Drug interactions
Bupropion-naltrexone + Flecainide
Severity: Major
Bupropion-naltrexone and Flecainide: 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
Flecainide is metabolized largely by CYP2D6 and has a narrow therapeutic index. Bupropion inhibition can raise flecainide concentrations, increasing risk of conduction slowing and proarrhythmia.
What this interaction means in plain words
Bupropion-naltrexone and Flecainide 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.
Bupropion-naltrexone belongs to Miscellaneous; Flecainide belongs to Cardiovascular.
Why it happens
Bupropion inhibits CYP2D6, decreasing flecainide metabolism.
What to do
Start flecainide at the low end of the dosing range or reduce its dose when bupropion is added, and monitor ECG (PR, QRS) and plasma flecainide levels.
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 Bupropion-naltrexone
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Bupropion-naltrexone + Isocarboxazid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion-naltrexone + Phenelzine Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
Other interactions of Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
Frequently asked questions
Can I take Bupropion-naltrexone with Flecainide?
MediHelp rates the interaction as major. Bupropion-naltrexone and Flecainide 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. Flecainide is metabolized largely by CYP2D6 and has a narrow therapeutic index. Bupropion inhibition can raise flecainide concentrations, increasing risk of conduction slowing and proarrhythmia.
How serious is the interaction between Bupropion-naltrexone and Flecainide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start flecainide at the low end of the dosing range or reduce its dose when bupropion is added, and monitor ECG (PR, QRS) and plasma flecainide levels.
What other medicines interact with Bupropion-naltrexone?
MediHelp also lists interactions of Bupropion-naltrexone with, for example, Hydrocodone, Hydromorphone, Isocarboxazid. The full list is on the Bupropion-naltrexone page.
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