Drug interactions
Buprenorphine subdermal implant + Hydrocodone
Severity: Major
Buprenorphine subdermal implant and Hydrocodone: major interaction.
Last updated Sources: US FDA label
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
Buprenorphine from the implant occupies mu receptors with high affinity and may reduce hydrocodone analgesia or cause withdrawal in opioid-tolerant patients. Additive sedation and respiratory depression can also occur.
What this interaction means in plain words
Buprenorphine subdermal implant and Hydrocodone 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
Partial agonist competition at mu-opioid receptors with additive CNS depression.
What to do
Avoid routine concurrent use and manage pain with non-opioid options or by coordinating with the buprenorphine prescriber. If used, monitor for withdrawal, poor analgesia and 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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References
Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Frequently asked questions
Can I take Buprenorphine subdermal implant with Hydrocodone?
MediHelp rates the interaction as major. Buprenorphine subdermal implant and Hydrocodone 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. Buprenorphine from the implant occupies mu receptors with high affinity and may reduce hydrocodone analgesia or cause withdrawal in opioid-tolerant patients. Additive sedation and respiratory depression can also occur.
How serious is the interaction between Buprenorphine subdermal implant and Hydrocodone?
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 routine concurrent use and manage pain with non-opioid options or by coordinating with the buprenorphine prescriber. If used, monitor for withdrawal, poor analgesia and respiratory depression.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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