Drug interactions

Buprenorphine + Ethanol

Severity: Major

Buprenorphine and Ethanol: major interaction.

Last updated 29 Oct 2026 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

Alcohol increases buprenorphine's sedative and respiratory depressant effects, and overdose deaths are reported with opioid and alcohol combinations. Psychomotor impairment is also greater.

Buprenorphine

What this interaction means in plain words

Buprenorphine and Ethanol 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.

Evidence level: High

Why it happens

Additive CNS and respiratory depression.

What to do

Advise patients to avoid alcohol while taking buprenorphine. Screen for alcohol use and monitor closely if intake continues.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Buprenorphine - FDA drug label (DailyMed) - section 7 Drug Interactions (names the partner; "the concomitant use of benzodiazepines or other CNS depressants, including alcohol, increases the risk of respiratory depression, profound sedation, coma, and d") — DailyMed (FDA label)

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 Ethanol?

MediHelp rates the interaction as major. Buprenorphine and Ethanol 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. Alcohol increases buprenorphine's sedative and respiratory depressant effects, and overdose deaths are reported with opioid and alcohol combinations. Psychomotor impairment is also greater.

How serious is the interaction between Buprenorphine and Ethanol?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid alcohol while taking buprenorphine. Screen for alcohol use and monitor closely if intake continues.

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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