Drug interactions
Buprenorphine buccal + Selegiline
Severity: Major
Buprenorphine buccal and Selegiline: 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
MAO inhibitors may cause severe and unpredictable potentiation of opioid effects, including serotonin syndrome, hypertensive reactions and respiratory depression. Buprenorphine labeling advises against use within 14 days of MAOI therapy.
What this interaction means in plain words
Buprenorphine buccal and Selegiline 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
Probable serotonergic and other poorly defined potentiation of opioid effects by MAO inhibition.
What to do
Avoid the combination, or if unavoidable, use the lowest effective buprenorphine dose with close monitoring for serotonin syndrome and respiratory depression. Choose a non-opioid analgesic if possible.
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
- Eldepryl 10mg Tablets - SmPC sections 4.3/4.5 (names the partner; "Pethidine, tramadol, buprenorphine and other opioids") — electronic medicines compendium (UK SmPC)
Other interactions of Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Frequently asked questions
Can I take Buprenorphine buccal with Selegiline?
MediHelp rates the interaction as major. Buprenorphine buccal and Selegiline 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. MAO inhibitors may cause severe and unpredictable potentiation of opioid effects, including serotonin syndrome, hypertensive reactions and respiratory depression. Buprenorphine labeling advises against use within 14 days of MAOI therapy.
How serious is the interaction between Buprenorphine buccal and Selegiline?
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 the combination, or if unavoidable, use the lowest effective buprenorphine dose with close monitoring for serotonin syndrome and respiratory depression. Choose a non-opioid analgesic if possible.
What other medicines interact with Selegiline?
MediHelp also lists interactions of Selegiline with, for example, Amitriptyline, Amoxapine, Atomoxetine. The full list is on the Selegiline page.
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