Drug interactions
Buprenorphine buccal + Clonazepam
Severity: Major
Buprenorphine buccal and Clonazepam: 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
Concurrent benzodiazepine and buprenorphine use increases the risk of profound sedation, respiratory depression, coma and death. Regulators have issued boxed warnings for this combination.
What this interaction means in plain words
Buprenorphine buccal and Clonazepam 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 and respiratory depression via GABA-A potentiation and mu-opioid receptor agonism.
What to do
Prescribe together only if no alternative exists, with the lowest effective doses and limited duration. Monitor for sedation and respiratory depression and educate patients and caregivers.
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 Clonazepam
- Calcium / magnesium / potassium / sodium oxybates + Clonazepam Contraindicated
- Clonazepam + Sodium oxybate Contraindicated
- Alfentanil + Clonazepam Major
- Alprazolam + Clonazepam Major
- Amobarbital + Clonazepam Major
- Belladonna and opium + Clonazepam Major
Frequently asked questions
Can I take Buprenorphine buccal with Clonazepam?
MediHelp rates the interaction as major. Buprenorphine buccal and Clonazepam 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. Concurrent benzodiazepine and buprenorphine use increases the risk of profound sedation, respiratory depression, coma and death. Regulators have issued boxed warnings for this combination.
How serious is the interaction between Buprenorphine buccal and Clonazepam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prescribe together only if no alternative exists, with the lowest effective doses and limited duration. Monitor for sedation and respiratory depression and educate patients and caregivers.
What other medicines interact with Clonazepam?
MediHelp also lists interactions of Clonazepam with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Alfentanil. The full list is on the Clonazepam page.
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