Drug interactions
Buprenorphine subdermal implant + Hydromorphone
Severity: Major
Buprenorphine subdermal implant and Hydromorphone: 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
The buprenorphine implant provides continuous receptor occupancy for months, so it can blunt hydromorphone analgesia or precipitate withdrawal in dependent patients. Overlapping use also adds to sedation and respiratory depression.
What this interaction means in plain words
Buprenorphine subdermal implant and Hydromorphone 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
High-affinity partial agonism by buprenorphine competes with hydromorphone at mu receptors, with additive CNS depression.
What to do
Avoid concurrent use except when closely supervised, for example short-term acute pain care; monitor for withdrawal, poor analgesia and respiratory depression. Involve the buprenorphine prescriber in pain planning.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Buprenorphine subdermal implant with Hydromorphone?
MediHelp rates the interaction as major. Buprenorphine subdermal implant and Hydromorphone 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. The buprenorphine implant provides continuous receptor occupancy for months, so it can blunt hydromorphone analgesia or precipitate withdrawal in dependent patients. Overlapping use also adds to sedation and respiratory depression.
How serious is the interaction between Buprenorphine subdermal implant and Hydromorphone?
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 concurrent use except when closely supervised, for example short-term acute pain care; monitor for withdrawal, poor analgesia and respiratory depression. Involve the buprenorphine prescriber in pain planning.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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