Sublocade, Brixadi (buprenorphine, long-acting injection) dosage, indications, interactions, adverse reactions, etc. (2023)

Abametapir will increase the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Avoid or use alternative medicines. Avoid taking drugs that are substrates of CYP3A4 within 2 weeks of abametasvir. Avoid amitapil if this is not possible.

Avastin and buprenorphine, long-acting injections, both increase sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Buprenorphine, long-acting injections, and amiodarone can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and amisulpride can prolong the QTc interval. Avoid or use alternative medicines.Amisulpride and buprenorphine, long-acting injections, both increased sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Buprenorphine, long-acting injections, and amitriptyline all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and amoxa prolong the QTc interval on average. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and anagrelide can prolong the QTc interval. Avoid or use alternative medicines.

Apalutamide reduces buprenorphine levels or effects by affecting metabolism by the hepatic/intestinal enzyme CYP3A4, long-acting injection. Avoid or use alternative medicines. Coadministration of apalutamide (a strong CYP3A4 inducer) with CYP3A4 substrate drugs may reduce exposure to these drugs. Avoid or substitute these medications with other medications if possible. If drugs must be co-administered, assess for loss of therapeutic effect. Adjust dosage according to prescribing information, if necessary.

Buprenorphine, long-acting injections, and apomorphine all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and aripiprazole all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections and arsenic trioxide can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and artemether can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injectables, and artemether/benzoxanthraquinone prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and asenaq prolong the QTc interval on average. Avoid or use alternative medicines.Asenapine and buprenorphine, long-acting injections, both increase sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Asenapine transdermal and buprenorphine, long-acting injection both increase sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Buprenorphine, long-acting injections, and atomoxetine can prolong the QTc interval. Avoid or use alternative medicines.

Both avapritinib and buprenorphine, long-acting injections, increased sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Buprenorphine, long-acting injection and azithromycin can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and bedaquiline all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injection reduces the effects of phenhydrocodone/acetaminophen through pharmacodynamic antagonism. Avoid or use alternative medicines. Mixing opioid agonists/antagonists and partial opioid agonists may reduce the analgesic effects of hydrocodone (benzohydrocodone prodrug of hydrocodone) and/or accelerate withdrawal in opioid-tolerant patients break symptoms.Hydrocodone/acetaminophen and buprenorphine, long-acting injections, may increase sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Both brexpiprazole and buprenorphine, long-acting injections, increased sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Both brimonidine and buprenorphine, long-acting injections, can increase sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Brivaracetam and buprenorphine, long-acting injections, both increased sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Both buprenorphine subcutaneous implants and buprenorphine depot injections increased sedation. Avoid or use alternative medicines. Use only in patients for whom alternative treatment options are unsuitable

Buprenorphine, long-acting injection and ceritinib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and chloroquine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and chlorpromazine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and ciprofloxacin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and citalopram can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and clarithromycin can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and clomipramine all prolong the QTc interval. Avoid or use alternative medicines.

Clonidine, buprenorphine, long-acting injections. Increase the toxicity of the other through pharmacodynamic synergy. Avoid or use alternative medicines. Coadministration may enhance CNS depressive effects.

Buprenorphine, long-acting injections, and chlordiazepoxide prolong the QTc interval on average. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and crizotinib all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and dasatinib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and degarelix can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and desflurane can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and desipramine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and deutetrabenazine all increased the QTc interval. Avoid or use alternative medicines.

Diazepam nasal drops, buprenorphine, long-acting injections. Increase the toxicity of the opponent through pharmacodynamic synergy. Avoid or use alternative medicines. May cause deep sedation, respiratory depression, coma and death if co-administered. Withhold concomitant prescriptions for these drugs in patients for whom other treatment options are inadequate. Limit dosage and duration to the minimum needed. Monitor closely for signs of respiratory depression and sedation.

