Drug interactions
Buprenorphine + Quinidine
Severity: Major
Buprenorphine and Quinidine: 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
Quinidine is a well-known QT-prolonging antiarrhythmic, and buprenorphine can modestly prolong the QT interval, particularly the transdermal and high-dose forms. Together they may raise the risk of torsades de pointes. Quinidine also inhibits CYP3A4 weakly, which could raise buprenorphine exposure.
What this interaction means in plain words
Buprenorphine and Quinidine 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; Quinidine belongs to Anti Parasitic.
Why it happens
Additive QT prolongation through cardiac potassium channel effects, with possible minor CYP3A4 inhibition by quinidine.
What to do
Avoid the combination where possible; if it is needed, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc. Consider an alternative analgesic or antiarrhythmic.
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 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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
Frequently asked questions
Can I take Buprenorphine with Quinidine?
MediHelp rates the interaction as major. Buprenorphine and Quinidine 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. Quinidine is a well-known QT-prolonging antiarrhythmic, and buprenorphine can modestly prolong the QT interval, particularly the transdermal and high-dose forms. Together they may raise the risk of torsades de pointes. Quinidine also inhibits CYP3A4 weakly, which could raise buprenorphine exposure.
How serious is the interaction between Buprenorphine and Quinidine?
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; if it is needed, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc. Consider an alternative analgesic or antiarrhythmic.
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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