Drug interactions
Buprenorphine long-acting + Hydrocodone
Severity: Major
Buprenorphine long-acting and Hydrocodone: 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
Long-acting injectable buprenorphine gives sustained mu receptor occupancy, which can reduce hydrocodone analgesia or cause withdrawal symptoms. Concurrent use may also add to sedation and respiratory depression.
What this interaction means in plain words
Buprenorphine long-acting and Hydrocodone 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
Sustained high-affinity partial agonism competes with hydrocodone at mu receptors, plus additive CNS depression.
What to do
Avoid concurrent use where possible and consider non-opioid analgesia. If hydrocodone is needed, monitor closely for withdrawal, pain control and 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
Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Frequently asked questions
Can I take Buprenorphine long-acting with Hydrocodone?
MediHelp rates the interaction as major. Buprenorphine long-acting and Hydrocodone 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. Long-acting injectable buprenorphine gives sustained mu receptor occupancy, which can reduce hydrocodone analgesia or cause withdrawal symptoms. Concurrent use may also add to sedation and respiratory depression.
How serious is the interaction between Buprenorphine long-acting and Hydrocodone?
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 concurrent use where possible and consider non-opioid analgesia. If hydrocodone is needed, monitor closely for withdrawal, pain control and respiratory depression.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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