Drug interactions
Buprenorphine long-acting + Phenelzine
Severity: Contraindicated
Buprenorphine long-acting and Phenelzine: contraindicated interaction.
Last updated
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 an MAO inhibitor with buprenorphine may cause serotonin syndrome or opioid toxicity, including respiratory depression and coma. Long-acting injectable buprenorphine cannot be quickly withdrawn, which prolongs exposure if a reaction occurs. Labeling advises against use during or within 14 days of MAOI therapy.
What this interaction means in plain words
Buprenorphine long-acting and Phenelzine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Additive serotonergic effects and potentiation of opioid CNS and respiratory depression, possibly through altered opioid metabolism, in the setting of MAO inhibition.
What to do
Do not start long-acting buprenorphine within 14 days of stopping phenelzine or while it is being taken. Choose a non-serotonergic alternative or allow an adequate washout.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Phenelzine
- 5-HTP + Phenelzine Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amoxapine + Phenelzine Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Benzphetamine + Phenelzine Contraindicated
- Brimonidine + Phenelzine Contraindicated
Frequently asked questions
Can I take Buprenorphine long-acting with Phenelzine?
MediHelp rates the interaction as contraindicated. Buprenorphine long-acting and Phenelzine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Combining an MAO inhibitor with buprenorphine may cause serotonin syndrome or opioid toxicity, including respiratory depression and coma. Long-acting injectable buprenorphine cannot be quickly withdrawn, which prolongs exposure if a reaction occurs. Labeling advises against use during or within 14 days of MAOI therapy.
How serious is the interaction between Buprenorphine long-acting and Phenelzine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not start long-acting buprenorphine within 14 days of stopping phenelzine or while it is being taken. Choose a non-serotonergic alternative or allow an adequate washout.
What other medicines interact with Phenelzine?
MediHelp also lists interactions of Phenelzine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Phenelzine page.
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