Drug interactions
Buprenorphine + Cenobamate
Severity: Moderate
Buprenorphine and Cenobamate: 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
Cenobamate induces CYP3A4, which may lower buprenorphine concentrations and reduce analgesic or opioid-substitution efficacy. Both drugs also cause sedation and dizziness, so central depressant effects are additive.
What this interaction means in plain words
Buprenorphine and Cenobamate 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; Cenobamate belongs to Central Nervous System.
Why it happens
CYP3A4 induction by cenobamate increases buprenorphine metabolism, combined with additive CNS depression.
What to do
Monitor for withdrawal symptoms or loss of analgesia and increase the buprenorphine dose if needed. Also monitor for sedation and reassess doses if cenobamate is stopped.
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 Cenobamate
Frequently asked questions
Can I take Buprenorphine with Cenobamate?
MediHelp rates the interaction as moderate. Buprenorphine and Cenobamate 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. Cenobamate induces CYP3A4, which may lower buprenorphine concentrations and reduce analgesic or opioid-substitution efficacy. Both drugs also cause sedation and dizziness, so central depressant effects are additive.
How serious is the interaction between Buprenorphine and Cenobamate?
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 or loss of analgesia and increase the buprenorphine dose if needed. Also monitor for sedation and reassess doses if cenobamate is stopped.
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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