Buprenorphine, long-acting injections, and disopyramide all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and dofetilide can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and dolasetron can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and donepezil can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and doxel can prolong the QTc interval on average. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and efavirenz can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injectables, and eliglustat all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and encorafenib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and entrectinib all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injection and eribulin can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injection and erythromycin base can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and erythromycin ethylsuccinate can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and erythromycin lactobionate can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and erythromycin stearate all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and escitalopram all prolong the QTc interval. Avoid or use alternative medicines.

Fexinidazole increases the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Avoid or use alternative medicines. Fexinidazole inhibits CYP3A4. Coadministration may increase the risk of adverse reactions from CYP3A4 substrates.Buprenorphine, long-acting injection and fexinidazole can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injectables, and fingolimod all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and flecainide all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and fluoxetine all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and fluvoxamine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and foscarnet can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injectables, and fostemsavir all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and gemifloxacin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injectables, and gemtuzumab all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and gilteritinib all increased the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injectables, and glasdegib all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and goserelin can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and granisetron all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and haloperidol all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and histrelin can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injection reduces the effects of hydrocodone by pharmacodynamic antagonism. Avoid or use alternative medicines. Mixing opioid agonists/antagonists and partial opioid agonists may reduce the analgesic effect of hydrocodone and/or accelerate withdrawal symptoms in opioid-tolerant patients. .

Buprenorphine, long-acting injections, and hydroxychloroquine sulfate can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and ibutilide can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and iloperidone all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and imipramine all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and inotuzumab all increased the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and isoflurane all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injection and itraconazole can prolong the QTc interval. Avoid or use alternative medicines.

ivosidenib will reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Avoid or use alternative medicines. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or substitute with alternative therapy. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.Buprenorphine, long-acting injections, and ivosidenib all shortened the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and lapatinib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections and lefamulin can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injection and lenvatinib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and leuprolide can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and levofloxacin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and lithium can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injection and lofexidine can prolong the QTc interval. Avoid or use alternative medicines.

lonafarnib will increase the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Avoid or use alternative medicines. Avoid coadministration with sensitive CYP3A substrates. If coadministration is unavoidable, monitor for adverse reactions and reduce the CYP3A substrate dose according to the product label.

Buprenorphine, long-acting injections, and loperamide all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and lopinavir can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injectables, and macimorelin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and mefloquine all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and methadone can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injection, metoclopramide intranasal. Either increase the effect of the other by the other (see comments). Avoid or use alternative medicines. Comment: Avoid intranasal or interacting medications with metoclopramide based on the importance of the medication to the patient.

Buprenorphine, long-acting injections, and midostaurin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and mifepristone can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and mirtazapine prolong the QTc interval on average. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and mobotinib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and moxifloxacin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and nilotinib all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and nortriptyline all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and octreotide can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and ofloxacin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injection and olanzapine can prolong the QTc interval on average. Avoid or use alternative medicines. Limited data, including some case reports, suggest that olanzapine may significantly prolong the QTc interval in rare cases

Buprenorphine, long-acting injection, oxydine. Other (see comments). Avoid or use alternative medicines. Comment: Concomitant use may reduce the analgesic effect of oxycidine and/or induce withdrawal symptoms.

Buprenorphine, long-acting injectables, and intranasal olopatadine all increase sedation. Avoid or use alternative medicines. Co-administration increases the risk of central nervous system depression, which may lead to parasitic impairment of psychomotor performance and lead to daytime impairment.

Buprenorphine, long-acting injections, and ondansetron all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and osilodrostat all increased the QTc interval. Avoid or use alternative medicines. Dose-dependent QT prolongation - avoid drugs known to prolong the QT interval

Buprenorphine, long-acting injections, and osimertinib all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and oxaliplatin all prolong the QTc interval. Avoid or use alternative medicines.

Both ozanimod and buprenorphine, long-acting injections, increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or use alternative medicines. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse effects, including hypertensive crisis. Therefore, concomitant use of ozanimod with drugs that increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.Buprenorphine, long-acting injections, and ozanimod can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and paliperidone can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and panobinostat all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and pasireotide all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and pazopanib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and pentamidine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and pimavanserin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and pimozide all prolong the QTc interval. Taboo.

