, burned on the shoulder or the outside of the calf, each smaller than a match head. It stings for a second. This is not the part anyone finds difficult, and if you want the points somewhere clothing will cover, say so now rather than later.
Minute 1 to 3Onset, and it is fast
The face heats and reddens. Heart rate climbs, often past 120. Ears burn, lips and eyelids can swell, the throat feels tight and full. It is the fastest onset of anything worked with at this house, and it is genuinely alarming the first time. The practitioner will tell you what is happening while it happens.
Minute 3 to 15The peak
Blood pressure falls while heart rate stays high, so a wave of heaviness arrives and almost everyone ends up on the floor. Nausea builds through it. Most guests vomit once or twice in this window. You are lying on your side, with a hand on you and a bucket in reach, and this is the part people mean when they say kambo is hard.
Minute 15 to 30It breaks
Heat drains out of the face first, the swelling goes down, heart rate settles. It recedes faster than it arrived, which surprises people more than the onset does. Most guests are sitting up and talking by minute twenty five.
Minute 30 to 60Flat and quiet
Heavy, tired, occasionally euphoric, usually very thirsty. Fluids come in measured, salted amounts rather than freely. Blood pressure is taken again, and again an hour later. Nobody is left alone in this window.
The rest of the dayYours, and nothing is scheduled
Sleep, eat when you want it, sit in the garden, do nothing. The points scab within a day and heal into small pale circles that stay visible for months and often years. That is a permanent mark and worth deciding about beforehand.
The next dayNo ceremony
Kambo never sits within twenty four hours of an ayahuasca night in either direction. We do not stack medicines onto one day and we do not use one to prepare you for another.
02 · Side by side
Kambo is the harder forty minutes and the easier day
| Kambo | Ayahuasca | |
|---|---|---|
| Duration | Twenty to forty minutes | Five to six hours |
| Psychoactive | No, not at all | Profoundly |
| Time of day | Morning, in daylight | Night, in the dark |
| Who is with you | One practitioner, one guest | Shipibo maestros, twelve guests |
| Purging | Near universal, and fast | Common, spread through the night |
| What screening is about | Your heart and your fluid balance | MAO inhibition and psychiatric history |
| Can it be stopped | Points can be wiped, which shortens it | No, once it begins it runs |
| In your week here | One optional rest day session | Four ceremonies across seven nights |
The line that matters is the screening row
Ayahuasca screening is largely a question about monoamine oxidase inhibition and psychiatric history: what you take and what you have been diagnosed with. Kambo screening is a question about your cardiovascular system and your fluid balance. Different question, different answer. Being cleared for one tells you nothing about the other, and most weeks we clear someone for ayahuasca and decline them for kambo.
Which people find harder
Guests who have done both almost always describe kambo as the more unpleasant experience and the far easier day. Ayahuasca takes a night and often the following morning. Kambo takes forty minutes and leaves you tired. Nobody has ever told us the reverse.
It is not preparation
A common claim is that kambo opens you up or cleans you out before ayahuasca. There is no evidence for that and it is a convenient thing for a centre to say, because it turns an optional session into a recommended one. We do not say it and we do not schedule it that way.
03 · The real risk
The dangerous part of kambo is not the frog
People have died from kambo. We would rather you read the mechanisms here, from us, than find them somewhere else after you have booked.
Almost every kambo death that has reached a medical journal or a coroner’s court comes back to one of two mechanisms, and in neither case is the secretion doing something unexpected.
The first is water. A large number of practitioners instruct guests to drink two to four litres immediately before a session, on the theory that it helps you purge. The peptides then trigger heavy vomiting and impair the kidney’s ability to excrete free water. Sodium in the blood falls sharply, water moves into the brain, and the brain swells inside a skull that cannot accommodate it. In a case published in 2025, a thirty five year old woman who had followed her facilitator’s pre-hydration protocol reached hospital with a serum sodium of 123 millimoles per litre, developed diffuse cerebral oedema, and was declared brain dead. She was six months postpartum and had asthma. Nothing in her history would have flagged on a standard kambo screen. The water did it.
