Drug interactions
Buprenorphine long-acting + Safinamide
Severity: Major
Buprenorphine long-acting and Safinamide: 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
Safinamide is a selective MAO-B inhibitor, and combining it with an opioid such as buprenorphine can lead to serotonin syndrome or opioid toxicity with respiratory depression and coma. The labeling for long-acting buprenorphine injection advises against use with MAO inhibitors because the depot cannot be quickly withdrawn if toxicity develops.
What this interaction means in plain words
Buprenorphine long-acting and Safinamide 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
MAO inhibition combined with opioid serotonergic activity and additive CNS and respiratory depression.
What to do
Avoid starting long-acting buprenorphine injection in patients taking safinamide or within 14 days of stopping it, and consider an alternative analgesic or opioid use disorder therapy. If the combination cannot be avoided, monitor for serotonin toxicity and sedation or respiratory depression.
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 Safinamide
- Amitriptyline + Safinamide Contraindicated
- Amoxapine + Safinamide Contraindicated
- Amphetamine polistirex + Safinamide Contraindicated
- Clomipramine + Safinamide Contraindicated
- Cyclobenzaprine + Safinamide Contraindicated
- Desipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Buprenorphine long-acting with Safinamide?
MediHelp rates the interaction as major. Buprenorphine long-acting and Safinamide 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. Safinamide is a selective MAO-B inhibitor, and combining it with an opioid such as buprenorphine can lead to serotonin syndrome or opioid toxicity with respiratory depression and coma. The labeling for long-acting buprenorphine injection advises against use with MAO inhibitors because the depot cannot be quickly withdrawn if toxicity develops.
How serious is the interaction between Buprenorphine long-acting and Safinamide?
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 starting long-acting buprenorphine injection in patients taking safinamide or within 14 days of stopping it, and consider an alternative analgesic or opioid use disorder therapy. If the combination cannot be avoided, monitor for serotonin toxicity and sedation or respiratory depression.
What other medicines interact with Safinamide?
MediHelp also lists interactions of Safinamide with, for example, Amitriptyline, Amoxapine, Amphetamine polistirex. The full list is on the Safinamide page.
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