Buprenorphine and naloxone interactions

Consider recommending or prescribing an opioid overdose reversal agent ( see WARNINGS, Life-Threatening Respiratory Depression ; DOSAGE AND ADMINISTRATION, Patient Access to Naloxone for the Emergency Treatment of Opioid Overdose ). (Acetaminophen and codeine label, Warnings)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Buprenorphine and naloxone sublingual tablet is contraindicated in patients with a history of hypersensitivity to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported [see Warnings and Precautions (5.9) ] . (Buprenorphine and naloxone label, Contraindications)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

REYATAZ ↓ atazanavir The coadministration of REYATAZ and buprenorphine without ritonavir is not recommended. (Atazanavir label, Drug interactions)

• Avoid concurrent use of alcohol or other central nervous system (CNS) depressants with azelastine hydrochloride and fluticasone propionate nasal spray because further decreased alertness and impairment of CNS performance may occur. (Azelastine and fluticasone label, Warnings and precautions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Withdrawal Avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including belladonna and opium suppositories. (Belladonna and opium label, Warnings and precautions)

Opioid Antagonist: Naloxegol ↑ naloxegol Avoid use with BIXLENVO; if unavoidable, decrease the dosage of naloxegol and monitor for adverse reactions. (Bictegravir, emtricitabine, and tenofovir alafenamide label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Buprenorphine label, Boxed warning)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate Capsules. (Butalbital, acetaminophen, caffeine, and codeine label, Warnings and precautions)

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including BUTALBITAL, ASPIRIN, CAFFEINE and CODEINE PHOSPHATE. (Butalbital, aspirin, caffeine, and codeine label, Warnings and precautions)

Management of respiratory depression may include close observation, supportive measures, and use of opioid overdose reversal agents (e.g., naloxone, nalmefene), depending on the patient's clinical status [see OVERDOSAGE ]. (Butorphanol label, Warnings)

CNS Depressants The concomitant use of EQUETRO and other CNS depressants can increase the risk of respiratory depression, profound sedation, hypotension, and syncope. (Carbamazepine label, Drug interactions)

Avoid concurrent use of Carbinoxamine Maleate Extended-Release Oral Suspension with alcohol or other central nervous system depressants because additional impairment of central nervous system performance may occur. (Carbinoxamine label, Warnings and precautions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Avoid concurrent use of QUZYTTIR with alcohol or other CNS depressants because additional reduction in alertness and additional impairment of CNS performance may occur. (Cetirizine label, Warnings and precautions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.). (Chlorpromazine label, Contraindications)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Table 8: Drugs That are Affected by and Affecting Ciprofloxacin Drugs That are Affected by Ciprofloxacin Drug(s) Recommendation Comments Tizanidine Contraindicated Concomitant administration of tizanidine and ciprofloxacin is contraindicated due to the potentiation of hypotensive and sedative effects of tizanidine [see Contraindications ( 4.2 )]. (Ciprofloxacin label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Avoid use with other central nervous system (CNS) depressants ( 5.3 ) (Clonidine label, Warnings and precautions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including Codeine Sulfate Tablets. (Codeine label, Warnings and precautions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

…elbasvir/grazoprevir Lipid modifying agents: lomitapide, lovastatin, simvastatin Opioid Antagonist: naloxegol PDE-5 inhibitor: sildenafil when used for treatment of pulmonary arterial hypertension Sedatives/hypnotics: orally administered midazolam, triazolam Co-administration of PREZISTA/ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance… (Darunavir label, Contraindications)

…elbasvir/grazoprevir Lipid modifying agents: lomitapide, lovastatin, simvastatin Opioid Antagonist: naloxegol PDE-5 inhibitor: sildenafil when used for treatment of pulmonary arterial hypertension Sedatives/hypnotics: orally administered midazolam, triazolam PREZCOBIX or PREZCOBIX PED is contraindicated in patients receiving certain co-administered drugs for which altered plasma… (Darunavir and cobicistat label, Contraindications)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

CONTRAINDICATIONS Diphenoxylate hydrochloride and atropine sulfate is contraindicated in: • Pediatric patients less than 6 years of age due to the risks of respiratory and central nervous system (CNS) depression (see WARNINGS ). (Diphenoxylate and atropine label, Contraindications)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Central nervous system (CNS) depressants: Concurrent use with alcohol or other CNS depressants is not recommended ( 5.1 ) (Doxylamine and pyridoxine label, Warnings and precautions)

Other risk factors may include age over 65 years, alcohol abuse, and use of agents such as benzodiazepines, volatile anesthetics, and IV opiates. (Droperidol label, Boxed warning)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

