Buprenorphine Drug interactions can accidentally happen; here is how to prevent them.
Suboxone, also known as buprenorphine, is an FDA-approved prescription medication for opioid addiction treatment. Buprenorphine has been used clinically since 2002 and has proven to be an effective partial opioid agonist. It also has other uses, like helping people with chronic pain under the right circumstances. Knowing how it can interact with other substances is essential if you take this medication as part of your medication assisted treatment (MAT) program for opioid use disorder.
Patients prescribed buprenorphine often receive this medication to take at home. That means it is generally safe when taken as directed. However, there is a risk of adverse effects if it is mixed with other medications, especially benzodiazepines, commonly referred to as “benzos”. Learn more about buprenorphine drug interactions to avoid while using it to safeguard your health.
How Suboxone Works for Opioid Addiction
Before we cover the dangers of mixing buprenorphine with other substances, let us cover the basics. Buprenorphine is the generic name for a prescription drug called Suboxone. The only difference is that Suboxone also contains naloxone, which is an overdose reversal drug.
Buprenorphine belongs to a class of medications called partial opioid agonists. It primarily works to reduce cravings for other opioids. This drug activates the brain’s opioid receptors as if an opioid is in the body but with weaker effects.
This long-acting drug is usually prescribed in a sublingual tablet or film that dissolves under the tongue. It can be effective for 24 hours or more before a patient needs another dose. Buprenorphine is safe to take alone or in a compound including naloxone.
Buprenorphine treatment can be negatively affected if taken with certain medications commonly prescribed for comorbidities of substance use disorder. This is why you must disclose all medications you take while in MAT, especially if prescribed by different medical providers.
Buprenorphine drug interactions to avoid should be stated in every pharmacy pamphlet accompanying a filled prescription. Still, understanding how these substances interact is crucial to preventing a potentially fatal medical emergency.
Buprenorphine Drug Interactions to Avoid with Other Prescription Medications
Drug interactions with buprenorphine can increase your risk of severe side effects. When mixed with the wrong substances, the combination can produce the following symptoms:
- Shallow breathing
- Extreme dizziness
- Drowsiness
- Disorientation
- In rare cases, death
Suboxone and benzodiazepines are among the worst combinations. This includes:
- Klonopin (clonazepam)
- Xanax (alprazolam)
- Valium (diazepam)
- Restoril (temazepam)
- Ativan (lorazepam)
Other drugs can increase buprenorphine’s effects because of their ability to slow your metabolism and heart rate. As your metabolism slows, the medications do not break down as quickly. This causes them to be in your bloodstream longer than intended.
These drugs that can increase buprenorphine’s effects include:
- Some antidepressants like Nardil (phenelzine) and Prozac (fluoxetine)
- Antibiotics like Biaxin XL (clarithromycin) and Ery-Tab (erythromycin)
- Antifungals such as Diflucan (fluconazole) and Sporanox (itraconazole)
In contrast, some medications can decrease buprenorphine’s effects, causing the drug to not be as effective. This issue happens when your metabolism increases, and the drug breaks down much faster. Thus, the necessary therapeutic concentration of the drug in your blood and tissues will not be reached.
Steer clear of the following when on buprenorphine:
- Seizure medications like phenobarbital, Tegretol (carbamazepine) and Dilantin (phenytoin)
- Rifampin, a treatment for tuberculosis
Consult with your medical provider if you are currently on any other medications and are planning to start taking buprenorphine. Communicating with your medical team throughout your treatment is vital to ensure your safety.
Buprenorphine Drug Interactions to Avoid with Other Substances
Suboxone is safe and effective when used as prescribed. However, there are over-the-counter medications and other substances that can have adverse effects when taken with Suboxone.
- St. John’s wort, a flowering plant known for treating depression, is a popular herbal remedy. If taken with Suboxone, it can cause your body to break down the medication too quickly, making it less effective. It also carries the risk of serotonin syndrome, a serious side effect.
PLEASE NOTE: Although herbal remedies are very popular and easy to obtain over-the-counter, they are still substances! They can severely impact the effectiveness of many prescription medications. Always tell your medical provider if you plan to take any supplements or herbal remedies, as they can alter your prescription medication’s effectiveness.
- Medications that can cause drowsiness. This includes medicines like Benadryl or other antihistamines used to treat allergies. Drugstore sleep aids such as melatonin, valerian or doxylamine succinate can also cause impaired judgment, especially if driving or operating machinery.
- Alcohol. Even if you are not in recovery for alcohol use disorder, do not mix your Suboxone medication with alcohol. Alcohol is a depressant and slows down your central nervous system. When combined with buprenorphine, the effects can be doubled. This can lead to vomiting, nausea, fainting, heart palpitations and increased blood pressure.
If you plan to drink alcohol socially or moderately while taking Suboxone, speak with your medical provider. It is not safe for everyone, and there may be a better medication for your situation.
Use this handy online interactions checker to see if any of your medications could cause any issues while taking Suboxone.
Do not let potential drug interactions discourage you from starting buprenorphine treatment. Medical providers know alternative medications and safe dosages to prescribe if needed. Mental health disorders like anxiety and depression are prevalent in people with substance use disorder. Experienced medical providers can help you find the right combination of medications to help your co-occurring disorders while minimizing negative interactions.
Contact Health Care Resource Centers for Buprenorphine Treatment
At Health Care Resource Centers, we provide office-based opioid treatment (OBOT) for opioid addiction to support you on your journey to recovery. We pair medication with in-house counseling services to ensure your recovery without requiring daily visits to our treatment centers.
Let our team of expert medical providers in addiction medicine be your partner on your road to recovery. HCRC is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) and has provided addiction treatment services for over 30 years in the New England area.
Contact us today to learn more about how we can help you.
