What medications can you NOT take with Suboxone?
Suboxone is safe and effective when used as prescribed, but it can cause serious side effects when used with many other medications. Drugs that can have negative effects when taken with Suboxone include:
- Benzodiazepines, such as Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), Ativan (lorazepam) and Restoril (temazepam). When used improperly or without medical supervision, these medications can result in slowed breathing which can be life-threatening and cause death
- Any medication that also causes drowsiness as a side effect, such as sedating antihistamines (used to treat allergies), opioids (such as morphine), antidepressants (used to improve mood) or antipsychotics (help with unusual thoughts or behaviors), may have an additive effect, making you more drowsy and affecting your ability to drive or operate a vehicle or machinery or make good decisions
- St. John's wort (an herbal remedy purported to have antidepressant properties)
- Alcohol which can increase side effects such as nausea, vomiting, constipation and headache and also decrease blood pressure, increase your risk of having a heart attack (myocardial infarction), and impair your thinking or reaction times.
These medications may increase the effects of Suboxone:
- Some antibiotics, including Biaxin (clarithromycin) and Ery-Tab (erythromycin)
- Some antidepressants, including Prozac (fluoxetine) and Nardil (phenelzine)
- Antifungals, such as Diflucan (fluconazole), Nizoral (ketoconazole) and Sporanox (itraconazole)
- HIV medications known as protease inhibitors: Crixivan (indinavir), Norvir (ritonavir), Fortovase and Invirase (saquinavir) and Kaletra (lopinavir/ritonavir)
These medications may decrease the effects of Suboxone:
- Some seizure medications, including phenobarbital, Tegretol (carbamazepine) and Dilantin (phenytoin)
- Rifadin (rifampin), a treatment for tuberculosis (can increase the metabolism of Suboxone)
- Revia or Vivitrol (both contain naltrexone)
It's important to tell your doctor about medicines you are taking while you're on Suboxone, including prescription drugs, over-the-counter medicine, vitamins and herbal supplements. Also avoid drinking alcohol, taking sedatives or other opioid pain medication, or using illegal drugs while on Suboxone.
Suboxone is a medication that combines the two drugs buprenorphine and naloxone. It is used to treat addiction to opioid drugs (like heroin) and prescription painkillers, including:
Buprenorphine, the active drug in Suboxone, is a partial opioid agonist. That means it works partially like an opioid, but its effects are weaker than drugs like heroin or methadone. It lowers the effects of withdrawal symptoms and reduces cravings for other opioids.
Naloxone is an opioid antagonist, or "blocker." It is only absorbed if Suboxone is injected instead of being dissolved in the mouth as prescribed. If injected, it causes uncomfortable withdrawal symptoms in order to discourage IV use.
Related questions
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References
- National Alliance on Mental Illness (NAMI). Buprenorphine/naloxone (Suboxone). January 2021. Available at: https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Buprenorphine/Buprenorphine-Naloxone-(Suboxone). [Accessed August 22, 2022].
- McCance-Katz E, Sullivan L, Nallani S. Drug interactions of clinical importance among the opioids, methadone and buprenorphine, and other frequently prescribed medications: a review. Am J Addict. 2010 Jan-Feb; 19(1): 4-16. https://doi.org/10.1111/j.1521-0391.2009.00005.x.
- Substance Abuse and Mental Health Services Administration (SAMHSA). Clinical guidelines for the use of buprenorphine in the treatment of opioid addiction. 2004. Available at: https://www.naabt.org/documents/TIP40.pdf. [Accessed August 22, 2022].
- U.S. National Library of Medicine. Buprenorphine sublingual and buccal (opioid dependence). January 15, 2022. Available at: https://medlineplus.gov/druginfo/meds/a605002.html. [Accessed August 22, 2022].
- Indivior. Suboxone (medication guide). June 2022. Available at: https://www.suboxone.com/pdfs/medication-guide.pdf. [Accessed August 22, 2022].
- What Are the Dangers and Risks of Mixing Suboxone and Alcohol? Updated August 19, 2022. American Addiction Centers. [Accessed August 22, 2022]. https://americanaddictioncenters.org/suboxone/mixing-with-alcohol
- What is Suboxone? Updated July 2022. American Addiction Centers. https://americanaddictioncenters.org/suboxone/what-happens-if-you-take-drugs-while-on-suboxone [Accessed August 22, 2022].
Read next
How long does Suboxone withdrawal last?
Withdrawal symptoms typically last for approximately one month, although this may vary depending on the duration of use, the dosage of Suboxone, alcohol use, and presence of medical conditions including other mental health disorders. Physical symptoms (such as nausea, vomiting, headaches) of withdrawal commonly begin within 24 hours after the last dose and last for approximately 10 days. These are generally worse in the first 72 hours. Continue reading
What happens if you take opiates on Suboxone?
If you use opiates while on Suboxone (a combination of buprenorphine and naloxone), the strong effects or “high” of the opiates will be dulled or blocked. Continue reading
How long should you wait before taking Suboxone?
You typically have to wait 12-24 hours after last using short acting opioids before you start taking Suboxone as a treatment for opioid use disorder. The exact length of time depends on the type of opioid used. Continue reading
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- Side Effects of Suboxone (detailed)
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