This article describes possible interactions with Suboxone. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Suboxone comes as a film you place under your tongue or against your cheek to dissolve.
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Other drugs and Suboxone
The drugs in the list below may interact with Suboxone. This article doesn’t include all drugs that may interact with Suboxone.
Drug classes or drugs that may interact with Suboxone include:
- benzodiazepines:
- drug examples: alprazolam (Xanax), clonazepam (Klonopin)
- what might happen: can increase the risk of central nervous system (CNS) depression as a side effect of Suboxone and the benzodiazepine drug
- diuretics:
- drug examples: hydrochlorothiazide (Microzide), furosemide (Lasix)
- what might happen: can make the diuretic less effective
- monoamine oxidase inhibitors (MAOIs):
- drug examples: phenelzine (Nardil), tranylcypromine (Parnate)
- what might happen: can increase the risk of side effects of Suboxone and the MAOI drug
- muscle relaxants:
- drug examples: carisoprodol (Soma), cyclobenzaprine (Amrix)
- what might happen: can increase the risk of CNS depression as a side effect of Suboxone and the muscle relaxant drug
- other opioids:
- sedative/hypnotic drugs:
- drug examples: eszopiclone (Lunesta), zolpidem (Ambien)
- what might happen: can increase the risk of CNS depression as a side effect of Suboxone and the sedative/hypnotic drug
- certain antibiotics:
- drug examples: clarithromycin, erythromycin (Eryc, others)
- what might happen: can increase the risk of side effects of Suboxone
- “azole” antifungals:
- drug examples: ketoconazole, itraconazole (Sporanox, Tolsura)
- what might happen: can increase the risk of side effects of Suboxone
- certain antiepileptic drugs:
- drug examples: carbamazepine (Tegretol, others), phenytoin (Dilantin)
- what might happen: can make Suboxone less effective and may trigger opioid withdrawal symptoms
- certain antiretroviral drugs:
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Get free cardWhen to avoid Suboxone
Certain health conditions or other factors could increase some risks with Suboxone. Because of this, doctors may not prescribe Suboxone in these cases. These health conditions or other factors are called contraindications.
Here’s a contraindication for Suboxone:
- Past allergic reaction to Suboxone: If you’ve ever had an allergic reaction to Suboxone or either of its ingredients (buprenorphine and naloxone), taking it again may cause another allergic reaction.
Before you start taking Suboxone, tell your doctor if the above relates to you. They can recommend whether you should take Suboxone.
Alcohol and Suboxone
Suboxone is known to interact with alcohol. It’s best to avoid drinking alcohol while you’re taking Suboxone.
Taking Suboxone and drinking alcohol may cause:
- drowsiness
- CNS depression, which affects your ability to think, move, and make decisions
- coma
It may also cause death in serious cases. If you drink alcohol and have concerns about avoiding it while taking Suboxone, talk with your doctor.
Other interactions and Suboxone
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether Suboxone has these interactions.
The information below doesn’t include all other possible interactions with Suboxone.
Suboxone and supplements
Before taking Suboxone, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Suboxone interactions and herbs
Suboxone may interact with St. John’s wort. This herb is often used to ease symptoms of depression.
Taking Suboxone and St. John’s wort may make Suboxone less effective. It may also trigger opioid withdrawal symptoms. With withdrawal, you experience symptoms when you stop taking a drug that you’re dependent on.
This combination can also increase the risk of serotonin syndrome (high levels of serotonin in your body) as a side effect. Your doctor will likely suggest you don’t take St. John’s wort if you’re prescribed Suboxone.
Because of this, ask your doctor or pharmacist before using any herbs while taking Suboxone.
Suboxone interactions and vitamins
Suboxone isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before using any of these products while taking Suboxone.
Suboxone and food
Suboxone can interact with grapefruit and grapefruit juice. Grapefruit can increase the risk of side effects of Suboxone.
Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking Suboxone.
Suboxone and vaccines
Suboxone isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking Suboxone.
Suboxone and lab tests
Suboxone isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before having any tests while taking Suboxone.
Suboxone and cannabis or CBD
Reports have shown cannabis (commonly called marijuana) and cannabis products may interact with Suboxone. Cannabidiol (CBD) is an example of a cannabis product.
Taking Suboxone and cannabis may cause severe CNS depression. This is because both Suboxone and cannabis can cause this effect on their own. With CNS depression, your brain and nervous system slow down. It can become serious and life threatening if it slows down too much.
Before you take Suboxone, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Health factors and Suboxone
Certain medical conditions or other health factors may increase the risk of interactions with Suboxone. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking Suboxone, tell your doctor about your health history. They’ll determine whether Suboxone is right for you.
These health conditions or other factors might interact with Suboxone:
- Addison’s disease
- adrenal gland conditions, such as adrenal insufficiency
- alcohol use disorder
- breathing or lung conditions, such as asthma
- enlarged prostate or other conditions that cause difficulty with urination
- gallbladder conditions, such as gallstones
- history of a head or brain injury
- history of cavities or other dental conditions
- kidney conditions, such as chronic kidney disease
- forward curvature of the spine
- liver conditions, such as cirrhosis
- mental health conditions, such as depression
- thyroid conditions, such as hypothyroidism
- pregnancy or breastfeeding
- past allergic reaction to Suboxone
Preventing Suboxone interactions
You may be able to help avoid certain interactions with Suboxone. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking Suboxone.
Taking Suboxone exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about Suboxone and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Does my risk of interactions depend on my dosage of Suboxone?
- Do other drugs that could treat my condition have similar interactions?
- If I take Suboxone and have certain health conditions, will you be monitoring me more closely during treatment?
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.