Drug interactions
Buprenorphine subdermal implant + Linezolid
Severity: Major
Buprenorphine subdermal implant and Linezolid: major interaction.
Last updated Sources: Health Canada product monograph
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
Linezolid is a reversible nonselective MAO inhibitor, and buprenorphine has serotonergic activity. Combined use may precipitate serotonin syndrome, although the risk with buprenorphine is lower than with some other opioids.
What this interaction means in plain words
Buprenorphine subdermal implant and Linezolid 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
Linezolid's MAO inhibition adds to buprenorphine's serotonergic effects, increasing synaptic serotonin.
What to do
Avoid the combination if an alternative antibiotic is suitable. If necessary, monitor for agitation, tremor, hyperreflexia, hyperthermia and clonus, particularly in the first days, and stop linezolid 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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References
Other interactions of Linezolid
- Amoxapine + Linezolid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Benzphetamine + Linezolid Contraindicated
- Brimonidine + Linezolid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion + Linezolid Contraindicated
Frequently asked questions
Can I take Buprenorphine subdermal implant with Linezolid?
MediHelp rates the interaction as major. Buprenorphine subdermal implant and Linezolid 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. Linezolid is a reversible nonselective MAO inhibitor, and buprenorphine has serotonergic activity. Combined use may precipitate serotonin syndrome, although the risk with buprenorphine is lower than with some other opioids.
How serious is the interaction between Buprenorphine subdermal implant and Linezolid?
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 if an alternative antibiotic is suitable. If necessary, monitor for agitation, tremor, hyperreflexia, hyperthermia and clonus, particularly in the first days, and stop linezolid if serotonin syndrome is suspected.
What other medicines interact with Linezolid?
MediHelp also lists interactions of Linezolid with, for example, Amoxapine, Atomoxetine, Benzphetamine. The full list is on the Linezolid page.
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