Drug interactions
Buprenorphine + Diazepam intranasal
Severity: Major
Buprenorphine and Diazepam intranasal: 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
Opioids combined with benzodiazepines can cause profound sedation, respiratory depression, coma and death, as stated in regulatory boxed warnings. This applies to intranasal diazepam as it does to other forms.
What this interaction means in plain words
Buprenorphine and Diazepam intranasal 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.
Why it happens
Additive CNS and respiratory depression through GABA-A potentiation and mu-opioid agonism.
What to do
Reserve co-use for patients without alternatives, using the lowest doses and shortest durations. Monitor for sedation and respiratory depression and consider naloxone availability.
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
Frequently asked questions
Can I take Buprenorphine with Diazepam intranasal?
MediHelp rates the interaction as major. Buprenorphine and Diazepam intranasal 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. Opioids combined with benzodiazepines can cause profound sedation, respiratory depression, coma and death, as stated in regulatory boxed warnings. This applies to intranasal diazepam as it does to other forms.
How serious is the interaction between Buprenorphine and Diazepam intranasal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve co-use for patients without alternatives, using the lowest doses and shortest durations. Monitor for sedation and respiratory depression and consider naloxone availability.
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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