Drug interactions
Buprenorphine long-acting + Remifentanil
Severity: Major
Buprenorphine long-acting and Remifentanil: major 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
Concurrent use of remifentanil and long-acting buprenorphine can cause profound sedation, respiratory depression and death. Buprenorphine's receptor occupancy may also make analgesic dosing less predictable.
What this interaction means in plain words
Buprenorphine long-acting and Remifentanil 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 CNS and respiratory depression, with competitive mu-receptor binding.
What to do
Titrate remifentanil carefully with continuous monitoring of ventilation, oxygenation and sedation. Have airway support and 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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Other interactions of Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil Major
Frequently asked questions
Can I take Buprenorphine long-acting with Remifentanil?
MediHelp rates the interaction as major. Buprenorphine long-acting and Remifentanil 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. Concurrent use of remifentanil and long-acting buprenorphine can cause profound sedation, respiratory depression and death. Buprenorphine's receptor occupancy may also make analgesic dosing less predictable.
How serious is the interaction between Buprenorphine long-acting and Remifentanil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate remifentanil carefully with continuous monitoring of ventilation, oxygenation and sedation. Have airway support and naloxone available.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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