Drug interactions
Buprenorphine long-acting + Posaconazole
Severity: Major
Buprenorphine long-acting and Posaconazole: major interaction.
Last updated Sources: UK SmPC
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
Posaconazole may raise buprenorphine exposure and both agents can prolong QTc. With a long-acting depot injection, effects cannot be rapidly withdrawn.
What this interaction means in plain words
Buprenorphine long-acting and Posaconazole 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 QT prolongation plus CYP3A4 inhibition reducing buprenorphine clearance.
What to do
Obtain baseline ECG and monitor QTc and for sedation or respiratory depression. Choose an alternative antifungal where feasible.
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
- Noxafil 100 mg Gastro-resistant Tablets - SmPC sections 4.3/4.5 (class statement: CYP3A4 substrates; "Posaconazole is a potent inhibitor of CYP3A4. Co-administration of posaconazole with CYP3A4 substrates may result in large increases in exposure to CYP3A4 subst") — electronic medicines compendium (UK SmPC)
Other interactions of Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Frequently asked questions
Can I take Buprenorphine long-acting with Posaconazole?
MediHelp rates the interaction as major. Buprenorphine long-acting and Posaconazole 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. Posaconazole may raise buprenorphine exposure and both agents can prolong QTc. With a long-acting depot injection, effects cannot be rapidly withdrawn.
How serious is the interaction between Buprenorphine long-acting and Posaconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain baseline ECG and monitor QTc and for sedation or respiratory depression. Choose an alternative antifungal where feasible.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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