Drug interactions
Buprenorphine + Remimazolam
Severity: Major
Buprenorphine and Remimazolam: 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
Remimazolam is a benzodiazepine, and using it with an opioid such as buprenorphine increases the risk of profound sedation and respiratory depression. Hypoxia, apnea, coma and death are possible.
What this interaction means in plain words
Buprenorphine and Remimazolam 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; Remimazolam belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression from GABA-A potentiation plus opioid receptor agonism.
What to do
Titrate remimazolam carefully, often at reduced doses, and continuously monitor vital signs and oxygen saturation during sedation and recovery. Have airway support available.
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 Remimazolam
Frequently asked questions
Can I take Buprenorphine with Remimazolam?
MediHelp rates the interaction as major. Buprenorphine and Remimazolam 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. Remimazolam is a benzodiazepine, and using it with an opioid such as buprenorphine increases the risk of profound sedation and respiratory depression. Hypoxia, apnea, coma and death are possible.
How serious is the interaction between Buprenorphine and Remimazolam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate remimazolam carefully, often at reduced doses, and continuously monitor vital signs and oxygen saturation during sedation and recovery. Have airway support available.
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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