Drug interactions
Buprenorphine + Efavirenz
Severity: Moderate
Buprenorphine and Efavirenz: 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
Efavirenz can prolong the QT interval, notably at higher exposures, and buprenorphine may add to this effect. Efavirenz also induces CYP3A4 and can lower buprenorphine concentrations, though withdrawal is usually not clinically significant.
What this interaction means in plain words
Buprenorphine and Efavirenz 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; Efavirenz belongs to Anti Virals.
Why it happens
Additive QT prolongation, plus efavirenz induction of CYP3A4 that increases buprenorphine metabolism.
What to do
Monitor the ECG when risk factors are present and watch for opioid withdrawal or inadequate analgesia. Adjust the buprenorphine dose according to response.
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 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 Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Buprenorphine with Efavirenz?
MediHelp rates the interaction as moderate. Buprenorphine and Efavirenz 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. Efavirenz can prolong the QT interval, notably at higher exposures, and buprenorphine may add to this effect. Efavirenz also induces CYP3A4 and can lower buprenorphine concentrations, though withdrawal is usually not clinically significant.
How serious is the interaction between Buprenorphine and Efavirenz?
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 the ECG when risk factors are present and watch for opioid withdrawal or inadequate analgesia. Adjust the buprenorphine dose according to response.
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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