The second is the heart. A 2018 death in Italy involved a man with obesity and ventricular hypertrophy who died of an abnormal heart rhythm during a session. A New South Wales coroner’s inquest, reporting in 2024 into a 2019 Australian death, found the cause to be an adverse cardiac event triggered by the administration of the kambo toxin, and observed that people administering kambo may not themselves be prepared for what to do in an emergency. New South Wales now prohibits its supply or use without express authorisation, and the coroner stated she would have recommended outright illegality had that change not already been made.
Deaths have also been reported in Brazil in 2008, in Australia in 2021 where excessive vomiting is suspected to have perforated the oesophagus, in Mexico in 2024, and in the United Kingdom in March 2026. The published non fatal adverse events include hepatitis, psychosis, seizure, prolonged vomiting, oesophageal rupture and cardiac arrest.
Fluid is measured, not encouraged
You drink a specific recorded volume before and after, salted rather than plain. We do not ask you to load water. If you have loaded water on your own that morning, the session does not run, and that is not negotiable at the door.
A physician on the property
Not on call and not fifteen minutes away. On site, with blood pressure taken before, immediately after and an hour later, and a clinic twelve minutes from the house with a Cusco hospital at twenty, on sealed road.
Cardiovascular fitness is a separate gate
Cardiac history, blood pressure tracked across several days at altitude, and any cardiac event inside twelve months is a hard no rather than a conversation. This gate is unrelated to your ayahuasca clearance.
One practitioner, one guest
Never a group. Most of the serious harm on record happened where one person was managing several at once and could not reach the one who needed reaching.
We would rather lose the booking
If your blood pressure is unsettled, if you drank water on your own, if you slept badly, if you are still short of breath on the stairs after four days in Cusco, the session moves or does not happen at all. There is no version of this where we run it anyway because you have flown a long way and it is your last morning. That decision belongs to the physician and not to you, and not to us.
Sources for this section
- Thompson C, Williams ML. Review of the physiological effects of Phyllomedusa bicolor skin secretion peptides on humans receiving kambo. Drug Science, Policy and Law, 2022. journals.sagepub.com
- Shamanic kambo frog hyponatremic toxicity leading to brain death: a case report, 2025. pubmed.ncbi.nlm.nih.gov
- Inquest into the death of Natasha Lechner, Coroners Court of New South Wales, findings published 2024. coroners.nsw.gov.au
- Kambo: what is the frog poison spiritual ritual killing detoxers? Al Jazeera, 29 May 2026. aljazeera.com
- Health alert: do not use ayahuasca or kambo. US Embassy in Peru, 23 January 2025. pe.usembassy.gov
04 · Altitude
At 11,150 feet, altitude has already done some of kambo’s work
Cusco sits at 11,150 feet. Thin dry air raises your resting heart rate, pulls fluid out of you through every breath, and shifts how your body holds sodium, all before anything is applied to your skin. Kambo raises heart rate, dilates vessels, drops blood pressure and empties you out. Those two things stack, and they stack in exactly the direction that has caused harm elsewhere.
Almost everything written about kambo describes sessions run near sea level, in the Amazon basin or in a European treatment room. The safety literature does not account for a guest whose plasma volume has already contracted from four days at altitude. So we do not run it the way a jungle centre runs it.
Kambo is never held in the first half of the week. You arrive at least two days before anything begins, the physician records blood pressure and oxygen saturation daily from arrival, and kambo becomes available from day four at the earliest, once there are several days of readings to look at. Not how you say you feel. What the numbers actually did.
Arrive two days early
Non negotiable for every guest, for the ayahuasca as much as the kambo, and the single thing that most affects how the week goes.
Never before day four
And never in the first half of the week regardless of how well you say you feel on day two.
Mornings only
So there are eight waking hours of observation afterwards, with the physician on the property for all of them.
Electrolytes, not water
Rehydration afterwards is measured and salted, because plain water after heavy vomiting is what drives sodium down.