…Lipid-modifying Agents: lomitapide, lovastatin, simvastatin Phosphodiesterase-5 (PDE-5) Inhibitor: sildenafil when administered as REVATIO ® for the treatment of pulmonary arterial hypertension Sedative/hypnotics: triazolam, orally administered midazolam Coadministration of GENVOYA is contraindicated with drugs that: Are highly dependent on CYP3A for clearance and for which… (Elvitegravir, cobicistat, emtricitabine, and tenofovir label, Contraindications)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

The use of LUNESTA with other sedative-hypnotics at bedtime or the middle of the night is not recommended. (Eszopiclone label, Warnings and precautions)

Management of respiratory depression may include close observation, supportive measures, and use of opioid overdose reversal agents (e.g., naloxone, nalmefene) , depending on the patient's clinical status [see Overdosage (10) ] . (Fentanyl label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

…Hypericum perforatum ) Lipid modifying agents: Lomitapide, lovastatin, simvastatin Non-nucleoside reverse transcriptase inhibitor: Delavirdine PDE5 inhibitor: Sildenafil (Revatio) (for treatment of pulmonary arterial hypertension) Sedative/hypnotics: Midazolam, triazolam Hypersensitivity to fosamprenavir calcium or amprenavir (e.g., Stevens-Johnson syndrome). (Fosamprenavir label, Contraindications)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Opioids Respiratory depression and sedation, sometimes resulting in death, have been reported following coadministration of gabapentin with opioids (e.g., morphine, hydrocodone, oxycodone, buprenorphine) [see Warnings and Precautions (5.8) ] . (Gabapentin label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Additionally, avoid the use of mixed agonist/antagonist analgesics (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including HYSINGLA ER. (Hydrocodone label, Warnings and precautions)

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including hydrocodone bitartrate and acetaminophen tablets. (Hydrocodone and acetaminophen label, Warnings)

Management of respiratory depression includes discontinuation of Hydrocodone Polistirex and Chlorpheniramine Polistirex, close observation, supportive measures, and use of opioid antagonists (e.g. naloxone), depending on the patient’s clinical status [ see Overdosage (10) ]. (Hydrocodone and chlorpheniramine label, Warnings and precautions)

Management of respiratory depression includes discontinuation of hydrocodone bitartrate and homatropine methylbromide, close observation, supportive measures, and use of opioid overdose reversal agents (e.g., naloxone or nalmefene), depending on the patient's clinical status [see Overdosage (10) ] . (Hydrocodone and homatropine label, Warnings and precautions)

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including Hydrocodone Bitartrate and Ibuprofen Tablets. (Hydrocodone and ibuprofen label, Warnings)

Management of respiratory depression may include close observation, supportive measures, and use of opioid overdose reversal agents (e.g., naloxone, nalmefene), depending on the patient’s clinical status [see Overdosage ( 10 )] . (Hydromorphone label, Warnings and precautions)

Rarely, cardiac arrests and death have been reported in association with the combined use of hydroxyzine hydrochloride intramuscularly and other CNS depressants. (Hydroxyzine label, Precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (e.g., respiratory depression, coma). (Buprenorphine and naloxone label, Drug interactions)

Benzodiazepines, Opioid Analgesics, or other CNS Depressants : Concomitant use may result in profound sedation, respiratory depression, coma, or death. (Ketamine label, Drug interactions)

This may potentiate and prolong hypnotic and sedative effects, especially with repeated dosing or chronic administration of these agents. (Ketoconazole label, Contraindications)

BOXED WARNING Ketorolac tromethamine tablets, a nonsteroidal anti-inflammatory drug (NSAID), are indicated for the short-term (up to 5 days in adults), management of moderately severe acute pain that requires analgesia at the opioid level and only as continuation treatment following IV or IM dosing of ketorolac tromethamine, if necessary. (Ketorolac label, Boxed warning)

Opioid Antagonist: naloxegol ↑ naloxegol Avoid use with SUNLENCA; if unavoidable, decrease the dosage of naloxegol and monitor for adverse reactions. (Lenacapavir label, Drug interactions)

Avoid concurrent use of alcohol or other central nervous system depressants with XYZAL. (Levocetirizine label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including Levorphanol. (Levorphanol label, Warnings)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Increased Risk of Opioid Overdose after Opioid Discontinuation : Patients who complete opioid discontinuation are at an increased risk of fatal overdose should they resume opioid use. (Lofexidine label, Warnings and precautions)

