Drug Interactions Involving Suboxone: Other Prescription Meds, Alcohol, and More
Suboxone, a combination of buprenorphine and naloxone, is a prescription medication used to treat opioid use disorder. While Suboxone can be an effective treatment, it's essential to understand its interactions with other medications, supplements, and foods.
One of the key interactions to be aware of is with opioids and mixed agonist-antagonist opioids. Combining Suboxone with other opioids like pentazocine, nalbuphine, or butorphanol can precipitate withdrawal or cause adverse effects. Taking tramadol with Suboxone requires careful timing—tramadol should be taken only after Suboxone, ideally with medical supervision, to avoid severe precipitated withdrawal symptoms.
Another important interaction to consider is with QT-prolonging agents, which can increase the risk of serious cardiac arrhythmias.
Certain antifungals, antibiotics, and psychotropics can also interact with Suboxone, potentially requiring dose adjustments or avoidance. Supplements and herbals, while not always detailed, should be discussed with your healthcare provider, as they may increase sedation or alter drug levels.
Non-opioid pain relievers like ibuprofen, acetaminophen, and naproxen are usually safe with Suboxone, but combining Suboxone with other pain medications (especially opioids) should only be done under medical supervision to avoid dangerous interactions.
Alcohol can increase CNS depression risks with Suboxone and should generally be avoided or limited. No specific food interactions with Suboxone have been widely reported or documented, but maintaining consistent diet and discussing any herbal supplements with your doctor is advisable.
Before starting treatment with Suboxone, it's crucial to inform your doctor if you're taking any opioid drugs, buspirone, or other medications that may interact with Suboxone. Taking Suboxone in combination with naltrexone may cause opioid withdrawal.
Certain foods and drinks may interact with Suboxone. Grapefruit and grapefruit juice may raise the level of Suboxone in your body, increasing your risk of side effects.
Taking Suboxone and an opioid may increase the risk of side effects from both Suboxone and the opioid. Before you start treatment with Suboxone, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take.
While there aren't any specific reports of vitamins interacting with Suboxone, it's recommended to talk with your doctor or pharmacist before taking any vitamin product with Suboxone.
Suboxone is not known to interact with over-the-counter pain medications, such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol). However, Suboxone can interact with prescription pain medications, such as opioid drugs.
Caffeine is not known to interact with Suboxone. Suboxone and cannabis (marijuana) or CBD have not been specifically reported to interact with each other, but it's advisable to talk with your doctor before using cannabis in combination with Suboxone.
Suboxone and vaccines aren't known to interact with one another. Certain medical conditions and other factors may increase the risk of interactions with Suboxone, including allergic reaction, alcohol misuse, breathing or lung problems, tooth problems, adrenal gland problems, mental health problems, head injury, pregnancy, breastfeeding, liver problems, and a history of substance abuse.
Suboxone can interact with a wide variety of medications, including benzodiazepines, sedatives, muscle relaxers, antipsychotics, opioids, CYP3A4 blockers and inducers, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, monoamine oxidase inhibitors (MAOIs), certain allergy medications called antihistamines, certain treatments for nerve pain, certain stimulant drugs, anticholinergic drugs, drugs that can affect your heart rhythm, diuretics, certain HIV medications, mirtazapine, trazodone, ondansetron, and buspirone.
Always consult a healthcare provider before starting or stopping any medications, supplements, or making dietary changes while on Suboxone. Your doctor will likely recommend that you do not drink alcohol while you're taking Suboxone. You can likely take varenicline (Chantix) with Suboxone. It's safe to take sildenafil (Viagra) during Suboxone treatment, but vardenafil (Levitra) may interact with Suboxone and increase the risk of affecting your heart rhythm.
In summary, key interactions involve opioids (risk of precipitated withdrawal), QT-prolonging medications (heart risk), certain antifungals and psychotropics (dose adjustments needed), and potentially sedative supplements. Always consult a healthcare provider before making any changes to your medication, supplement, or dietary routine while on Suboxone.
- Suboxone, a medication used for opioid use disorder, can interact with QT-prolonging agents, increasing the risk of serious cardiac arrhythmias.
- Combining Suboxone with opioids like pentazocine, nalbuphine, or butorphanol can precipitate withdrawal or cause adverse effects, and careful timing is necessary when taking tramadol with Suboxone.
- Non-opioid pain relievers like ibuprofen, acetaminophen, and naproxen are usually safe with Suboxone, but combining Suboxone with other pain medications (especially opioids) should only be done under medical supervision.
- Suboxone can interact with a wide variety of medications, including benzodiazepines, antipsychotics, opioids, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs), among others.
- Before starting treatment with Suboxone, it's crucial to inform your doctor about any other medications you're taking, such as opioid drugs, buspirone, or other potential interactants.
- Certain medical conditions and factors, including mental health problems, liver problems, and a history of substance abuse, may increase the risk of interactions with Suboxone. Consult a healthcare provider before making any changes to your medication, supplement, or dietary routine while on Suboxone.
