Drug interactions
Buprenorphine + Diazepam
Severity: Major
Buprenorphine and Diazepam: 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
Co-administration of buprenorphine and diazepam can cause profound sedation, respiratory depression, coma and death. This is a well-recognised and labeled hazard, and fatalities have been reported with injected or misused combinations.
What this interaction means in plain words
Buprenorphine and Diazepam 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; Diazepam belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression via opioid receptors and GABA-A receptor potentiation.
What to do
Avoid concurrent use where alternatives exist; if unavoidable, use minimum doses and duration with close monitoring of sedation and breathing. Counsel on avoiding alcohol 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
Other interactions of Diazepam
Frequently asked questions
Can I take Buprenorphine with Diazepam?
MediHelp rates the interaction as major. Buprenorphine and Diazepam 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. Co-administration of buprenorphine and diazepam can cause profound sedation, respiratory depression, coma and death. This is a well-recognised and labeled hazard, and fatalities have been reported with injected or misused combinations.
How serious is the interaction between Buprenorphine and Diazepam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where alternatives exist; if unavoidable, use minimum doses and duration with close monitoring of sedation and breathing. Counsel on avoiding alcohol 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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