Drug interactions
Buprenorphine + Mifepristone
Severity: Major
Buprenorphine and Mifepristone: 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
Mifepristone inhibits CYP3A4, which may raise buprenorphine exposure and increase sedation and respiratory depression. Both drugs have also been linked to QT prolongation, adding to arrhythmia risk.
What this interaction means in plain words
Buprenorphine and Mifepristone 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; Mifepristone belongs to Endocrine.
Why it happens
CYP3A4 inhibition by mifepristone reduces buprenorphine metabolism, combined with additive QT effects.
What to do
Avoid long-term combined use such as mifepristone for Cushing's syndrome. If needed, monitor for opioid excess, consider lowering the buprenorphine dose and check an ECG.
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 Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Buprenorphine with Mifepristone?
MediHelp rates the interaction as major. Buprenorphine and Mifepristone 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. Mifepristone inhibits CYP3A4, which may raise buprenorphine exposure and increase sedation and respiratory depression. Both drugs have also been linked to QT prolongation, adding to arrhythmia risk.
How serious is the interaction between Buprenorphine and Mifepristone?
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 long-term combined use such as mifepristone for Cushing's syndrome. If needed, monitor for opioid excess, consider lowering the buprenorphine dose and check an ECG.
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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