Drug interactions
Buprenorphine + Citalopram
Severity: Major
Buprenorphine and Citalopram: 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
Citalopram causes dose-dependent QT prolongation and buprenorphine may add to this. Both drugs also have serotonergic activity, so serotonin syndrome is a rare additional risk.
What this interaction means in plain words
Buprenorphine and Citalopram 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.
Buprenorphine belongs to Musculoskeletal; Citalopram belongs to Central Nervous System.
Why it happens
Additive QT prolongation, plus possible additive serotonergic effects.
What to do
Keep citalopram at or below labeled maximum doses and check the ECG and electrolytes in at-risk patients. Monitor for agitation, tremor and hyperthermia suggestive of serotonin toxicity.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Buprenorphine and Citalopram, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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
Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Buprenorphine with Citalopram?
MediHelp rates the interaction as major. Buprenorphine and Citalopram 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. Citalopram causes dose-dependent QT prolongation and buprenorphine may add to this. Both drugs also have serotonergic activity, so serotonin syndrome is a rare additional risk.
How serious is the interaction between Buprenorphine and Citalopram?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep citalopram at or below labeled maximum doses and check the ECG and electrolytes in at-risk patients. Monitor for agitation, tremor and hyperthermia suggestive of serotonin toxicity.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
