Drug interactions
Buprenorphine + Mitotane
Severity: Moderate
Buprenorphine and Mitotane: moderate 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
Mitotane strongly induces CYP3A4 and can substantially lower buprenorphine concentrations. Pain control may worsen or withdrawal symptoms may emerge, and the induction persists after mitotane is stopped.
What this interaction means in plain words
Buprenorphine and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Buprenorphine belongs to Musculoskeletal; Mitotane belongs to Oncology.
Why it happens
Mitotane induces CYP3A4, increasing buprenorphine clearance.
What to do
Monitor for loss of analgesia or withdrawal and increase the buprenorphine dose as needed. Consider an alternative opioid not dependent on CYP3A4 if control is poor.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Buprenorphine with Mitotane?
MediHelp rates the interaction as moderate. Buprenorphine and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Mitotane strongly induces CYP3A4 and can substantially lower buprenorphine concentrations. Pain control may worsen or withdrawal symptoms may emerge, and the induction persists after mitotane is stopped.
How serious is the interaction between Buprenorphine and Mitotane?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of analgesia or withdrawal and increase the buprenorphine dose as needed. Consider an alternative opioid not dependent on CYP3A4 if control is poor.
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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