Drug interactions
Buprenorphine + Ranolazine
Severity: Moderate
Buprenorphine and Ranolazine: moderate 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 have been associated with QT interval prolongation, so combined use may add to arrhythmia risk, especially with higher doses, bradycardia or electrolyte disturbance. Ranolazine is also a CYP3A4 substrate and a weak inhibitor, which may modestly raise buprenorphine exposure.
What this interaction means in plain words
Buprenorphine and Ranolazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Buprenorphine belongs to Musculoskeletal; Ranolazine belongs to Cardiovascular.
Why it happens
Additive QT prolongation, with possible minor CYP3A4 inhibition by ranolazine.
What to do
Consider a baseline and follow-up ECG, particularly in patients with other QT risk factors, and correct potassium and magnesium. Monitor for increased opioid effects.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Frequently asked questions
Can I take Buprenorphine with Ranolazine?
MediHelp rates the interaction as moderate. Buprenorphine and Ranolazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs have been associated with QT interval prolongation, so combined use may add to arrhythmia risk, especially with higher doses, bradycardia or electrolyte disturbance. Ranolazine is also a CYP3A4 substrate and a weak inhibitor, which may modestly raise buprenorphine exposure.
How serious is the interaction between Buprenorphine and Ranolazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider a baseline and follow-up ECG, particularly in patients with other QT risk factors, and correct potassium and magnesium. Monitor for increased opioid effects.
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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