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Drug interactions

Buprenorphine + Secobarbital

Severity: Major

Buprenorphine and Secobarbital: major interaction.

Last updated Sources: US FDA label

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

Barbiturates combined with opioids produce additive CNS and respiratory depression, which may be severe. Secobarbital also induces CYP3A4, which can lower buprenorphine levels and cause withdrawal or reduced analgesia, and the sedative effects may persist or become unpredictable.

What this interaction means in plain words

Buprenorphine and Secobarbital 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; Secobarbital belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Additive CNS and respiratory depression, plus CYP3A4 induction that increases buprenorphine metabolism.

What to do

Avoid the combination if possible, or use the lowest doses and monitor sedation and respiratory rate closely. Watch for withdrawal symptoms and adjust the buprenorphine dose as needed.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Buprenorphine with Secobarbital?

MediHelp rates the interaction as major. Buprenorphine and Secobarbital 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. Barbiturates combined with opioids produce additive CNS and respiratory depression, which may be severe. Secobarbital also induces CYP3A4, which can lower buprenorphine levels and cause withdrawal or reduced analgesia, and the sedative effects may persist or become unpredictable.

How serious is the interaction between Buprenorphine and Secobarbital?

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 if possible, or use the lowest doses and monitor sedation and respiratory rate closely. Watch for withdrawal symptoms and adjust the buprenorphine dose as needed.

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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