Drug interactions
Buprenorphine + Fluoxetine
Severity: Moderate
Buprenorphine and Fluoxetine: 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
Fluoxetine has a modest QT-prolonging potential and buprenorphine may add to it. Both have serotonergic activity, and fluoxetine also inhibits CYP2D6, which is not a major buprenorphine pathway.
What this interaction means in plain words
Buprenorphine and Fluoxetine 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; Fluoxetine belongs to Central Nervous System.
Why it happens
Additive QT prolongation and additive serotonergic effects.
What to do
Monitor for serotonin toxicity such as clonus, agitation and hyperthermia. Check an ECG in patients with cardiac risk factors.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Buprenorphine with Fluoxetine?
MediHelp rates the interaction as moderate. Buprenorphine and Fluoxetine 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. Fluoxetine has a modest QT-prolonging potential and buprenorphine may add to it. Both have serotonergic activity, and fluoxetine also inhibits CYP2D6, which is not a major buprenorphine pathway.
How serious is the interaction between Buprenorphine and Fluoxetine?
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 for serotonin toxicity such as clonus, agitation and hyperthermia. Check an ECG in patients with cardiac risk factors.
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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