Drug interactions
Belladonna and opium + Buprenorphine
Severity: Major
Belladonna and opium and Buprenorphine: major 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
Opium in this preparation is a full mu agonist, so buprenorphine may blunt its effect or precipitate withdrawal in opioid-dependent patients. Additive sedation and respiratory depression are also possible, and belladonna adds anticholinergic effects.
What this interaction means in plain words
Belladonna and opium and Buprenorphine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Competition at mu-opioid receptors between a partial and a full agonist, with additive CNS depression.
What to do
Avoid combining them; choose a non-opioid antispasmodic when feasible. If both are used, monitor for withdrawal, inadequate effect and sedation.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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
Frequently asked questions
Can I take Belladonna and opium with Buprenorphine?
MediHelp rates the interaction as major. Belladonna and opium and Buprenorphine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Opium in this preparation is a full mu agonist, so buprenorphine may blunt its effect or precipitate withdrawal in opioid-dependent patients. Additive sedation and respiratory depression are also possible, and belladonna adds anticholinergic effects.
How serious is the interaction between Belladonna and opium and Buprenorphine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining them; choose a non-opioid antispasmodic when feasible. If both are used, monitor for withdrawal, inadequate effect and sedation.
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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