Drug interactions
Buprenorphine + Sotalol
Severity: Major
Buprenorphine and Sotalol: 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
Sotalol is a class III antiarrhythmic with a clear risk of QT prolongation and torsades de pointes. Buprenorphine adds a small QT effect, and the combination also raises concern in patients with bradycardia.
What this interaction means in plain words
Buprenorphine and Sotalol 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; Sotalol belongs to Cardiovascular.
Why it happens
Additive QT prolongation through potassium channel blockade.
What to do
Avoid if possible, or monitor the ECG and electrolytes closely and use the lowest effective buprenorphine dose. Consider a non-QT-prolonging analgesic.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Buprenorphine with Sotalol?
MediHelp rates the interaction as major. Buprenorphine and Sotalol 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. Sotalol is a class III antiarrhythmic with a clear risk of QT prolongation and torsades de pointes. Buprenorphine adds a small QT effect, and the combination also raises concern in patients with bradycardia.
How serious is the interaction between Buprenorphine and Sotalol?
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 if possible, or monitor the ECG and electrolytes closely and use the lowest effective buprenorphine dose. Consider a non-QT-prolonging analgesic.
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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