Drug interactions
Buprenorphine + Carbamazepine
Severity: Moderate
Buprenorphine and Carbamazepine: 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
Carbamazepine induces CYP3A4 and can substantially lower buprenorphine concentrations, risking withdrawal or inadequate pain control. Additive sedation may also occur.
What this interaction means in plain words
Buprenorphine and Carbamazepine 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.
Buprenorphine belongs to Musculoskeletal; Carbamazepine belongs to Central Nervous System.
Why it happens
CYP3A4 induction by carbamazepine increases buprenorphine clearance.
What to do
Monitor for withdrawal symptoms and reduced analgesia and increase the buprenorphine dose if needed. Reassess the dose if carbamazepine is stopped, as levels will rise.
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 Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Buprenorphine with Carbamazepine?
MediHelp rates the interaction as moderate. Buprenorphine and Carbamazepine 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. Carbamazepine induces CYP3A4 and can substantially lower buprenorphine concentrations, risking withdrawal or inadequate pain control. Additive sedation may also occur.
How serious is the interaction between Buprenorphine and Carbamazepine?
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 withdrawal symptoms and reduced analgesia and increase the buprenorphine dose if needed. Reassess the dose if carbamazepine is stopped, as levels will rise.
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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