Drug interactions
Buprenorphine buccal + Posaconazole
Severity: Major
Buprenorphine buccal and Posaconazole: major interaction.
Last updated Sources: UK SmPC
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 agents can prolong the QTc interval, and posaconazole may also raise buprenorphine exposure. This increases the risk of torsades de pointes and opioid toxicity.
What this interaction means in plain words
Buprenorphine buccal and Posaconazole 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 QT prolongation plus CYP3A4 inhibition by posaconazole reducing buprenorphine clearance.
What to do
Avoid if possible; otherwise obtain baseline ECG, correct electrolytes and monitor QTc and for sedation or respiratory depression.
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
- Noxafil 100 mg Gastro-resistant Tablets - SmPC sections 4.3/4.5 (class statement: CYP3A4 substrates; "Posaconazole is a potent inhibitor of CYP3A4. Co-administration of posaconazole with CYP3A4 substrates may result in large increases in exposure to CYP3A4 subst") — electronic medicines compendium (UK SmPC)
Other interactions of Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Frequently asked questions
Can I take Buprenorphine buccal with Posaconazole?
MediHelp rates the interaction as major. Buprenorphine buccal and Posaconazole 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. Both agents can prolong the QTc interval, and posaconazole may also raise buprenorphine exposure. This increases the risk of torsades de pointes and opioid toxicity.
How serious is the interaction between Buprenorphine buccal and Posaconazole?
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 if possible; otherwise obtain baseline ECG, correct electrolytes and monitor QTc and for sedation or respiratory depression.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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