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Drug interactions

Buprenorphine + Procarbazine

Severity: Major

Buprenorphine and Procarbazine: 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

Procarbazine has MAO-inhibiting activity, and opioids used with MAO inhibitors may cause serotonin toxicity, hypotension, hyperpyrexia and profound CNS depression. This interaction can be severe.

What this interaction means in plain words

Buprenorphine and Procarbazine 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; Procarbazine belongs to Oncology.

Evidence level: Low

Why it happens

Weak MAO inhibition by procarbazine may potentiate opioid serotonergic and CNS effects; mechanism not fully established.

What to do

Avoid the combination where possible and choose a non-serotonergic analgesic. If unavoidable, use low doses and monitor for serotonin syndrome and sedation.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Buprenorphine with Procarbazine?

MediHelp rates the interaction as major. Buprenorphine and Procarbazine 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. Procarbazine has MAO-inhibiting activity, and opioids used with MAO inhibitors may cause serotonin toxicity, hypotension, hyperpyrexia and profound CNS depression. This interaction can be severe.

How serious is the interaction between Buprenorphine and Procarbazine?

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 the combination where possible and choose a non-serotonergic analgesic. If unavoidable, use low doses and monitor for serotonin syndrome and sedation.

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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