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Buprenorphine Hydrochloride

Also known as: Buprenorphine Hydrochloride

Route: Sublingual

Check Buprenorphine Hydrochloride Interactions →

20 interactions on record⛔ Black Box Warning

Buprenorphine Hydrochloride has 20 known drug interactions based on U.S. FDA drug labeling data. 15 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Alcohol, Carbamazepine, Erythromycin. Patients taking Buprenorphine Hydrochloride should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.

Total: 20
Major: 15
Moderate: 3

Major (15)

Buprenorphine Hydrochloride + Alcohol— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…
Buprenorphine Hydrochloride + Carbamazepine— CYP3A4 inducer decreases buprenorphine plasma concentration, potentially resulting in decreased efficacy or withdrawal s…
Buprenorphine Hydrochloride + Erythromycin— CYP3A4 inhibitor that can increase plasma concentration of buprenorphine, resulting in increased or prolonged opioid eff…
Buprenorphine Hydrochloride + Gabapentin— CNS depressant with additive effects; concomitant use increases risk of respiratory depression, profound sedation, coma,…
Buprenorphine Hydrochloride + Ketoconazole— CYP3A4 inhibitor that can increase plasma concentration of buprenorphine, resulting in increased or prolonged opioid eff…
Buprenorphine Hydrochloride + Muscle Relaxants— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…
Buprenorphine Hydrochloride + Nitrazepam— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…
Buprenorphine Hydrochloride + Phenytoin— CYP3A4 inducer decreases buprenorphine plasma concentration, potentially resulting in decreased efficacy or withdrawal s…
Buprenorphine Hydrochloride + Pregabalin— CNS depressant with additive effects; concomitant use increases risk of respiratory depression, profound sedation, coma,…
Buprenorphine Hydrochloride + Rifampin— CYP3A4 inducer decreases buprenorphine plasma concentration, potentially resulting in decreased efficacy or withdrawal s…
Buprenorphine Hydrochloride + Ritonavir— CYP3A4 inhibitor that can increase plasma concentration of buprenorphine, resulting in increased or prolonged opioid eff…
Buprenorphine Hydrochloride + Sedating Antihistamines— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…
Buprenorphine Hydrochloride + Sedatives— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…
Buprenorphine Hydrochloride + Topical Local Anesthetics— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…
Buprenorphine Hydrochloride + Tranquilizers— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…

Moderate (3)

Buprenorphine Hydrochloride + Atazanavir— Other PIs with CYP3A4 inhibitory activity (atazanavir and atazanavir/ritonavir) resulted in elevated levels of buprenorp…
Buprenorphine Hydrochloride + Cyp3a Inducers— Concomitant use decreases buprenorphine plasma concentration, potentially resulting in decreased efficacy or withdrawal …
Buprenorphine Hydrochloride + Mao Inhibitors— Increase buprenorphine plasma concentration, resulting in increased or prolonged opioid effects, particularly respirator…

Buprenorphine Hydrochloride + Alcohol⚠️Major

Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depressant effects.

Buprenorphine Hydrochloride + Carbamazepine⚠️Major

CYP3A4 inducer decreases buprenorphine plasma concentration, potentially resulting in decreased efficacy or withdrawal syndrome. Upon discontinuation, buprenorphine levels increase with risk of serious respiratory depression.

Buprenorphine Hydrochloride + Erythromycin⚠️Major

CYP3A4 inhibitor that can increase plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects and respiratory depression.

Buprenorphine Hydrochloride + Gabapentin⚠️Major

CNS depressant with additive effects; concomitant use increases risk of respiratory depression, profound sedation, coma, and death.

Buprenorphine Hydrochloride + Ketoconazole⚠️Major

CYP3A4 inhibitor that can increase plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects and respiratory depression.

Buprenorphine Hydrochloride + Muscle Relaxants⚠️Major

Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depressant effects.

Buprenorphine Hydrochloride + Nitrazepam⚠️Major

Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depressant effects.

Buprenorphine Hydrochloride + Phenytoin⚠️Major

Buprenorphine Hydrochloride + Pregabalin⚠️Major

CNS depressant with additive effects; concomitant use increases risk of respiratory depression, profound sedation, coma, and death.

Buprenorphine Hydrochloride + Rifampin⚠️Major

Buprenorphine Hydrochloride + Ritonavir⚠️Major

CYP3A4 inhibitor that can increase plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects and respiratory depression.

Buprenorphine Hydrochloride + Sedating Antihistamines⚠️Major

Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depressant effects.

Buprenorphine Hydrochloride + Sedatives⚠️Major

Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depressant effects.

Buprenorphine Hydrochloride + Topical Local Anesthetics⚠️Major

Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depressant effects.

Buprenorphine Hydrochloride + Tranquilizers⚠️Major

Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depressant effects.

Buprenorphine Hydrochloride + Atazanavir🟡Moderate

Other PIs with CYP3A4 inhibitory activity (atazanavir and atazanavir/ritonavir) resulted in elevated levels of buprenorphine and norbuprenorphine, and patients in one study reported increased sedation. Symptoms of opioid excess have been found in post-marketing reports of patients receiving buprenorphine and atazanavir with and without ritonavir concomitantly. Intervention: Monitor patients taking Buprenorphine Sublingual Tablets and atazanavir with and without ritonavir, and reduce dose of Buprenorphine Sublingual Tablets if warranted.

Buprenorphine Hydrochloride + Cyp3a Inducers🟡Moderate

Concomitant use decreases buprenorphine plasma concentration, potentially resulting in decreased efficacy or withdrawal syndrome. Discontinuation may cause serious respiratory depression.

Buprenorphine Hydrochloride + Mao Inhibitors🟡Moderate

Increase buprenorphine plasma concentration, resulting in increased or prolonged opioid effects, particularly respiratory depression and sedation.

Buprenorphine Hydrochloride + Lopinavirℹ️Unknown

Intervention: Patients who are on chronic buprenorphine sublingual tablets treatment should have their dose monitored if NNRTIs are added to their treatment regimen Examples: Efavirenz, nevirapine, etravirine, delavirdine Antiretrovirals: Protease inhibitors (PIs) Clinical Impact: Studies have shown some antiretroviral protease inhibitors (PIs) with CYP3A4 inhibitory activity (nelfinavir, lopinavir/ritonavir, ritonavir) have little effect on buprenorphine pharmacokinetic and no significant pharmacodynamic effects.

Buprenorphine Hydrochloride + Nelfinavirℹ️Unknown

Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine. For informational purposes only. Always consult your pharmacist or physician.