Drug interactions
Buprenorphine + Hydrocodone
Severity: Major
Buprenorphine and Hydrocodone: 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
Buprenorphine is a high-affinity partial mu agonist that can displace hydrocodone, reducing analgesia and precipitating withdrawal in opioid-dependent patients. Both also add to sedation and respiratory depression.
What this interaction means in plain words
Buprenorphine and Hydrocodone 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; Hydrocodone belongs to Musculoskeletal.
Why it happens
Partial agonist competition at mu receptors with additive CNS and respiratory depression.
What to do
Avoid routine combination; plan opioid transitions with specialist input. If both are needed, monitor for withdrawal, poor analgesia, sedation and respiratory depression.
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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
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 Hydrocodone?
MediHelp rates the interaction as major. Buprenorphine and Hydrocodone 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 is a high-affinity partial mu agonist that can displace hydrocodone, reducing analgesia and precipitating withdrawal in opioid-dependent patients. Both also add to sedation and respiratory depression.
How serious is the interaction between Buprenorphine and Hydrocodone?
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 routine combination; plan opioid transitions with specialist input. If both are needed, monitor for withdrawal, poor analgesia, sedation and respiratory depression.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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