Drug interactions
Buprenorphine long-acting + Duloxetine
Severity: Major
Buprenorphine long-acting and Duloxetine: major interaction.
Last updated Sources: US FDA label
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
Buprenorphine has been associated with serotonin syndrome when combined with serotonergic drugs such as duloxetine. Because the injection is long-acting, the opioid cannot be quickly withdrawn if toxicity arises. Additive CNS depression can also occur.
What this interaction means in plain words
Buprenorphine long-acting and Duloxetine 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 serotonergic activity of the opioid and the SNRI.
What to do
Monitor closely for signs of serotonin syndrome after injection and with changes in duloxetine dose. Treat symptomatically and stop the serotonergic agent if toxicity develops.
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 Duloxetine
- Duloxetine + Isocarboxazid Contraindicated
- Duloxetine + Linezolid Contraindicated
- Duloxetine + Methylene blue Contraindicated
- Duloxetine + Phenelzine Contraindicated
- Duloxetine + Procarbazine Contraindicated
- Duloxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Buprenorphine long-acting with Duloxetine?
MediHelp rates the interaction as major. Buprenorphine long-acting and Duloxetine 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. Buprenorphine has been associated with serotonin syndrome when combined with serotonergic drugs such as duloxetine. Because the injection is long-acting, the opioid cannot be quickly withdrawn if toxicity arises. Additive CNS depression can also occur.
How serious is the interaction between Buprenorphine long-acting and Duloxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor closely for signs of serotonin syndrome after injection and with changes in duloxetine dose. Treat symptomatically and stop the serotonergic agent if toxicity develops.
What other medicines interact with Duloxetine?
MediHelp also lists interactions of Duloxetine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Duloxetine page.
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