Drug interactions
Buprenorphine + Ibutilide
Severity: Major
Buprenorphine and Ibutilide: major 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
Ibutilide is a potent class III antiarrhythmic with a substantial risk of torsades de pointes. Adding buprenorphine, which can prolong QT, may further increase that risk.
What this interaction means in plain words
Buprenorphine and Ibutilide 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; Ibutilide belongs to Cardiovascular.
Why it happens
Additive QTc prolongation via effects on cardiac repolarization.
What to do
Avoid if possible, particularly with transdermal or high-dose buprenorphine. If ibutilide is given, use continuous ECG monitoring and ensure potassium and magnesium are normal.
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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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 Ibutilide
- Amiodarone + Ibutilide Contraindicated
- Amisulpride + Ibutilide Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Clarithromycin + Ibutilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Dolasetron + Ibutilide Contraindicated
Frequently asked questions
Can I take Buprenorphine with Ibutilide?
MediHelp rates the interaction as major. Buprenorphine and Ibutilide 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. Ibutilide is a potent class III antiarrhythmic with a substantial risk of torsades de pointes. Adding buprenorphine, which can prolong QT, may further increase that risk.
How serious is the interaction between Buprenorphine and Ibutilide?
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 if possible, particularly with transdermal or high-dose buprenorphine. If ibutilide is given, use continuous ECG monitoring and ensure potassium and magnesium are normal.
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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