Drug interactions
Buprenorphine buccal + Perphenazine
Severity: Major
Buprenorphine buccal and Perphenazine: major interaction.
Last updated Sources: Health Canada product monograph
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 an opioid with a sedating phenothiazine increases the risk of profound sedation, respiratory depression and coma. Both agents can also prolong the QT interval, adding arrhythmia risk.
What this interaction means in plain words
Buprenorphine buccal and Perphenazine 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, plus additive QT prolongation.
What to do
Use the lowest effective doses and monitor sedation and respiratory status, particularly at initiation or dose changes. Obtain an ECG if other QT risk factors exist and correct electrolyte abnormalities.
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 Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Buprenorphine buccal with Perphenazine?
MediHelp rates the interaction as major. Buprenorphine buccal and Perphenazine 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 an opioid with a sedating phenothiazine increases the risk of profound sedation, respiratory depression and coma. Both agents can also prolong the QT interval, adding arrhythmia risk.
How serious is the interaction between Buprenorphine buccal and Perphenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor sedation and respiratory status, particularly at initiation or dose changes. Obtain an ECG if other QT risk factors exist and correct electrolyte abnormalities.
What other medicines interact with Perphenazine?
MediHelp also lists interactions of Perphenazine with, for example, Ibutilide, Pimozide, Thioridazine. The full list is on the Perphenazine page.
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