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Drug Interactions between buprenorphine / naloxone and remifentanil

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

naloxone remifentanil

Applies to: buprenorphine / naloxone and remifentanil

MONITOR: This warning does not apply to the naloxone component in non-injectable formulations of naloxone-containing combination medicines. Naloxone injection is an antagonist that will reverse the actions of opiates. This reversal can occur when the opiate drug is being used clinically and when it is being abused. Physically dependent patients may experience withdrawal symptoms. Abrupt postoperative opioid reversal has resulted in hypotension, ventricular tachycardia and fibrillation, pulmonary edema, cardiac arrest, encephalopathy, and death.

MANAGEMENT: Patients receiving naloxone injection should be monitored for changes in vital signs, nausea, vomiting, diarrhea, aches, fever, runny nose, sneezing, nervousness, irritability, shivering, abdominal cramps.

References (4)
  1. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  2. (2001) "Product Information. Narcan (naloxone)." DuPont Pharmaceuticals
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Cerner Multum, Inc. "Australian Product Information."
Moderate

buprenorphine remifentanil

Applies to: buprenorphine / naloxone and remifentanil

ADJUST DOSE: Potent narcotics, when used as an adjuvant in patients receiving alfentanil, remifentanil, or sufentanil for anesthesia or conscious sedation, may further decrease cardiac output and respiratory drive.

MANAGEMENT: The dosage of alfentanil, remifentanil, or sufentanil may need to be decreased in patients who have received large doses of narcotics.

References (1)
  1. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.

Drug and food interactions

Major

buprenorphine food

Applies to: buprenorphine / naloxone

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including buprenorphine. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

MANAGEMENT: Patients taking buprenorphine should not consume alcohol or use medications that contain alcohol on days of buprenorphine dosing. In general, potent narcotics such as buprenorphine should not be combined with alcohol.

References (4)
  1. (2023) "Product Information. Sublocade (buprenorphine)." Indivior Inc., SUPPL-28
  2. (2023) "Product Information. Probuphine (buprenorphine)." Titan Pharmaceuticals Inc, SUPPL-14
  3. (2023) "Product Information. Buprenorphine (buprenorphine)." G.L. Pharma UK Ltd
  4. (2023) "Product Information. Temgesic (buprenorphine)." Reckitt Benckiser Pty Ltd

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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