Buprenorphine and Selegiline interaction
Buprenorphine and Selegiline: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
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 (BELBUCA) label · effective 2026-01-02
Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome opioid toxicity (e.g., respiratory depression, coma) [see Warnings and Precautions (5.2) ].
Intervention: The use of BELBUCA is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.
Serotonergic Drugs : Concomitant use may result in serotonin syndrome.
Avoid concomitant use in patients receiving MAOIs or within 14 days of stopping treatment with an MAOI.
Monoamine Oxidase Inhibitors (MAOIs) : Can potentiate the effects of buprenorphine.
From the Selegiline (ZELAPAR) label · effective 2021-06-01
ZELAPAR is contraindicated in patients with: • Concomitant use of opioid drugs (e.g., meperidine, tramadol, or methadone).
ZELAPAR is contraindicated in patients using the following drugs: opioid drugs (e.g., meperidine, tramadol, methadone), MAO inhibitors including selective MAO-B inhibitors, dextromethorphan, St.
Opioid Drugs Because serious, sometimes fatal reactions have been precipitated with concomitant use of opioid drugs (e.g., meperidine and its derivatives, methadone, or tramadol) and MAOIs, including selective MAO-B inhibitors, concomitant use of these drugs with ZELAPAR is contraindicated [see Contraindications ( 4 ) and Warnings and Precautions ( 5.2 )] .
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Open in the checkerNot 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.