Can Subutex interact with other medications or foods?

Subutex (buprenorphine), a medicine that helps treat addiction to opioid drugs -- including heroin and narcotic painkillers like morphine -- can interact with alcohol and with many other medications. Interactions can go in both directions: Subutex may interfere with other medicines, and other medicines may interfere with Subutex.

Some interactions can be very serious, even deadly. Drinking alcohol while you are taking Subutex can lead to loss of consciousness or death, for instance. And taking any other medicine that causes drowsiness -- including pain medicines, antihistamines, antianxiety drugs, tranquilizers, antidepressants or sleeping pills -- increases your risk of serious, potentially deadly side effects if you also take Subutex.

Before taking Subutex, tell your doctor and pharmacist if you drink alcohol or grapefruit juice. Also give them a list of all your other medicines (prescription and nonprescription) and dietary and herbal supplements. Once you start taking Subutex, do not take any new medicine or supplement without checking with your doctor and pharmacist first. Be especially careful to mention if you take any of the following:
  • acetaminophen
  • antifungal medications, including ketoconazole, fluconazole and itraconazole
  • antibiotics, including clarithromycin, erythromycin, metronidazole and troleandomycin
  • drugs that suppress the immune system, including cyclosporine 
  • cholesterol-lowering drugs with names that end in "statin"
  • antiseizure medications, including carbamazepine, ethosuximide, phenobarbital and phenytoin
  • cimetidine, a drug that reduces stomach acid
  • danazol, a drug used to treat endometriosis
  • the corticosteroid dexamethasone
  • high blood pressure medicine, including diltiazem and verapamil
  • the asthma medication zafirlukast
  • antidepressants, such as fluoxetine and nefazodone
  • drugs that treat anxiety or obsessive-compulsive disorder, such as fluvoxamine
  • drugs used in the treatment of human immunodeficiency virus (HIV) infection, including delavirdine, indinavir, nelfinavir, saquinavir, rifabutin and ritonavir
  • drugs that treat tuberculosis, including isoniazid and rifampin
  • the diabetes drug troglitazone
  • iron products
  • niacin
  • methotrexate, a drug used to treat psoriasis, rheumatoid arthritis and some forms of cancer
  • oral contraceptives

Continue Learning about Opiate Agonists

How can I prevent breathing problems caused by opioid medications?
Travis M. Hendry, MDTravis M. Hendry, MD
Respiratory depression caused by opioid medications can be prevented by doing the following: Tel...
More Answers
How do opioids relieve pain?
James P. Ioli, DPMJames P. Ioli, DPM
Prescription drugs that contain opioids (opioid analgesics) such as codeine are useful for pain ...
More Answers
Can I use tramadol if I have a history of diabetes?
Stacy Wiegman, PharmDStacy Wiegman, PharmD
Tramadol belongs to a class of drugs called opioid analgesics, which doctors prescribe for the treat...
More Answers
What should I tell my doctor before taking an opioid medication?
Dr. Travis M. Hendry, MDDr. Travis M. Hendry, MD
Before you start taking an opioid medication, talk to your doctor and pharmacist. Follow these tips:...
More Answers

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.