Buprenorphine, long-acting injections, and pitolisant all increased the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and ponesimod all increased the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and primaquine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and procainamide can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and promethazine can shorten the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and propafenone can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and protriptyline can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and quetiapine prolong the QTc interval on average. Avoid or use alternative medicines.

Buprenorphine, long-acting injection and quinidine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and quinine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and ribociclib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and rilpivirine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and risperidone can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and romidepsin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and saquinavir can prolong the QTc interval. Avoid or use alternative medicines.

selinexor, buprenorphine, long-acting injection. Unspecified interaction mechanism. Avoid or use alternative medicines. Patients treated with selinexor may experience neurotoxicity. Avoid taking selinexor with other medicines that may cause dizziness or confusion.

Buprenorphine, long-acting injectables, and selpercatinib all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and sertraline all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and sevoflurane all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and cinnimod can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and solifenacin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and sorafenib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and sotalol can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, a long-acting injection reduces the effect of sufentanil SL through pharmacodynamic antagonism. Avoid or use alternative medicines. Co-administration of opioid mixed agonists/antagonists or partial agonists may reduce the analgesic effect of sufentail SL and/or contribute to withdrawal symptoms.

Buprenorphine, long-acting injection and sunitinib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and tacrolimus can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injectables, and telavancin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and tetrabenazine can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and toremifene can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and trazodone can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and triclabendazole all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and trimipramine all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and triptorelin can prolong the QTc interval. Avoid or use alternative medicines.

Tucatinib will increase the levels or effects of buprenorphine, long-acting injection, by affecting the hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or use alternative medicines. Avoid concomitant use of tucatinib and CYP3A substrates, where minimal concentration changes may result in serious or life-threatening toxicity. If unavoidable, reduce CYP3A substrate dose according to product label.

Buprenorphine, long-acting injections, and vandetanib can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and vardenafil can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and vemurafenib all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and venlafaxine can shorten the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and voclosporin all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and voriconazole all prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and vorinostat all prolong the QTc interval. Avoid or use alternative medicines.

voxelotor will increase the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Avoid or use alternative medicines. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. If unavoidable, consider dose reduction of sensitive CYP3A4 substrates.

Buprenorphine, long-acting injections, and ziprasidone can prolong the QTc interval. Avoid or use alternative medicines.

Buprenorphine, long-acting injections, and albuterol can prolong the QTc interval. Use warnings/monitoring.

Alfentanil increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injections, and alfuzosin all prolong the QTc interval. Use warnings/monitoring.

Alprazolam increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injection reduces the effect of amiloride through pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Amiodarone increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Amitriptyline, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Amobarbital reduces buprenorphine levels or effects by affecting metabolism by the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.Amobarbital increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Amoxapine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Amphetamines, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Amphetamine polistirex, buprenorphine, long-acting injections. Increased toxicity of the other via serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Apalutamide will decrease the level or effect of buprenorphine by increasing the elimination of long-acting injections. Use warnings/monitoring. Apalutamide induces UGT and may reduce systemic exposure of drugs that are substrates of UGT.

Aprepitant increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Buprenorphine, a long-acting injection, increases the effects of abaclofen by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

Buprenorphine, long-acting injections, and arformoterol can prolong the QTc interval. Use warnings/monitoring.

Aripiprazole increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Armodafinil can reduce the level or effect of buprenorphine by affecting the metabolism of liver/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Asenapine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Atazanavir increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Atracurium increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injection augments the effects of atropine through pharmacodynamic synergy. Use warnings/monitoring. Coadministration of buprenorphine with anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.

Buprenorphine, a long-acting injection, increases the effects of baclofen by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

belzutifan will reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. If coadministration of Belzutifene with a sensitive CYP3A4 substrate cannot be avoided, consider increasing the dose of the sensitive CYP3A4 substrate according to its prescribing information.

