Drug interactions
Buprenorphine + Olanzapine / samidorphan
Severity: Contraindicated
Buprenorphine and Olanzapine / samidorphan: contraindicated 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
Samidorphan blocks opioid receptors, reducing buprenorphine's effect and potentially precipitating withdrawal in opioid-dependent patients. This is a labeled contraindication in patients using opioids.
What this interaction means in plain words
Buprenorphine and Olanzapine / samidorphan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Samidorphan is a mu-opioid receptor antagonist that opposes buprenorphine's effects.
What to do
Do not combine, and observe the labeled opioid-free interval before starting. Use a different antipsychotic for patients on buprenorphine maintenance.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + Thioridazine Contraindicated
- Buprenorphine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Buprenorphine with Olanzapine / samidorphan?
MediHelp rates the interaction as contraindicated. Buprenorphine and Olanzapine / samidorphan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Samidorphan blocks opioid receptors, reducing buprenorphine's effect and potentially precipitating withdrawal in opioid-dependent patients. This is a labeled contraindication in patients using opioids.
How serious is the interaction between Buprenorphine and Olanzapine / samidorphan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine, and observe the labeled opioid-free interval before starting. Use a different antipsychotic for patients on buprenorphine maintenance.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Phenelzine. The full list is on the Buprenorphine page.
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