Medications can make a real difference in a person’s life. It can help for anything from getting rid of a migraine to helping you through the challenges of opioid use disorder (OUD). However, all medications come with risks and benefits. Having open conversations with your provider about whether the benefits outweigh the possible risks for you is essential. In this case, we’re talking about buprenorphine and potential drug interactions.

Buprenorphine is a type of medication for opioid use disorder, or MOUD. It works by partially activating the same receptors in the brain that opioids do as a way to reduce withdrawal symptoms, including cravings. It can be taken daily through a pill or film that dissolves under the tongue. However, monthly injections are also available in some clinics.

While buprenorphine can help people along their recovery journey, there could be issues if the ingredients don’t react well to something else in your body. That’s why both you and your providers should keep an eye on certain drug interactions. If your body shows signs of a negative combination between buprenorphine and something else, then changes may need to be made.

Read on to learn the basics of drug interactions. We've also made a list of a few buprenorphine interactions to discuss with your provider. Then, we’ll talk about how Groups can support you if a buprenorphine drug interaction occurs.

What to know about buprenorphine drug interactions

A drug interaction doesn’t simply mean that there’s something else coming into contact with the medication, such as buprenorphine in the body. It means that how the drug affects the body is impacted by something else. It can lead to buprenorphine not working as well. There could also be side effects that are outside of what’s expected of the drug on its own.

There are a few different things that can lead to an interaction with buprenorphine, including:

• Another drug or medication
• A food or drink ingredient
• Supplements
• A pre-existing medical condition

4 buprenorphine drug interactions to be aware of

Buprenorphine is a staple in the treatment for many people with OUD. However, it’s possible that they will need to make adjustments to their current diet or lifestyle if there are potential drug interactions that can do more harm than good.

In the case of certain medical conditions or medications that are seen as required, a different MOUD than buprenorphine may need to be considered, such as methadone.

Here are four buprenorphine drug interactions every patient and provider should monitor:

• Antidepressants

Mental health and OUD can be closely connected. A substance use disorder is a type of mental health condition that requires treatment. But it’s also common for people with OUD to experience symptoms of a co-occurring mental health condition.

Approximately 36% of people with OUD experience depression. Nearly 30% have anxiety symptoms. Anxiety and depression can be managed on a daily basis with antidepressants. However, several types of antidepressants can cause a drug interaction with buprenorphine.

One category of antidepressant is selective serotonin reuptake inhibitors, such as Lexapro (escitalopram) and Celexa (citalopram). They can increase the amount of serotonin in the brain to increase positive emotions. But when mixed with buprenorphine, there’s an increased risk of serotonin syndrome. That basically means that there’s an excess of serotonin. It can lead to symptoms like:

• Agitation
• Rapid heart rate
• Dilated pupils
• Shivering

Serotonin syndrome can be severe in some cases, causing a high fever or seizures. If you experience symptoms of serotonin syndrome, seek emergency medical care immediately.

Along with the risk of serotonin syndrome, the drowsiness that comes from each medication can worsen the side effect, potentially interfering with everyday life.

• Alcohol

Combining alcohol and medication isn’t something that’s ever going to be encouraged by a provider. However, many people like to enjoy a drink or two on the weekends or after a long day. But it’s important to recognize the potential impact that it could have on your buprenorphine.

One of the main things that come from a drug interaction between alcohol and buprenorphine is the intensifying of each one’s effects. They each can cause drowsiness and dizziness. That means the effects could be worsened when they’re combined. You’re essentially doubling their effects.

The sedative effects of alcohol and buprenorphine can also cause slow or shallow breathing. It could potentially lead to a medical emergency or death.

Some people may be able to handle alcohol and buprenorphine better than others. But any amount can bring a risk. You also want to reduce the possibility of becoming dependent on alcohol as a coping mechanism for your OUD recovery.

• Respiratory depression

In the previous point, we talked about how buprenorphine can cause your breathing to slow down, or become shallow. This is what’s known as respiratory depression.

However, it’s also possible to have respiratory depression as a pre-existing condition before starting buprenorphine. The condition makes the drug interaction a larger risk for a medical emergency or death. The breathing can become severely slowed down, or stop altogether.

Respiratory depression can be caused by, or be a side effect of, the use or misuse of a drug or prescription medication, such as opioids or benzodiazepines. But it can also be a chronic condition that stems from impacted breathing. A few examples include chronic obstructive pulmonary disease (COPD) or obstructive sleep apnea.

• Liver disease

Your liver is the main organ that breaks down buprenorphine after each dose. That’s why it’s important to consider the current health of your liver before starting the prescription.

Buprenorphine can increase the enzyme (protein) levels in your liver. It could potentially cause damage, inflammation, and impacted function of the organ. Conditions that affect your liver should be discussed with your provider. Liver disease or hepatitis C are a couple of examples. If your liver has been damaged by alcohol use disorder, that should also be considered.

If buprenorphine still seems like the best option, the liver enzyme levels should be regularly tested and monitored by your provider to reduce the risk of complications down the line.

This is far from being a complete list. There are dozens, if not hundreds, of potential buprenorphine drug interactions. Be sure to be completely open with your provider about your medical history and your habits to reduce the risk of negative impacts.

Groups provides buprenorphine through Suboxone while monitoring for drug interactions

Drug interactions are important to be aware of before you start medication. But it’s possible that you unknowingly eat something or take something that doesn’t agree with buprenorphine. These aren’t setbacks on your recovery. They just mean that you should talk to your provider and see if changes need to be made to reduce the risk of future issues.

Buprenorphine is one of the main ingredients of Suboxone, the medication that we provide for our members at Groups. But we also want to make sure that it’s the safest and most effective option for you as you go through your recovery journey. That’s why we help you manage your medication. We also collaborate with your other providers to determine if changes are ever needed, such as after a drug interaction. It’s possible that Suboxone isn’t the right choice for you, and other MOUD options need to be explored.

Give our Recovery Support Specialists a call today for more information or to begin your recovery. We provide treatment across the country — and we’re always expanding. See if we offer care in your state, either online or at one of our 130+ local offices. If Groups doesn't offer treatment in your area, you can locate other treatment options here.