Buprenorphine, long-acting injection reduces the effect of bendroflumethiazide by pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Bicalutamide increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Bosentan may reduce the level or effect of the long-acting injectable buprenorphine by affecting metabolism by the hepatic/intestinal enzyme CYP3A4. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

brexanolone, buprenorphine, long-acting injection. Increases the toxicity of the other by sedating. Use warnings/monitoring.

Buprenorphine, long-acting injection reduces the effect of bumetanide through pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Buprenorphine increases the toxicity of buprenorphine, and long-acting injections act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Transdermal buprenorphine increases the toxicity of buprenorphine, and long-acting injections act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buspirone increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Butobarbital reduces the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.Bubarbital increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Butalbital reduces the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.Butalbital can increase the toxicity of buprenorphine, and long-acting injections have pharmacodynamic synergy. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Butorphanol increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Carbamazepine reduces the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Cariprazine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, a long-acting injection, increases the effects of carisoprodol by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

Cenobamate reduces the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. When coadministered with cenobamate, increase the dose of the CYP3A4 substrate as needed.cenobamate, buprenorphine, long-acting injection. Adds the effect of the other by sedating. Use warnings/monitoring.

Ceritinib increases the levels or effects of buprenorphine, long-acting injectables, by affecting metabolism by the hepatic/intestinal enzyme CYP3A4. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Chloral hydrate increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Chlordiazepoxide increases the toxicity of buprenorphine, and long-acting injections have pharmacodynamic synergies. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injection reduces the effect of chlorothiazide by pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Chlorpromazine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injection reduces the effect of chlorthalidone by pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Buprenorphine, a long-acting injection, increases the effects of chlorzoxazone by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

Cisatracurium increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Citalopram, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Clarithromycin increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

clobazam reduces the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Clomipramine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Clonazepam increases the toxicity of buprenorphine, and long-acting injections have a synergistic effect. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Clorazepate increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Clozapine increases the toxicity of buprenorphine, and long-acting injections have a synergistic effect. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Cobicistat increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Codeine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Conivaptan increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Crizotinib increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Cyclobenzaprine, buprenorphine, long-acting injections. Either increases the toxicity of the other through serum potassium. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.Buprenorphine, a long-acting injection, increases the effects of cyclobenzaprine by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

Cyclosporine increases the level or effect of buprenorphine, long-acting injectables metabolized by affecting the liver/intestinal enzyme CYP3A4. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Dabrafenib can reduce the level or effect of buprenorphine by affecting the metabolism of liver/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Buprenorphine, a long-acting injection, increases the effects of dantrolene by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

Buprenorphine, long-acting injectables, and daridorexant all enhance sedation. Modify treatment/closely monitor. Co-administration increases the risk of central nervous system depression, which may lead to parasitic impairment of psychomotor performance and lead to daytime impairment.

Darunavir increases the level or effect of buprenorphine by affecting the metabolism of the liver/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Desflurane increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Desipramine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Desvenlafaxine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Dexamethasone reduces the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Dexmedetomidine increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

dexmethylphenidate, buprenorphine, long-acting injection. Each increases the toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Dextroamphetamine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Diazepam increases the toxicity of buprenorphine, and long-acting injections have pharmacodynamic synergy. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.Buprenorphine, a long-acting injection, increases the effects of diazepam by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

Buprenorphine, long-acting injection augments the effects of dicyclomine through pharmacodynamic synergy. Use warnings/monitoring. Coadministration of buprenorphine with anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.

