Drug interactions
Buprenorphine long-acting + Fluphenazine
Severity: Major
Buprenorphine long-acting and Fluphenazine: 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 a CNS-depressant antipsychotic with long-acting injectable buprenorphine increases the risk of profound sedation, respiratory depression, coma and death. Because the injectable depot cannot be removed, the effect persists and cannot be quickly reduced.
What this interaction means in plain words
Buprenorphine long-acting and Fluphenazine 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 pharmacodynamic CNS and respiratory depression.
What to do
Reserve the combination for cases where it is clearly needed, using the lowest effective fluphenazine dose. Monitor closely for sedation and respiratory depression, particularly after injection and with dose changes.
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 Fluphenazine
- Arsenic trioxide + Fluphenazine Contraindicated
- Dofetilide + Fluphenazine Contraindicated
- Fluphenazine + Ibutilide Contraindicated
- Fluphenazine + Pimozide Contraindicated
- Adagrasib + Fluphenazine Major
- Alfentanil + Fluphenazine Major
Frequently asked questions
Can I take Buprenorphine long-acting with Fluphenazine?
MediHelp rates the interaction as major. Buprenorphine long-acting and Fluphenazine 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 a CNS-depressant antipsychotic with long-acting injectable buprenorphine increases the risk of profound sedation, respiratory depression, coma and death. Because the injectable depot cannot be removed, the effect persists and cannot be quickly reduced.
How serious is the interaction between Buprenorphine long-acting and Fluphenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve the combination for cases where it is clearly needed, using the lowest effective fluphenazine dose. Monitor closely for sedation and respiratory depression, particularly after injection and with dose changes.
What other medicines interact with Fluphenazine?
MediHelp also lists interactions of Fluphenazine with, for example, Arsenic trioxide, Dofetilide, Ibutilide. The full list is on the Fluphenazine page.
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