…Hepatitis C direct acting antiviral: elbasvir/grazoprevir HMG-CoA Reductase Inhibitors: lovastatin, simvastatin Microsomal triglyceride transfer protein (MTTP) Inhibitor: lomitapide Non-opioid Analgesic (selective blocker of Nav1.8 sodium channels): suzetrigine PDE5 Inhibitor: sildenafil (Revatio ® ) when used for the treatment of pulmonary arterial hypertension Sedative/Hypnotics:… (Lopinavir and ritonavir label, Contraindications)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

CONTRAINDICATIONS Loxapine is contraindicated in comatose or severe drug-induced depressed states (alcohol, barbiturates, narcotics, etc.). Loxapine is contraindicated in individuals with known hypersensitivity to dibenzoxazepines. (Loxapine label, Contraindications)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Withdrawal Avoid the use of mixed agonist/antagonist (i.e., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist, including METHADOSE. (Methadone label, Warnings and precautions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (e.g., respiratory depression, coma). (Buprenorphine and naloxone label, Drug interactions)

Buprenorphine and naloxone sublingual tablet is contraindicated in patients with a history of hypersensitivity to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported [see Warnings and Precautions (5.9) ] . (Buprenorphine and naloxone label, Contraindications)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including Morphine Sulfate Oral Solution. (Morphine label, Warnings and precautions)

Management of respiratory depression may include close observation, supportive measures, and use of opioid overdose reversal agents (e.g., naloxone, nalmefene), depending on the patient's clinical status [see OVERDOSAGE ]. (Nalbuphine label, Warnings)

Buprenorphine and naloxone sublingual tablet is contraindicated in patients with a history of hypersensitivity to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported [see Warnings and Precautions (5.9) ] . (Buprenorphine and naloxone label, Contraindications)

Buprenorphine and naloxone sublingual tablet is contraindicated in patients with a history of hypersensitivity to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported [see Warnings and Precautions (5.9) ] . (Buprenorphine and naloxone label, Contraindications)

Buprenorphine and naloxone sublingual tablet is contraindicated in patients with a history of hypersensitivity to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported [see Warnings and Precautions (5.9) ] . (Buprenorphine and naloxone label, Contraindications)

Buprenorphine and naloxone sublingual tablet is contraindicated in patients with a history of hypersensitivity to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported [see Warnings and Precautions (5.9) ] . (Buprenorphine and naloxone label, Contraindications)

Buprenorphine and naloxone sublingual tablet is contraindicated in patients with a history of hypersensitivity to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported [see Warnings and Precautions (5.9) ] . (Buprenorphine and naloxone label, Contraindications)

Buprenorphine and naloxone sublingual tablet is contraindicated in patients with a history of hypersensitivity to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported [see Warnings and Precautions (5.9) ] . (Buprenorphine and naloxone label, Contraindications)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

…voclosporin • Microsomal triglyceride transfer protein inhibitor: lomitapide • Migraine medications: eletriptan, ubrogepant • Mineralocorticoid receptor antagonists: finerenone • Non-opioid analgesic (selective blocker of Na v 1.8 sodium channels): suzetrigine • Opioid antagonists: naloxegol • PDE5 inhibitor: sildenafil (Revatio ® ) when used for pulmonary arterial… (Nirmatrelvir and ritonavir label, Contraindications)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Management of respiratory depression may include close observation, supportive measures, and use of opioid opioid overdose reversal agents (e.g., naloxone, nalmefene), depending on the patient’s clinical status [see Overdosage ( 10.2 )] . (Oliceridine label, Warnings and precautions)

• Avoid concurrent use of alcohol or other central nervous system depressants with olopatadine hydrochloride nasal solution (nasal spray) ( 5.2 ). (Olopatadine label, Warnings and precautions)

• Avoid concurrent use of alcohol or other central nervous system (CNS) depressants with RYALTRIS because additional reductions in alertness and additional impairment of CNS performance may occur. (Olopatadine and mometasone label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Muscle Relaxants Clinical Impact: Oxycodone may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Oxycodone label, Drug interactions)

Withdrawal Avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including oxycodone hydrochloride tablets. (Oxycodone and acetaminophen label, Warnings and precautions)

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) and partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including Oxymorphone Hydrochloride Extended-Release Tablets. (Oxymorphone label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Buprenorphine and naloxone sublingual tablet is contraindicated in patients with a history of hypersensitivity to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported [see Warnings and Precautions (5.9) ] . (Buprenorphine and naloxone label, Contraindications)