Diethylacetone, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Diltiazem increases buprenorphine levels or effects by affecting metabolism by the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Doxepin, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Doxycycline increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Doxylamine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Dronedarone increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Duloxetine, buprenorphine, long-acting injection. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Efavirenz may reduce the levels or effects of long-acting buprenorphine injection by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Elagolix reduces the levels or effects of the long-acting injectable buprenorphine by affecting metabolism by the hepatic/intestinal enzyme CYP3A4. Modify treatment/closely monitor. Elagolix is ​​a weak to moderate inducer of CYP3A4. Monitor for CYP3A substrates if co-administered. Consider increasing the CYP3A substrate dose if needed.

elvitegravir/cobicistat/emtricitabine/tenofovir DF increases the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Enzalutamide reduces the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Erythromycin base will increase the level or effect of buprenorphine, long-acting injection by affecting the liver/intestinal enzyme CYP3A4 metabolism. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Erythromycin ethyl succinate increases the level or effect of buprenorphine, long-acting injection by affecting the liver/intestinal enzyme CYP3A4 metabolism. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Erythromycin lactobionate increases the levels or effects of buprenorphine, a long-acting injection, by affecting the liver/intestinal enzyme CYP3A4 metabolism. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Erythromycin stearate increases the levels or effects of buprenorphine, a long-acting injection, by affecting the liver/intestinal enzyme CYP3A4 metabolism. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Escitalopram, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Eslicarbazepine acetate may reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Estazolam increased the toxicity of buprenorphine, and long-acting injections acted synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Eszopiclone increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injection reduces the effects of ethacrynic acid by pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Ethanol increases the toxicity of buprenorphine, and long-acting injections act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Etomidate increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Etravirine can reduce the level or effect of buprenorphine by affecting the metabolism of liver/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Fentanyl increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Fentanyl nasal drops can increase the toxicity of buprenorphine, and long-acting injections have a pharmacodynamic synergistic effect. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Transdermal fentanyl increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Fentanyl transmucosal increases the toxicity of buprenorphine, and long-acting injections act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Fluconazole increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Fluoxetine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Fluphenazine increases the toxicity of buprenorphine, and long-acting injections act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.Buprenorphine, long-acting injections, and fluphenazine can prolong the QTc interval. Use warnings/monitoring.

Fluazepam increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Fluvoxamine and buprenorphine, long-acting injections, both increase serotonin levels. Use warnings/monitoring. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected

Fosamprenavir will increase the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Fosaprepitant increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Fosphenytoin may reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Buprenorphine, long-acting injection reduces the effect of furosemide through pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Gabapentin, buprenorphine, long-acting injections. Increase the effect of each other through pharmacodynamic synergy. Modify treatment/closely monitor. Coadministration of central nervous system depressants can result in severe, life-threatening and fatal respiratory depression. Use the lowest possible dose and monitor for respiratory depression and sedation.

gabapentin enacarbil, buprenorphine, long-acting injection. Both enhance the effect of the other through pharmacodynamic synergy. Modify treatment/closely monitor. Coadministration of central nervous system depressants can result in severe, life-threatening and fatal respiratory depression. Use the lowest possible dose and monitor for respiratory depression and sedation.

Buprenorphine, long-acting injectables, and ganaxolone all enhance sedation. Use warnings/monitoring.

Buprenorphine, long-acting injection augments the effects of glycopyrronium bromide through pharmacodynamic synergy. Use warnings/monitoring. Coadministration of buprenorphine with anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.

Grapefruit increases the levels or effects of buprenorphine, a long-acting injection, by affecting the liver/intestinal enzyme CYP3A4 metabolism. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Haloperidol increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.Haloperidol increases the toxicity of buprenorphine, and long-acting injections have a synergistic effect. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injection reduces the effect of hydrochlorothiazide by pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Hydromorphone increases the toxicity of buprenorphine, and long-acting injections have a synergistic effect. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injections, and hydroxyzine can prolong the QTc interval. Modify treatment/closely monitor. If co-administration is required, consider dose reduction of one or both drugs due to possible additive pharmacological effects

Buprenorphine, long-acting injection augments the effects of paeoniflorin through pharmacodynamic synergy. Use warnings/monitoring. Coadministration of buprenorphine with anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.