Cancelled rather than squeezed in
If the numbers are not right on the morning, the session is cancelled rather than moved to your last day. There is no pressure to fit it in before you fly, and no guest has ever been charged less for skipping it, because it never cost anything in the first place.
05 · Screening
The list we publish before you ask
This is a separate gate from your ayahuasca clearance, assessed by the same physician against a different set of questions. Being cleared for one has no bearing on the other.
Full stops
- Any diagnosed heart condition or arrhythmia, or a cardiac event within the last twelve months
- Low blood pressure, or blood pressure that has been unstable since you arrived
- Addison’s disease or any adrenal insufficiency
- Pregnancy, or breastfeeding
- Surgery within the last three months
- Current chemotherapy or radiotherapy
- Serious kidney disease, or any previous episode of hyponatremia
- Epilepsy or a seizure disorder
- Active pancreatic disease
- Under eighteen
Case by case
- Blood pressure medication, diuretics, or anything that affects fluid balance
- SSRIs, SNRIs and lithium, not for interaction but because vomiting and fluid shifts move blood levels
- Thyroid conditions
- A history of fainting or vasovagal syncope
- An eating disorder, current or within the last two years
- Asthma, and any condition affecting airway swelling
- Anything that made your ayahuasca clearance conditional rather than clean
Cleared for ayahuasca, declined for kambo, is a normal outcome
It happens most weeks and it is not a mistake, a downgrade, or something to argue with. The two assessments ask different questions. Nothing about your retreat changes if the answer on kambo is no, and the price does not change either, because kambo was never priced.
06 · Honesty
Four sentences we will not write about kambo
Where it stands legally
Kambo is legal in Peru and is used traditionally here. It is not an approved treatment anywhere in the world. Brazil banned its commercial sale and marketing in 2004, Australia prohibits supply or use without express authorisation, Chile prohibits importing it, and in January 2025 the US Embassy in Lima issued a health alert advising American citizens not to use ayahuasca or kambo in Peru. Nothing may be carried home. We would rather you read that alert now and bring us your questions than come across it afterwards and wonder what else we left out.
07 · Cost
Kambo is included, and it is never sold to you
Additional charge for kambo
Included in the seven night week for guests the physician clears for it separately and who ask for it themselves.
A centre that charges for kambo has a financial reason to recommend kambo. That is the entire argument. Price a second medicine separately and every conversation about whether a guest should have it is now a conversation with money in it, held by the person who benefits.
So we removed the reason. Nobody here earns anything from your saying yes. Nobody raises kambo with a guest who did not raise it first. If the physician declines you, the week costs exactly the same and nothing else about it changes.
What that also means is that we are not motivated to talk you into it, and you should be suspicious of anywhere that is. Ask any centre you are considering what a kambo session costs and what happens to that money if you are declined on the morning.
Four ceremonies with named Shipibo maestros, single occupancy room, the dieta kitchen, airport transfers, physician screening before payment, on site medical care, and twelve months of integration calls.
Flights and travel insurance. We ask every guest to carry insurance that covers medical evacuation, which matters more at this altitude than it would at sea level.
Which is what makes one practitioner to one guest possible for kambo in the first place.
08 · Questions
About kambo in Cusco
What is kambo?
Does kambo get you high?
How long does kambo last?
Does kambo hurt?
Will I vomit during kambo?
Do kambo marks scar?
Is kambo dangerous?
Why do you measure my water instead of telling me to drink a lot?
Is kambo legal in Peru?
Can I do kambo and ayahuasca in the same week?
Does altitude make kambo harder in Cusco?
Can I stop a kambo session once it has started?
How much does kambo cost at your retreat?
Is the frog harmed?
Apply
Now you know the forty minutes. Ask whether you are cleared for it.
Every application goes to the physician before anyone takes your money, and kambo is assessed separately from everything else. If the answer is no, the week costs the same and nothing else changes. If you did not ask about kambo, we will not bring it up.