Drug interactions
Buprenorphine + Lorazepam
Severity: Major
Buprenorphine and Lorazepam: 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 with lorazepam can lead to profound sedation, respiratory depression, coma and death. This risk is established and addressed by regulatory boxed warnings on opioid and benzodiazepine co-use.
What this interaction means in plain words
Buprenorphine and Lorazepam 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; Lorazepam belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression via opioid receptor agonism and GABA-A potentiation.
What to do
Avoid the combination when possible; if needed, use the lowest effective doses for the shortest duration and monitor sedation and breathing. Counsel on avoiding alcohol and consider naloxone.
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 Lorazepam
Frequently asked questions
Can I take Buprenorphine with Lorazepam?
MediHelp rates the interaction as major. Buprenorphine and Lorazepam 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 with lorazepam can lead to profound sedation, respiratory depression, coma and death. This risk is established and addressed by regulatory boxed warnings on opioid and benzodiazepine co-use.
How serious is the interaction between Buprenorphine and Lorazepam?
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 when possible; if needed, use the lowest effective doses for the shortest duration and monitor sedation and breathing. Counsel on avoiding alcohol and consider naloxone.
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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