Buprenorphine, long-acting injection augments the effect of paeoniflorin spray through pharmacodynamic synergy. Use warnings/monitoring. Coadministration of buprenorphine with anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.

idelalisib will increase the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Iloperidone increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.Iloperidone increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Imatinib increases the levels or effects of buprenorphine, long-acting injectables, by affecting metabolism by the hepatic/intestinal enzyme CYP3A4. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Imipramine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Buprenorphine, long-acting injection reduces the effect of indapamide through pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Indinavir increases the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Isocarboxazid, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Modify treatment/closely monitor. Concomitant use may result in life-threatening serotonin syndrome or opioid intoxication (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

Isoflurane increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Isoniazid increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Itradefylline increases the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Use warnings/monitoring. In clinical trials, istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction for sensitive CYP3A4 substrates.

Itraconazole increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Ketamine increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Ketoconazole increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Lapatinib may increase the levels or effects of buprenorphine, long-acting injectables, by affecting metabolism by the hepatic/intestinal enzyme CYP3A4. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

lasmiditan, buprenorphine, long-acting injection. Enhance the effect of the other party through the sedative effect. Use warnings/monitoring. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol, has not been evaluated in clinical studies. Lasmiditan may cause sedation, and other cognitive and/or neuropsychiatric adverse effects.

lemborexant, buprenorphine, long-acting injection. Enhance the effect of the other party through the sedative effect. Modify treatment/closely monitor. If lemborexant is co-administered with other CNS depressants, dose adjustment may be required due to possible additive effects.

Lenacapavir will increase the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. When initiating buprenorphine while taking lenacavir, use the lowest feasible initial or maintenance dose of buprenorphine and carefully titrate the dose to the desired effect. When starting lenacavir while taking buprenorphine, consider adjusting your buprenorphine dose. Monitor for clinical signs and symptoms.

Levoconazole increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Levomilnacipran, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Levorphanol increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Linezolid, buprenorphine, long-acting injection. Increased toxicity of the other through serotonin levels. Modify treatment/closely monitor. Concomitant use may result in life-threatening serotonin syndrome or opioid intoxication (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

lisdexamfetamine, buprenorphine, long-acting injection. Increased toxicity of the other via serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Lopinavir increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Lorazepam increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Loxapine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Loxapine inhalation increases the toxicity of buprenorphine, and long-acting injections have pharmacodynamic synergy. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Lumacaftor/ivacaftor will reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Lurasidone increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Maprotiline, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.Buprenorphine, long-acting injections, and maprotiline all prolong the QTc interval. Use warnings/monitoring.

Meperidine increases the toxicity of buprenorphine, and long-acting injections have a synergistic effect. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Meprobamate increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, a long-acting injection, increases the effects of metaxalone by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

Methadone increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Methamphetamine, buprenorphine, long-acting injectables. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Buprenorphine, a long-acting injection, increases the effects of methocarbamol by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

Mesobital increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injection augments the effects of methscopolamine through pharmacodynamic synergy. Use warnings/monitoring. Coadministration of buprenorphine with anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.

Buprenorphine, long-acting injection reduces the effect of methazine through pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Methylene blue, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Modify treatment/closely monitor. Concomitant use may result in life-threatening serotonin syndrome or opioid intoxication (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

Buprenorphine, long-acting injection reduces the effect of metolazone through pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Metronidazole increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Midazolam increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Midazolam intranasal, buprenorphine, long-acting injection. Increase the effect of each other through pharmacodynamic synergy. Modify treatment/closely monitor. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may result in profound and/or prolonged drug effects.

Milnacipran, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Mirtazapine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Mitotane can reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Morpholinone increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Morphine increases the toxicity of buprenorphine, and long-acting injections are subject to pharmacodynamic synergy. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Nafcillin can reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Nalbuphine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Nefazodone increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.Nefazodone, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Nelfinavir can increase the level or effect of buprenorphine, long-acting injection by affecting the liver enzyme CYP2E1 metabolism. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

netupitant/palonosetron will increase the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Nevirapine can reduce the level or effect of buprenorphine by affecting the metabolism of liver/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Nicardipine increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Nortriptyline, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Olanzapine increases the toxicity of buprenorphine, and long-acting injections have pharmacodynamic synergy. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, a long-acting injection, increases the effects of orphenadrine by other means (see review). Modify treatment/closely monitor. Comment: Buprenorphine may enhance the neuromuscular blockade of skeletal muscle relaxants and increase the risk of respiratory depression. Monitor for signs of respiratory depression that may be greater than otherwise expected and reduce muscle relaxant dose if necessary.