CONTRAINDICATIONS Perphenazine products are contraindicated in comatose or greatly obtunded patients and in patients receiving large doses of central nervous system depressants (barbiturates, alcohol, narcotics, analgesics, or antihistamines); in the presence of existing blood dyscrasias, bone marrow depression, or liver damage; and in patients who have shown… (Perphenazine label, Contraindications)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS; DEPENDENCE AND WITHDRAWAL REACTIONS AFTER USE OF SEZABY FOR A LONGER DURATION THAN RECOMMENDED; and ABUSE, MISUSE AND ADDICTION WITH UNAPPROVED USE IN ADOLESCENTS AND ADULTS Risks from Concomitant Use with Opioids Concomitant use of phenobarbital products, including SEZABY, and opioids may result in profound sedation,… (Phenobarbital label, Boxed warning)

• Respiratory Depression : May occur with LYRICA when used with concomitant CNS depressants or in the setting of underlying respiratory impairment. (Pregabalin label, Warnings and precautions)

Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.). Do not use in pediatric surgery. (Prochlorperazine label, Contraindications)

Management of respiratory depression includes discontinuation of Promethazine HCl and Codeine Phosphate Oral Solution, close observation, supportive measures, and use of opioid antagonists (e.g. naloxone), depending on the patient’s clinical status [ see Overdosage (10) ]. (Promethazine and codeine label, Warnings and precautions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (e.g., respiratory depression, coma). (Buprenorphine and naloxone label, Drug interactions)

In the case of life-threatening muscle rigidity, a rapid onset neuromuscular blocker or naloxone may be administered. (Remifentanil label, Warnings and precautions)

WARNING: DRUG-DRUG INTERACTIONS LEADING TO POTENTIALLY SERIOUS AND/OR LIFE THREATENING REACTIONS Co-administration of NORVIR with several classes of drugs including sedative hypnotics, antiarrhythmics, or ergot alkaloid preparations may result in potentially serious and/or life-threatening adverse events due to possible effects of NORVIR on the hepatic metabolism… (Ritonavir label, Boxed warning)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (e.g., respiratory depression, coma). (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Risk of Respiratory Depression Sevoflurane may cause respiratory depression, which may be augmented by opioid premedication or other agents causing respiratory depression. (Sevoflurane label, Warnings)

• Central Nervous System Depression Xyrem (sodium oxybate) is a CNS depressant. (Sodium oxybate label, Boxed warning)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Examples: phenelzine, tranylcypromine, linezolid Muscle Relaxants Clinical Impact: Buprenorphine may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Many, but not all, post-marketing reports regarding coma and death involved misuse by self-injection or were associated with the concomitant use of buprenorphine and benzodiazepines or other CNS depressant, including alcohol. (Buprenorphine and naloxone label, Warnings and precautions)

CONTRAINDICATIONS A known hypersensitivity to phenothiazines, comatose or greatly depressed states due to central nervous system depressants and, in cases of existing blood dyscrasias, bone marrow depression and preexisting liver damage. (Trifluoperazine label, Contraindications)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

The use of zaleplon with other sedative-hypnotics at bedtime or the middle of the night is not recommended (see ). (Zaleplon label, Warnings)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

The use of Zolpidem Tartrate with other sedative-hypnotics (including other zolpidem products) at bedtime or the middle of the night is not recommended. (Zolpidem label, Warnings and precautions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Inform patients also that the central nervous system depressant effects of allopurinol tablets may be additive to those of alcohol and other CNS depressants. (Allopurinol label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

25% increase Diazepam Benzodiazepines increase CNS concentrations of adenosine, a potent CNS depressant, while theophylline blocks adenosine receptors. (Aminophylline label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Use with CNS depressants may result in an additive or potentiating effect. (Brimonidine label, Drug interactions)

Use with CNS depressants may result in an additive or potentiating effect. (Brimonidine and timolol label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Possible early warning signs of central nervous system (CNS) toxicity are restlessness, anxiety, incoherent speech, lightheadedness, numbness and tingling of the mouth and lips, metallic taste, tinnitus, dizziness, blurred vision, tremors, twitching, CNS depression, or drowsiness. (Bupivacaine label, Warnings and precautions)

Possible early warning signs of central nervous system (CNS) toxicity are restlessness, anxiety, incoherent speech, lightheadedness, numbness and tingling of the mouth and lips, metallic taste, tinnitus, dizziness, blurred vision, tremors, twitching, CNS depression, or drowsiness. (Bupivacaine and epinephrine label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Opioids: Decreased exposure to clopidogrel. (Clopidogrel label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

…Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin and carbamazepine). (Desmopressin label, Drug interactions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

MOTOFEN ® may potentiate the action of barbiturates, tranquilizers, narcotics, and alcohol. (Difenoxin and atropine label, Drug interactions)

