Drug interactions
Buprenorphine subdermal implant + Fluconazole
Severity: Moderate
Buprenorphine subdermal implant and Fluconazole: 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
Fluconazole inhibits CYP3A4, which metabolizes buprenorphine, so buprenorphine exposure may rise. Both agents can also prolong the QT interval, adding to arrhythmia risk, and opioid effects such as sedation may intensify.
What this interaction means in plain words
Buprenorphine subdermal implant and Fluconazole 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.
Why it happens
CYP3A4 inhibition by fluconazole raises buprenorphine levels, together with additive QT prolongation.
What to do
Monitor for sedation, respiratory depression and QTc prolongation, particularly with other risk factors. Obtain an ECG if cardiac risk is present, and consider removing the implant if toxicity develops.
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?
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Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Frequently asked questions
Can I take Buprenorphine subdermal implant with Fluconazole?
MediHelp rates the interaction as moderate. Buprenorphine subdermal implant and Fluconazole 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. Fluconazole inhibits CYP3A4, which metabolizes buprenorphine, so buprenorphine exposure may rise. Both agents can also prolong the QT interval, adding to arrhythmia risk, and opioid effects such as sedation may intensify.
How serious is the interaction between Buprenorphine subdermal implant and Fluconazole?
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 QTc prolongation, particularly with other risk factors. Obtain an ECG if cardiac risk is present, and consider removing the implant if toxicity develops.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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