Drug interactions
Buprenorphine + Voriconazole
Severity: Major
Buprenorphine and Voriconazole: 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
Voriconazole inhibits CYP3A4, the main metabolic pathway of buprenorphine, which may raise buprenorphine concentrations and increase sedation and respiratory depression. Both drugs can also prolong the QT interval.
What this interaction means in plain words
Buprenorphine and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
CYP3A4 inhibition by voriconazole reduces buprenorphine clearance, plus additive QT prolongation.
What to do
Monitor for sedation, respiratory depression and QTc prolongation, and reduce the buprenorphine dose if needed. Consider an alternative antifungal if feasible.
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
Other interactions of Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Frequently asked questions
Can I take Buprenorphine with Voriconazole?
MediHelp rates the interaction as major. Buprenorphine and Voriconazole 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. Voriconazole inhibits CYP3A4, the main metabolic pathway of buprenorphine, which may raise buprenorphine concentrations and increase sedation and respiratory depression. Both drugs can also prolong the QT interval.
How serious is the interaction between Buprenorphine and Voriconazole?
MediHelp rates it major, 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 QTc prolongation, and reduce the buprenorphine dose if needed. Consider an alternative antifungal if feasible.
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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