Buprenorphine and naloxone and Granisetron interaction

Buprenorphine and naloxone and Granisetron: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Buprenorphine and naloxone label · effective 2026-06-16

Major

Serotonergic Drugs: Concomitant use may result in serotonin syndrome.

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Moderate

The risk of combining buprenorphine with other QT-prolonging agents is not known.

Warnings and precautionsby drug classView label on DailyMed
Minor

Intervention: None Serotonergic Drugs Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome.

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From the Granisetron (Granisetron Hydrochloride) label · effective 2025-04-24

Minor

In addition, the activity of the cytochrome P-450 subfamily 3A4 (involved in the metabolism of some of the main narcotic analgesic agents) is not modified by granisetron hydrochloride in vitro .

Drug interactionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.