Buprenorphine drug interactions

There are currently no reported drug interactions with buprenorphine however, buprenorphine is metabolized primarily by CYP3A4... 

An excellent brief article on buprenorphine treatment has been provided by Taikato et al. (2005), which notes the common possible side-effects (headaches, nausea and vomiting, sweating, constipation, etc.) and drug interactions. The limited central depressant effect of buprenorphine may be compounded by alcohol and antidepressants, while the metabolism of buprenorphine can be enhanced by anticonvulsants, with therefore possibly reduced efficacy. There have been some case reports of liver toxicity from buprenorphine that is reversible if the medication is stopped (Herve et al. 2004), and often clinical guidelines will recommend that liver function tests are included in buprenorphine treatment, as they definitely should be with naltrexone. 

McCance-Katz EF, Moody DE, Morse GD, Ma Q, Rainey PM. Lack of clinically significant drug interactions between nevirapine and buprenorphine. Am J Addict 2010 19(1) 30-7. 

Drug-drug interactions Treatment of pain with opiates can be complicated by respiratory depression and lethargy from overmedication. Buprenorphine is hepatically metabolised by the CYP3A4. Coadministration with a CYP3A4 inhibitor, ketoconazole had no effect on the metabolism of buprenorphine from a transdermal patch delivering drug at 10 Tg/h [91 -]. 

Buprenorphine is a weak analgesic [91], which precludes its ability to replace morphine in the treatment of chronic pain. However, development of compounds that interact with /u receptors in a similar manner as buprenorphine but that are more effective agonists and analgesics could lead to the development of drugs that can be used for the treatment of chronic pain but which have little or no abuse potential. 

Drugs that may interact with buprenorphine hydrochloride include barbiturate anesthetics, benzodiazepines, CNS depressants, CYP3A4 inducers and inhibitors, and MAOIs. 

Buprenorphine is the most lipophilic compound in the oripavine series of compounds and therefore enters the brain very easily. Usually, such a drug would react quickly with its receptor. The fact that it does not is therefore a feature of its interaction with the receptor rather than the ease with which it can reach the receptor. It is 100 times more active than morphine as an agonist and four times more active than nalorphine as an antagonist. It is a particularly safe drug since it has very little effect on respiration and what little effect it does have actually decreases at high doses. Therefore, the risks of suffocation from a drug overdose are much smaller than with... 

Although interaction studies have not been performed, the metabolism of buprenorphine is mediated by the cytochrome P450 isoenzyme CYP3A4 and therefore drugs that induce this enzyme such as carbamazepine, phe-... 

The interaction of buprenorphine with antiretroviral drugs has been reviewed [207 ]. Buprenorphine has fewer interactions with antiretroviral drugs than methadone and is associated with public health benefits, such as reduced risky behavior and spread of HIV. 

Douglas Bruce R, Moody DE, Chodkowski D, Andrews L, Fang WB, Morrison J, et al. Pharmacokinetic interactions between buprenor-phine/naloxone and raltegravir in subjects receiving chronic buprenorphine/naloxone treatment. Am J Drug Alcohol Abuse 2013 39(2) 80-5. 

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