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Drug interactions

Buprenorphine subdermal implant + Cyclosporin

Severity: Moderate

Buprenorphine subdermal implant and Cyclosporin: moderate 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

Cyclosporine inhibits CYP3A4 and may raise buprenorphine exposure. With an implant, the dose cannot easily be reduced, so opioid excess such as sedation and respiratory depression may occur.

What this interaction means in plain words

Buprenorphine subdermal implant and Cyclosporin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Evidence level: Moderate

Why it happens

Inhibition of CYP3A4-mediated buprenorphine metabolism by cyclosporine.

What to do

Monitor for sedation, respiratory depression and other signs of opioid excess when cyclosporine is started. If symptoms occur and cyclosporine cannot be stopped, consider removing the implant and switching to a formulation allowing dose titration.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Buprenorphine subdermal implant with Cyclosporin?

MediHelp rates the interaction as moderate. Buprenorphine subdermal implant and Cyclosporin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cyclosporine inhibits CYP3A4 and may raise buprenorphine exposure. With an implant, the dose cannot easily be reduced, so opioid excess such as sedation and respiratory depression may occur.

How serious is the interaction between Buprenorphine subdermal implant and Cyclosporin?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, respiratory depression and other signs of opioid excess when cyclosporine is started. If symptoms occur and cyclosporine cannot be stopped, consider removing the implant and switching to a formulation allowing dose titration.

What other medicines interact with Cyclosporin?

MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.

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