Drug interactions
Buprenorphine long-acting + Perphenazine
Severity: Major
Buprenorphine long-acting and Perphenazine: 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
Concomitant CNS depressants with buprenorphine increase the risk of profound sedation, respiratory depression, coma and death. Because the long-acting injection cannot be quickly withdrawn, the effect may persist for weeks.
What this interaction means in plain words
Buprenorphine long-acting and Perphenazine 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 CNS and respiratory depression from opioid and phenothiazine.
What to do
Limit the combination to patients without alternatives, using the lowest effective perphenazine dose and monitoring sedation and respiration closely. Counsel patients and caregivers about warning signs and avoid alcohol.
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 Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Buprenorphine long-acting with Perphenazine?
MediHelp rates the interaction as major. Buprenorphine long-acting and Perphenazine 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. Concomitant CNS depressants with buprenorphine increase the risk of profound sedation, respiratory depression, coma and death. Because the long-acting injection cannot be quickly withdrawn, the effect may persist for weeks.
How serious is the interaction between Buprenorphine long-acting and Perphenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit the combination to patients without alternatives, using the lowest effective perphenazine dose and monitoring sedation and respiration closely. Counsel patients and caregivers about warning signs and avoid alcohol.
What other medicines interact with Perphenazine?
MediHelp also lists interactions of Perphenazine with, for example, Ibutilide, Pimozide, Thioridazine. The full list is on the Perphenazine page.
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