Drug interactions
Buprenorphine + Selegiline transdermal
Severity: Major
Buprenorphine and Selegiline transdermal: 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
Combining an opioid with a monoamine oxidase inhibitor has been associated with serotonin toxicity, marked blood pressure changes, excessive sedation and respiratory depression. Buprenorphine has weaker serotonergic activity than some opioids, but the risk is not excluded and transdermal selegiline at antidepressant doses is nonselective for MAO.
What this interaction means in plain words
Buprenorphine and Selegiline transdermal 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.
Why it happens
Additive CNS depression and possible serotonergic or autonomic effects when MAO inhibition is combined with an opioid; the exact mechanism with buprenorphine is not fully established.
What to do
Avoid the combination where an alternative analgesic or antidepressant is possible. If it is unavoidable, start at low doses and monitor for agitation, hyperthermia, clonus, hypotension and sedation.
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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References
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
Frequently asked questions
Can I take Buprenorphine with Selegiline transdermal?
MediHelp rates the interaction as major. Buprenorphine and Selegiline transdermal 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. Combining an opioid with a monoamine oxidase inhibitor has been associated with serotonin toxicity, marked blood pressure changes, excessive sedation and respiratory depression. Buprenorphine has weaker serotonergic activity than some opioids, but the risk is not excluded and transdermal selegiline at antidepressant doses is nonselective for MAO.
How serious is the interaction between Buprenorphine and Selegiline transdermal?
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 an alternative analgesic or antidepressant is possible. If it is unavoidable, start at low doses and monitor for agitation, hyperthermia, clonus, hypotension and sedation.
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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