Drug interactions
Buprenorphine + Promethazine
Severity: Major
Buprenorphine and Promethazine: major 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
The concurrent use of promethazine and buprenorphine may lead to a significant reduction in the QTc interval, which can increase the risk of cardiac arrhythmias. Patients taking both medications should be monitored closely for any signs of cardiac issues.
What this interaction means in plain words
Buprenorphine and Promethazine 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; Promethazine belongs to Respiratory.
Why it happens
Both drugs have properties that can influence cardiac repolarization, potentially leading to alterations in the QTc interval.
What to do
It is advisable to avoid the combination of these two medications if possible. If their use together is necessary, continuous cardiac monitoring should be implemented to detect any potential arrhythmias early.
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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Other interactions of Promethazine
- Cabergoline + Promethazine Contraindicated
- Dopamine + Promethazine Contraindicated
- Ibutilide + Promethazine Contraindicated
- Pimozide + Promethazine Contraindicated
- Promethazine + Thioridazine Contraindicated
- Alfentanil + Promethazine Major
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 Promethazine?
MediHelp rates the interaction as major. Buprenorphine and Promethazine 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. The concurrent use of promethazine and buprenorphine may lead to a significant reduction in the QTc interval, which can increase the risk of cardiac arrhythmias. Patients taking both medications should be monitored closely for any signs of cardiac issues.
How serious is the interaction between Buprenorphine and Promethazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: It is advisable to avoid the combination of these two medications if possible. If their use together is necessary, continuous cardiac monitoring should be implemented to detect any potential arrhythmias early.
What other medicines interact with Promethazine?
MediHelp also lists interactions of Promethazine with, for example, Cabergoline, Dopamine, Ibutilide. The full list is on the Promethazine page.
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