Oxazepam increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Oxcarbazepine reduces the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Oxycodone increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Oxymorphone increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Paliperidone increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Pancuronium increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Paroxetine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.Buprenorphine, long-acting injections, and paroxetine can prolong the QTc interval. Use warnings/monitoring.

Pentazocine increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Pentobarbital reduces buprenorphine levels or effects by affecting metabolism by the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.Pentobarbital increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Perphenazine increases the toxicity of buprenorphine, and long-acting injections act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.Buprenorphine, long-acting injections, and perphenazine can prolong the QTc interval. Use warnings/monitoring.

Benzodimethazine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Phenelzine, buprenorphine, long-acting injection. Increased toxicity of the other through serotonin levels. Modify treatment/closely monitor. Concomitant use may result in life-threatening serotonin syndrome or opioid intoxication (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

Phenobarbital may decrease the level or effect of buprenorphine by affecting metabolism by the liver/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Phenytoin reduces the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Pimavanserin increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Pimozide increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Posaconazole increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Pregabalin, buprenorphine, long-acting injections. Enhance the effect of each other through pharmacodynamic synergy. Modify treatment/closely monitor. Coadministration of central nervous system depressants can result in severe, life-threatening and fatal respiratory depression. Use the lowest possible dose and monitor for respiratory depression and sedation.

Primidone reduces the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Prochlorperazine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.Buprenorphine, long-acting injections, and prochlorperazine can shorten the QTc interval. Use warnings/monitoring.

Buprenorphine, long-acting injection augments the effects of propantheline through pharmacodynamic synergy. Use warnings/monitoring. Coadministration of buprenorphine with anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.

Propofol increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Protriptyline, buprenorphine, long-acting injection. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Quazepam increases the toxicity of buprenorphine, and long-acting injections have pharmacodynamic synergies. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Quetiapine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Quinupristin/dalfopristin increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Ramelteon increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injections, and ranolazine can prolong the QTc interval. Use warnings/monitoring.

Rasagiline, buprenorphine, long-acting injection. Increased toxicity of the other through serotonin levels. Modify treatment/closely monitor. Concomitant use may result in life-threatening serotonin syndrome or opioid intoxication (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

Remifentanil increased the toxicity of buprenorphine, and long-acting injections acted synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

ribociclib will increase the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Rifabutin may reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Rifampicin may reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Rifapentine may reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Risperidone increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Ritonavir increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Rocuronium increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Rucaparib will increase the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Adjust dose of CYP3A4 substrates if clinically indicated.

safinamide, buprenorphine, long-acting injection. Increased toxicity of the other through serotonin levels. Modify treatment/closely monitor. Concomitant use may result in life-threatening serotonin syndrome or opioid intoxication (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

Saquinavir increases the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Schisandra will increase the level or effect of buprenorphine by affecting the metabolism of liver/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Secobarbital reduces the level or effect of buprenorphine by affecting the metabolism of the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.Secobarbital increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Selegiline, buprenorphine, long-acting injection. Increased toxicity of the other through serotonin levels. Modify treatment/closely monitor. Concomitant use may result in life-threatening serotonin syndrome or opioid intoxication (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

Selegiline transdermal, buprenorphine, long-acting injection. Increased toxicity of the other through serotonin levels. Modify treatment/closely monitor. Concomitant use may result in life-threatening serotonin syndrome or opioid intoxication (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

serdexmethylphenidate/dexmethylphenidate, buprenorphine, long-acting injection. Increased toxicity of the other via serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Sertraline increases the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.Sertraline, buprenorphine, long-acting injection. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Sevoflurane increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Buprenorphine, long-acting injection reduces the effect of spironolactone through pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

St. John's wort reduces buprenorphine levels or effects by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Stiripentol, buprenorphine, long-acting injection. Affects hepatic/intestinal enzyme CYP3A4 metabolism. Modify treatment/closely monitor. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor the effects of increased or decreased CYP3A4 substrates co-administered with stiripentol. CYP3A4 substrates may require dose adjustment.

