Drug interactions
Buprenorphine transdermal + Hydroxyzine
Severity: Major
Buprenorphine transdermal 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
Combining hydroxyzine with transdermal buprenorphine increases the chance of excessive sedation and respiratory depression. Buprenorphine levels persist after patch removal, so the effect may continue for some time.
What this interaction means in plain words
Buprenorphine transdermal 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
Limit combined use to patients lacking alternatives and use the lowest effective doses for the shortest time. Monitor for sedation and slowed breathing, particularly after dose changes.
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 transdermal with Hydroxyzine?
MediHelp rates the interaction as major. Buprenorphine transdermal 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. Combining hydroxyzine with transdermal buprenorphine increases the chance of excessive sedation and respiratory depression. Buprenorphine levels persist after patch removal, so the effect may continue for some time.
How serious is the interaction between Buprenorphine transdermal 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: Limit combined use to patients lacking alternatives and use the lowest effective doses for the shortest time. Monitor for sedation and slowed breathing, particularly after dose changes.
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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