Drug interactions
Buprenorphine subdermal implant + Isocarboxazid
Severity: Major
Buprenorphine subdermal implant and Isocarboxazid: major 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
Opioids with serotonergic activity combined with MAO inhibitors may cause serotonin syndrome, and buprenorphine adds CNS and respiratory depression. Buprenorphine labeling warns of this combination, though the evidence of serotonin syndrome with buprenorphine is limited.
What this interaction means in plain words
Buprenorphine subdermal implant and Isocarboxazid 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
MAO inhibition increases synaptic serotonin and buprenorphine may add serotonergic effects, plus additive CNS and respiratory depression.
What to do
Avoid the combination where possible, and if used observe closely for serotonin toxicity and sedation, particularly at initiation, and remove the implant if serotonin syndrome is suspected.
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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Other interactions of Isocarboxazid
- 5-HTP + Isocarboxazid Contraindicated
- Amitriptyline + Isocarboxazid Contraindicated
- Amobarbital + Isocarboxazid Contraindicated
- Amoxapine + Isocarboxazid Contraindicated
- Apraclonidine + Isocarboxazid Contraindicated
- Atomoxetine + Isocarboxazid Contraindicated
Frequently asked questions
Can I take Buprenorphine subdermal implant with Isocarboxazid?
MediHelp rates the interaction as major. Buprenorphine subdermal implant and Isocarboxazid 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. Opioids with serotonergic activity combined with MAO inhibitors may cause serotonin syndrome, and buprenorphine adds CNS and respiratory depression. Buprenorphine labeling warns of this combination, though the evidence of serotonin syndrome with buprenorphine is limited.
How serious is the interaction between Buprenorphine subdermal implant and Isocarboxazid?
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 the combination where possible, and if used observe closely for serotonin toxicity and sedation, particularly at initiation, and remove the implant if serotonin syndrome is suspected.
What other medicines interact with Isocarboxazid?
MediHelp also lists interactions of Isocarboxazid with, for example, 5-HTP, Amitriptyline, Amobarbital. The full list is on the Isocarboxazid page.
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