Drug interactions
Buprenorphine + Cimetidine
Severity: Moderate
Buprenorphine and Cimetidine: 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
Cimetidine may raise buprenorphine exposure through CYP3A4 inhibition, potentially increasing sedation and respiratory depression. The effect is expected to be modest.
What this interaction means in plain words
Buprenorphine and Cimetidine 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; Cimetidine belongs to Gastrointestinal Tract.
Why it happens
Cimetidine inhibits CYP3A4-mediated N-dealkylation of buprenorphine.
What to do
Monitor for sedation and respiratory depression, especially at initiation, and reduce the buprenorphine dose if needed; consider famotidine as an alternative.
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 Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
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 Buprenorphine with Cimetidine?
MediHelp rates the interaction as moderate. Buprenorphine and Cimetidine 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. Cimetidine may raise buprenorphine exposure through CYP3A4 inhibition, potentially increasing sedation and respiratory depression. The effect is expected to be modest.
How serious is the interaction between Buprenorphine and Cimetidine?
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 respiratory depression, especially at initiation, and reduce the buprenorphine dose if needed; consider famotidine as an alternative.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.
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