Drug interactions
Buprenorphine buccal + Clorazepate
Severity: Major
Buprenorphine buccal and Clorazepate: 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 buprenorphine with a benzodiazepine increases the risk of profound sedation, respiratory depression, coma and death. Regulators have issued boxed warnings for opioid-benzodiazepine use.
What this interaction means in plain words
Buprenorphine buccal and Clorazepate 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 from partial mu-opioid agonism and GABA-A potentiation.
What to do
Avoid unless no alternative exists, then use the lowest effective doses and monitor closely for sedation and respiratory depression. Counsel patients and caregivers about warning signs and consider naloxone availability.
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 Clorazepate
- Calcium / magnesium / potassium / sodium oxybates + Clorazepate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
- Alfentanil + Clorazepate Major
- Alprazolam + Clorazepate Major
- Amobarbital + Clorazepate Major
- Belladonna and opium + Clorazepate Major
Frequently asked questions
Can I take Buprenorphine buccal with Clorazepate?
MediHelp rates the interaction as major. Buprenorphine buccal and Clorazepate 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 buprenorphine with a benzodiazepine increases the risk of profound sedation, respiratory depression, coma and death. Regulators have issued boxed warnings for opioid-benzodiazepine use.
How serious is the interaction between Buprenorphine buccal and Clorazepate?
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 unless no alternative exists, then use the lowest effective doses and monitor closely for sedation and respiratory depression. Counsel patients and caregivers about warning signs and consider naloxone availability.
What other medicines interact with Clorazepate?
MediHelp also lists interactions of Clorazepate with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Alfentanil. The full list is on the Clorazepate page.
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