Drug interactions
Buprenorphine transdermal + Lorazepam
Severity: Major
Buprenorphine transdermal and Lorazepam: major interaction.
Last updated Sources: US FDA label
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
Concurrent benzodiazepine and buprenorphine use increases the risk of profound sedation, respiratory depression, coma and death. Transdermal buprenorphine continues to deliver drug for days, so effects can persist after removal.
What this interaction means in plain words
Buprenorphine transdermal and Lorazepam 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 via GABA-A potentiation and opioid receptor agonism.
What to do
Reserve for patients with no alternatives, use the lowest lorazepam dose and shortest duration, and monitor for respiratory depression and sedation. Provide naloxone and counsel patients and caregivers.
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 Lorazepam
Frequently asked questions
Can I take Buprenorphine transdermal with Lorazepam?
MediHelp rates the interaction as major. Buprenorphine transdermal and Lorazepam 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. Concurrent benzodiazepine and buprenorphine use increases the risk of profound sedation, respiratory depression, coma and death. Transdermal buprenorphine continues to deliver drug for days, so effects can persist after removal.
How serious is the interaction between Buprenorphine transdermal and Lorazepam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve for patients with no alternatives, use the lowest lorazepam dose and shortest duration, and monitor for respiratory depression and sedation. Provide naloxone and counsel patients and caregivers.
What other medicines interact with Lorazepam?
MediHelp also lists interactions of Lorazepam with, for example, Alfentanil, Alprazolam, Amobarbital. The full list is on the Lorazepam page.
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