Drug interactions
Atazanavir + Buprenorphine
Severity: Moderate
Atazanavir and Buprenorphine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Atazanavir inhibits CYP3A4 and raises buprenorphine and norbuprenorphine concentrations. This can cause excess opioid effects such as sedation, cognitive impairment and respiratory depression.
What this interaction means in plain words
Atazanavir and Buprenorphine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Atazanavir belongs to Anti Virals; Buprenorphine belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4-mediated buprenorphine N-dealkylation by atazanavir.
What to do
Monitor for sedation and opioid toxicity, and reduce the buprenorphine dose if symptoms occur. Atazanavir boosted with ritonavir warrants particular attention.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + Thioridazine Contraindicated
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Buprenorphine?
MediHelp rates the interaction as moderate. Atazanavir and Buprenorphine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Atazanavir inhibits CYP3A4 and raises buprenorphine and norbuprenorphine concentrations. This can cause excess opioid effects such as sedation, cognitive impairment and respiratory depression.
How serious is the interaction between Atazanavir and Buprenorphine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation and opioid toxicity, and reduce the buprenorphine dose if symptoms occur. Atazanavir boosted with ritonavir warrants particular attention.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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