Drug interactions
Buprenorphine subdermal implant + Verapamil
Severity: Moderate
Buprenorphine subdermal implant and Verapamil: 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
Verapamil, as a moderate CYP3A4 inhibitor, may raise buprenorphine concentrations from the implant. This can cause sedation, respiratory depression and other opioid toxicity, and the fixed implant dose cannot be easily adjusted.
What this interaction means in plain words
Buprenorphine subdermal implant and Verapamil 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
Inhibition of CYP3A4 reduces buprenorphine metabolism.
What to do
Monitor for sedation, respiratory depression and signs of overmedication. If toxicity occurs and the verapamil cannot be reduced or stopped, consider implant removal and switch to an adjustable buprenorphine 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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Frequently asked questions
Can I take Buprenorphine subdermal implant with Verapamil?
MediHelp rates the interaction as moderate. Buprenorphine subdermal implant and Verapamil 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. Verapamil, as a moderate CYP3A4 inhibitor, may raise buprenorphine concentrations from the implant. This can cause sedation, respiratory depression and other opioid toxicity, and the fixed implant dose cannot be easily adjusted.
How serious is the interaction between Buprenorphine subdermal implant and Verapamil?
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 signs of overmedication. If toxicity occurs and the verapamil cannot be reduced or stopped, consider implant removal and switch to an adjustable buprenorphine formulation.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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