Succinylcholine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Sufentanil increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Sufentanil SL increased the toxicity of buprenorphine, and long-acting injections acted synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Suvorexant increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Tapentadol increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Tasimelteon increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

tazemetostat will reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Use warnings/monitoring.

tecovirimat will reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Use warnings/monitoring. Tecovirimat is a weak CYP3A4 inducer. If co-administered, monitor the effectiveness of sensitive CYP3A4 substrates.

telotristat ethyl will reduce the level or effect of buprenorphine by affecting the liver/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine coadministered with CYP3A4 inducers to buprenorphine long-acting injectables should be monitored to ensure adequate buprenorphine plasma levels. If the buprenorphine dose is insufficient and the CYP3A4 inducer cannot be reduced or discontinued, return the patient to a buprenorphine formulation that allows dose adjustment.

Temazepam increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Tetracyclines increase buprenorphine levels or effects by affecting metabolism by the hepatic/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Thioridazine increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Thiothixene increases the toxicity of buprenorphine, and long-acting injections act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Tipranavir increases the level or effect of buprenorphine by affecting the metabolism of the liver/intestinal enzyme CYP3A4, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Buprenorphine, long-acting injection reduces the effect of torasemide by pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Tramadol increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Tranylcypromine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Modify treatment/closely monitor. Concomitant use may result in life-threatening serotonin syndrome or opioid intoxication (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

Trazodone, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Buprenorphine, long-acting injection reduces the effects of triamterene through pharmacodynamic antagonism. Modify treatment/closely monitor. Opioids can reduce the diuretic effect by inducing the release of vasopressin.

Triazolam increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Trifluoperazine increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.Buprenorphine, long-acting injectables, and trifluoperazine all shorten the QTc interval. Use warnings/monitoring.

Trimipramine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Vecuronium increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Venlafaxine, buprenorphine, long-acting injections. Increased toxicity of the other through serotonin levels. Use warnings/monitoring. Concomitant use may result in life-threatening serotonin syndrome. If concomitant use is required, observe the patient carefully, especially during initiation of therapy and during dose adjustments of serotonergic agents. Discontinue buprenorphine if serotonin syndrome is suspected.

Verapamil increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Voriconazole increases the level or effect of buprenorphine by affecting the hepatic/intestinal enzyme CYP3A4 metabolism, long-acting injection. Modify treatment/closely monitor. Patients switching from transmucosal buprenorphine co-administered with a CYP3A4 inhibitor to buprenorphine long-acting injectables should be monitored to ensure adequate plasma levels of buprenorphine. Within 2 weeks, if signs and symptoms of buprenorphine toxicity or overdose develop and the concomitant CYP3A4 inhibitor cannot be reduced or discontinued, switch the patient back to a buprenorphine formulation that allows dose adjustment.

Zaleplon increases the toxicity of buprenorphine, long-acting injectables via pharmacodynamic synergy. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Ziprasidone increases the toxicity of buprenorphine, and long-acting injections act synergistically. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.

Zolpidem increases the toxicity of buprenorphine, and long-acting injectables act synergistically through pharmacodynamics. Modify treatment/closely monitor. Coadministration of buprenorphine with benzodiazepines or other CNS depressants increases the risk of adverse effects, including overdose, respiratory depression, and death. In most cases, it is best to discontinue the benzodiazepine or other CNS depressant. In some cases, it may be appropriate to monitor a tapered dose of CNS depressants in higher levels of care. In other cases, it may be appropriate to taper the patient's prescribed benzodiazepines or other CNS depressants or reduce them to the lowest effective dose.