Drug interactions
Buprenorphine + Paroxetine
Severity: Minor
Buprenorphine and Paroxetine: minor 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
Both drugs may prolong the QT interval at higher exposures, though the risk with paroxetine is low. Paroxetine also carries a theoretical risk of serotonin syndrome with opioids, and as a strong CYP2D6 inhibitor it has little effect on buprenorphine, which is cleared mainly by CYP3A4.
What this interaction means in plain words
Buprenorphine and Paroxetine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Buprenorphine belongs to Musculoskeletal; Paroxetine belongs to Central Nervous System.
Why it happens
Possible additive QT prolongation and serotonergic effects.
What to do
No dose change is needed in most patients; check an ECG if other QT-prolonging drugs or risk factors are present. Counsel patients to report agitation, tremor, fever or palpitations.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Buprenorphine and Paroxetine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Buprenorphine with Paroxetine?
MediHelp rates the interaction as minor. Buprenorphine and Paroxetine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Both drugs may prolong the QT interval at higher exposures, though the risk with paroxetine is low. Paroxetine also carries a theoretical risk of serotonin syndrome with opioids, and as a strong CYP2D6 inhibitor it has little effect on buprenorphine, which is cleared mainly by CYP3A4.
How serious is the interaction between Buprenorphine and Paroxetine?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No dose change is needed in most patients; check an ECG if other QT-prolonging drugs or risk factors are present. Counsel patients to report agitation, tremor, fever or palpitations.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
