Drug interactions
Buprenorphine long-acting + Meperidine
Severity: Major
Buprenorphine long-acting and Meperidine: 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
Combining meperidine with extended-release buprenorphine adds opioid effects on the central nervous system. This can cause profound sedation, respiratory depression, coma and death. Buprenorphine's high receptor affinity may also blunt meperidine analgesia or complicate pain control.
What this interaction means in plain words
Buprenorphine long-acting and Meperidine 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 opioid-receptor mediated CNS and respiratory depression, with competition at mu-opioid receptors between a partial agonist and a full agonist.
What to do
Avoid concurrent use where possible, and if a second opioid is unavoidable use the lowest dose for the shortest time. Monitor sedation level and respiratory rate closely and make naloxone available.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Buprenorphine long-acting with Meperidine?
MediHelp rates the interaction as major. Buprenorphine long-acting and Meperidine 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 meperidine with extended-release buprenorphine adds opioid effects on the central nervous system. This can cause profound sedation, respiratory depression, coma and death. Buprenorphine's high receptor affinity may also blunt meperidine analgesia or complicate pain control.
How serious is the interaction between Buprenorphine long-acting and Meperidine?
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 if a second opioid is unavoidable use the lowest dose for the shortest time. Monitor sedation level and respiratory rate closely and make naloxone available.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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