Drug interactions
Buprenorphine + Lefamulin
Severity: Major
Buprenorphine and Lefamulin: 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
Lefamulin is a CYP3A inhibitor that can raise buprenorphine exposure, and both drugs have QT-prolonging potential. This may increase sedation, respiratory depression and arrhythmia risk. Oral lefamulin tablets carry a stronger concern than the injection.
What this interaction means in plain words
Buprenorphine and Lefamulin 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; Lefamulin belongs to Anti Bacterial.
Why it happens
Lefamulin inhibits CYP3A4 metabolism of buprenorphine, with additive QT prolongation.
What to do
Monitor ECG and for sedation or respiratory depression, and correct electrolyte abnormalities. Consider an alternative antibiotic when other QT risks are present.
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 Lefamulin
- Lefamulin + Methadone Contraindicated
- Lefamulin + Pimavanserin Contraindicated
- Lefamulin + Pimozide Contraindicated
- Lefamulin + Quinidine Contraindicated
- Alfuzosin + Lefamulin Major
- Amiodarone + Lefamulin Major
Frequently asked questions
Can I take Buprenorphine with Lefamulin?
MediHelp rates the interaction as major. Buprenorphine and Lefamulin 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. Lefamulin is a CYP3A inhibitor that can raise buprenorphine exposure, and both drugs have QT-prolonging potential. This may increase sedation, respiratory depression and arrhythmia risk. Oral lefamulin tablets carry a stronger concern than the injection.
How serious is the interaction between Buprenorphine and Lefamulin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG and for sedation or respiratory depression, and correct electrolyte abnormalities. Consider an alternative antibiotic when other QT risks are present.
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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