Drug interactions
Buprenorphine buccal + Procarbazine
Severity: Major
Buprenorphine buccal and Procarbazine: 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
Procarbazine has MAO inhibiting activity, and opioids used with MAOIs can cause serotonin syndrome or excessive CNS and respiratory depression. The risk with buprenorphine is described mainly in labeling and is less well documented.
What this interaction means in plain words
Buprenorphine buccal and Procarbazine 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
MAO inhibition may enhance serotonergic and CNS depressant effects of the opioid; mechanism not fully characterised.
What to do
Avoid buprenorphine during procarbazine therapy and for 14 days after stopping. If unavoidable, use the lowest dose and monitor for sedation, respiratory depression and serotonin toxicity.
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 Procarbazine
- Adenovirus types 4 and 7 live + Procarbazine Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amoxapine + Procarbazine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Bcg vaccine live + Procarbazine Contraindicated
- Brimonidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Buprenorphine buccal with Procarbazine?
MediHelp rates the interaction as major. Buprenorphine buccal and Procarbazine 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. Procarbazine has MAO inhibiting activity, and opioids used with MAOIs can cause serotonin syndrome or excessive CNS and respiratory depression. The risk with buprenorphine is described mainly in labeling and is less well documented.
How serious is the interaction between Buprenorphine buccal and Procarbazine?
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 buprenorphine during procarbazine therapy and for 14 days after stopping. If unavoidable, use the lowest dose and monitor for sedation, respiratory depression and serotonin toxicity.
What other medicines interact with Procarbazine?
MediHelp also lists interactions of Procarbazine with, for example, Adenovirus types 4 and 7 live, Amitriptyline, Amoxapine. The full list is on the Procarbazine page.
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