Drug interactions
Buprenorphine buccal + Efavirenz
Severity: Moderate
Buprenorphine buccal and Efavirenz: moderate 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
Both drugs have been associated with QT prolongation, so combined use may add to the risk of arrhythmia. Efavirenz may also lower buprenorphine levels by inducing its metabolism, possibly reducing analgesia or causing withdrawal symptoms.
What this interaction means in plain words
Buprenorphine buccal and Efavirenz can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive QTc prolongation, plus efavirenz induction of CYP3A4-mediated buprenorphine metabolism.
What to do
Obtain an ECG and correct potassium and magnesium abnormalities in patients with other QT risk factors. Monitor for opioid withdrawal or inadequate analgesia and adjust the buprenorphine dose if needed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Buprenorphine buccal with Efavirenz?
MediHelp rates the interaction as moderate. Buprenorphine buccal and Efavirenz can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs have been associated with QT prolongation, so combined use may add to the risk of arrhythmia. Efavirenz may also lower buprenorphine levels by inducing its metabolism, possibly reducing analgesia or causing withdrawal symptoms.
How serious is the interaction between Buprenorphine buccal and Efavirenz?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG and correct potassium and magnesium abnormalities in patients with other QT risk factors. Monitor for opioid withdrawal or inadequate analgesia and adjust the buprenorphine dose if needed.
What other medicines interact with Efavirenz?
MediHelp also lists interactions of Efavirenz with, for example, Cobimetinib, Dienogest / estradiol valerate, Dihydroergotamine intranasal. The full list is on the Efavirenz page.
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