Drug interactions
Buprenorphine subdermal implant + Hydroxyzine
Severity: Major
Buprenorphine subdermal implant and Hydroxyzine: major interaction.
Last updated Sources: UK SmPC
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
Hydroxyzine adds sedative effects to buprenorphine, which may lead to excessive drowsiness and respiratory depression. The risk is higher in opioid-naive patients or those with respiratory disease.
What this interaction means in plain words
Buprenorphine subdermal implant and Hydroxyzine 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
Additive CNS and respiratory depression from opioid agonism and H1-antihistamine sedation.
What to do
Use together only when alternatives are inadequate, at the lowest effective hydroxyzine dose. Monitor for sedation and respiratory depression and advise against driving.
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 Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Buprenorphine subdermal implant with Hydroxyzine?
MediHelp rates the interaction as major. Buprenorphine subdermal implant and Hydroxyzine 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. Hydroxyzine adds sedative effects to buprenorphine, which may lead to excessive drowsiness and respiratory depression. The risk is higher in opioid-naive patients or those with respiratory disease.
How serious is the interaction between Buprenorphine subdermal implant and Hydroxyzine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use together only when alternatives are inadequate, at the lowest effective hydroxyzine dose. Monitor for sedation and respiratory depression and advise against driving.
What other medicines interact with Hydroxyzine?
MediHelp also lists interactions of Hydroxyzine with, for example, Droperidol, Pimozide, Thioridazine. The full list is on the Hydroxyzine page.
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