Drug interactions
Buprenorphine subdermal implant + Metronidazole
Severity: Moderate
Buprenorphine subdermal implant and Metronidazole: moderate 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
Metronidazole may weakly inhibit CYP3A4 and increase buprenorphine exposure. Because the implant dose cannot be titrated, overexposure could cause sedation or respiratory depression.
What this interaction means in plain words
Buprenorphine subdermal implant and Metronidazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
CYP3A4 inhibition by metronidazole may reduce buprenorphine metabolism.
What to do
Monitor for sedation, respiratory depression and other signs of buprenorphine excess when metronidazole is started. If toxicity occurs and metronidazole cannot be stopped, consider implant removal and switching to an adjustable formulation.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Metronidazole
- Ethanol + Metronidazole Contraindicated
- Metronidazole + Pimozide Contraindicated
- Amiodarone + Metronidazole Major
- Disulfiram + Metronidazole Major
- Ergotamine + Metronidazole Major
- Lomitapide + Metronidazole Major
Frequently asked questions
Can I take Buprenorphine subdermal implant with Metronidazole?
MediHelp rates the interaction as moderate. Buprenorphine subdermal implant and Metronidazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Metronidazole may weakly inhibit CYP3A4 and increase buprenorphine exposure. Because the implant dose cannot be titrated, overexposure could cause sedation or respiratory depression.
How serious is the interaction between Buprenorphine subdermal implant and Metronidazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, respiratory depression and other signs of buprenorphine excess when metronidazole is started. If toxicity occurs and metronidazole cannot be stopped, consider implant removal and switching to an adjustable formulation.
What other medicines interact with Metronidazole?
MediHelp also lists interactions of Metronidazole with, for example, Ethanol, Pimozide, Amiodarone. The full list is on the Metronidazole page.
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