Drug interactions
Buprenorphine + Pentobarbital
Severity: Major
Buprenorphine and Pentobarbital: 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
Barbiturates and opioids produce additive CNS and respiratory depression. Pentobarbital also induces CYP3A4 and may lower buprenorphine levels, so effects can be unpredictable.
What this interaction means in plain words
Buprenorphine and Pentobarbital 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.
Why it happens
Additive CNS depression plus CYP3A4 induction by pentobarbital increasing buprenorphine clearance.
What to do
Avoid combining unless essential, and monitor respiratory status and sedation closely. Watch for reduced buprenorphine effect or withdrawal with prolonged barbiturate use.
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
Frequently asked questions
Can I take Buprenorphine with Pentobarbital?
MediHelp rates the interaction as major. Buprenorphine and Pentobarbital 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. Barbiturates and opioids produce additive CNS and respiratory depression. Pentobarbital also induces CYP3A4 and may lower buprenorphine levels, so effects can be unpredictable.
How serious is the interaction between Buprenorphine and Pentobarbital?
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 combining unless essential, and monitor respiratory status and sedation closely. Watch for reduced buprenorphine effect or withdrawal with prolonged barbiturate use.
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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