Drug interactions
Buprenorphine + Ritonavir
Severity: Moderate
Buprenorphine and Ritonavir: 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
Ritonavir is a strong CYP3A4 inhibitor and can raise buprenorphine exposure, since buprenorphine is mainly cleared through CYP3A4. This may cause excess opioid effects such as sedation, respiratory depression and cognitive impairment.
What this interaction means in plain words
Buprenorphine and Ritonavir 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; Ritonavir belongs to Anti Virals.
Why it happens
Ritonavir inhibits CYP3A4-mediated N-dealkylation of buprenorphine, reducing its clearance.
What to do
Monitor for sedation, respiratory depression and impaired cognition, especially when starting or stopping ritonavir. Reduce the buprenorphine dose if signs of opioid excess occur.
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 Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Buprenorphine with Ritonavir?
MediHelp rates the interaction as moderate. Buprenorphine and Ritonavir 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. Ritonavir is a strong CYP3A4 inhibitor and can raise buprenorphine exposure, since buprenorphine is mainly cleared through CYP3A4. This may cause excess opioid effects such as sedation, respiratory depression and cognitive impairment.
How serious is the interaction between Buprenorphine and Ritonavir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, respiratory depression and impaired cognition, especially when starting or stopping ritonavir. Reduce the buprenorphine dose if signs of opioid excess occur.
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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