Consider these observations in clinical decisions when prescribing buprenorphine and naloxone sublingual tablets to patients with risk factors such as hypokalemia, bradycardia, recent conversion from atrial fibrillation, congestive heart failure, digitalis therapy, baseline QT prolongation, subclinical long-QT syndrome, or severe hypomagnesemia. (Buprenorphine and naloxone label, Warnings and precautions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Addiction, Abuse, and Misuse: Buprenorphine can be abused in a similar manner to other opioids. (Buprenorphine and naloxone label, Warnings and precautions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Possible early warning signs of central nervous system (CNS) toxicity are restlessness, anxiety, incoherent speech, lightheadedness, metallic taste, tinnitus, dizziness, blurred vision, tremors, twitching, CNS depression, or drowsiness. (Lidocaine and epinephrine label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Methadone Diphenylheptane opioids (e.g., methadone) have been shown in nonclinical studies to dose-dependently reduce the activation of ClC-2 by lubiprostone in the gastrointestinal tract. (Lubiprostone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Concurrent use of metyrosine with alcohol or other CNS depressants can increase their sedative effects. (Metyrosine label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

The interaction with high-dose fentanyl appears to be due to the combination of nifedipine and a beta-blocker, but the possibility that it may occur with nifedipine alone, with low doses of fentanyl, in other surgical procedures, or with other narcotic analgesics cannot be ruled out. (Nifedipine label, Warnings)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Opioids: Decreased exposure to prasugrel. (Prasugrel label, Drug interactions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Isoflurane and enflurane may also prolong the duration of action of initial and maintenance doses of Rocuronium Bromide Injection and decrease the average infusion requirement of Rocuronium Bromide Injection by 40% compared to opioid/nitrous oxide/oxygen anesthesia. (Rocuronium label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

25% increase Diazepam Benzodiazepines increase CNS concentrations of adenosine, a potent CNS depressant, while theophylline blocks adenosine receptors. (Theophylline label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

The recent use of other drugs that cause CNS depression or EPS symptoms may also increase the risk; consider reducing the dosage or discontinuing the drug. (Trimethobenzamide label, Warnings and precautions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

The risk of combining buprenorphine with other QT-prolonging agents is not known. (Buprenorphine and naloxone label, Warnings and precautions)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Buprenorphine and naloxone label, Drug interactions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Warn patients of the potential danger of self-administration of benzodiazepines or other CNS depressants while under treatment with buprenorphine and naloxone sublingual tablets [see Warnings and Precautions (5.3) , Drug Interactions (7) ] . (Buprenorphine and naloxone label, Warnings and precautions)

Examples: Selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase (MAO) inhibitors… (Buprenorphine and naloxone label, Drug interactions)

Examples: Selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase (MAO) inhibitors… (Buprenorphine and naloxone label, Drug interactions)

Antihistamines Amphetamines may counteract the sedative effect of antihistamines. (Dextroamphetamine label, Drug interactions)

In Postanesthetic Use Doxapram is neither an antagonist to muscle relaxant drugs nor a specific narcotic antagonist. (Doxapram label, Warnings)

The “gasping syndrome” is characterized by central nervous system (CNS) depression, metabolic acidosis, and gasping respirations. (Epoetin alfa label, Warnings and precautions)

In RA, concomitant medications besides MTX were nonsteroidal anti-inflammatory agents (NSAIDs), folic acid, corticosteroids and/or narcotics. (Infliximab label, Drug interactions)

Patients with Grade 1 and 2 TFR may also be treated with corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs) and/or narcotic analgesics for management of TFR symptoms. (Lenalidomide label, Warnings and precautions)

…to date with the following: (1) cardiac glycosides– digitalis and digoxin; (2) hypoglycemics–insulin, chlorpropamide, phenformin, tolazamide, and tolbutamide; (3) tranquilizers and sedatives–chlordiazepoxide, diazepam, and phenobarbital; (4) antigout–allopurinol, colchicine, and probenecid; (5) antiarrhythmics–procainamide, propranolol (see WARNINGS however),… (Prazosin label, Drug interactions)

Narcotics: Exacerbation of bradycardia possible. (Pyridostigmine label, Drug interactions)

Examples: Selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase (MAO) inhibitors… (Buprenorphine and naloxone label, Drug interactions)

…adjustment is needed when SINGULAIR is co-administered with theophylline, prednisone, prednisolone, oral contraceptives, fexofenadine, digoxin, warfarin, gemfibrozil, itraconazole, thyroid hormones, sedative hypnotics, non-steroidal anti-inflammatory agents, benzodiazepines, decongestants, and Cytochrome P450 (CYP) enzyme inducers [see Clinical Pharmacology (12.3) ]. (Montelukast label, Drug interactions)