Drug interactions
Buprenorphine + Clozapine
Severity: Major
Buprenorphine and Clozapine: 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
Clozapine can prolong the QT interval and buprenorphine may add to this effect. Both also cause sedation, and opioids combined with clozapine may add to respiratory and circulatory depression.
What this interaction means in plain words
Buprenorphine and Clozapine 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; Clozapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation and additive CNS depression.
What to do
Check a baseline ECG and electrolytes and monitor for sedation, hypotension and respiratory depression. Use the lowest effective doses and titrate slowly.
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
Other interactions of Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Frequently asked questions
Can I take Buprenorphine with Clozapine?
MediHelp rates the interaction as major. Buprenorphine and Clozapine 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. Clozapine can prolong the QT interval and buprenorphine may add to this effect. Both also cause sedation, and opioids combined with clozapine may add to respiratory and circulatory depression.
How serious is the interaction between Buprenorphine and Clozapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check a baseline ECG and electrolytes and monitor for sedation, hypotension and respiratory depression. Use the lowest effective doses and titrate slowly.
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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