Drug interactions
Brexanolone + Buprenorphine
Severity: Major
Brexanolone and Buprenorphine: major interaction.
Last updated Sources: US FDA label
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
Both drugs depress the central nervous system, and combined use can cause excessive sedation, loss of consciousness and respiratory depression. Brexanolone infusion already carries a risk of sedation, which is compounded by an opioid.
What this interaction means in plain words
Brexanolone 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
Additive CNS depression through opioid receptor agonism and GABA-A positive allosteric modulation.
What to do
Monitor sedation level and pulse oximetry continuously during the brexanolone infusion, and interrupt or reduce the infusion if excessive sedation develops. Consider whether the opioid dose can be reduced.
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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References
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 Brexanolone with Buprenorphine?
MediHelp rates the interaction as major. Brexanolone 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. Both drugs depress the central nervous system, and combined use can cause excessive sedation, loss of consciousness and respiratory depression. Brexanolone infusion already carries a risk of sedation, which is compounded by an opioid.
How serious is the interaction between Brexanolone 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: Monitor sedation level and pulse oximetry continuously during the brexanolone infusion, and interrupt or reduce the infusion if excessive sedation develops. Consider whether the opioid dose can be reduced.
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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