Drug interactions
Buprenorphine + Linezolid
Severity: Major
Buprenorphine and Linezolid: 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
Linezolid is a reversible non-selective MAO inhibitor, and combining it with an opioid such as buprenorphine may cause serotonin toxicity or CNS depression. Reports of agitation, hyperthermia, hypotension and sedation exist for opioids with MAO inhibitors.
What this interaction means in plain words
Buprenorphine and Linezolid 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; Linezolid belongs to Anti Bacterial.
Why it happens
MAO inhibition by linezolid may potentiate serotonergic and CNS effects of opioids; the exact mechanism with buprenorphine is not well established.
What to do
Avoid the combination where possible and use an alternative antibiotic. If linezolid is essential, monitor closely for serotonin syndrome, sedation and blood pressure changes and reduce the buprenorphine dose if needed.
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 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 Linezolid
- Amoxapine + Linezolid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Benzphetamine + Linezolid Contraindicated
- Brimonidine + Linezolid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion + Linezolid Contraindicated
Frequently asked questions
Can I take Buprenorphine with Linezolid?
MediHelp rates the interaction as major. Buprenorphine and Linezolid 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. Linezolid is a reversible non-selective MAO inhibitor, and combining it with an opioid such as buprenorphine may cause serotonin toxicity or CNS depression. Reports of agitation, hyperthermia, hypotension and sedation exist for opioids with MAO inhibitors.
How serious is the interaction between Buprenorphine and Linezolid?
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 the combination where possible and use an alternative antibiotic. If linezolid is essential, monitor closely for serotonin syndrome, sedation and blood pressure changes and reduce the buprenorphine dose if needed.
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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