Selected Opioids/Phenobarbital; Primidone Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Initially, both medicines can cause sedation or suppress your natural urge to breathe. Over time, the phenobarbital may speed up how quickly your liver processes your pain medicine.

What might happen:

Initially, you could have more side effects from both medicines, but after you have been on the combination for a while your pain medicine may not work as well.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to monitor you more closely to be sure that you are not having side effects and that both medications are working. Your medicine doses may need to be adjusted.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Duragesic (fentanyl) US prescribing information. Janssen Pharmaceuticals, Inc. August, 2014.
  • 2.Apadaz (benzhydrocodone and acetaminophen) US prescribing information. KemPharm, Inc.. February, 2018.
  • 3.Suboxone sublingual tablet (buprenorphine and naloxone) prescribing information. Reckitt Benckiser Pharmaceuticals Inc. February 1, 2018.
  • 4.Butrans (buprenorphine) US prescribing information. Purdue Pharm L.P. September, 2018.
  • 5.Zohydro ER (hydrocodone bitarate) US prescribing information. Zogenix Inc. August, 2014.
  • 6.Dolophine (methadone hydrochloride) US prescribing information. Wast-Ward Pharmaceuticals Corp. February 1, 2018.
  • 7.OxyContin (oxycodone hydrochloride) US prescribing information. Perdue Pharma L.P. September, 2018.
  • 8.Levopidon (levomethadone) Swedish Summary of Product Characteristics. DNE Pharma AS November 30, 2018.
  • 9.Anderson Gail D. Chapter 42: Pharmacokinetics and Drug Interactions. In: Wyllie's Treatment of Epilepsy: Principles and Practice, 5th Ed. 2011.
  • 10.Center for Substance Abuse Treatment. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40. Substance Abuse and Mental Health Services Administration (US) 2004.
  • 11.McCance-Katz EF, Sullivan LE, Nallani S. Drug interactions of clinical importance among the opioids, methadone and buprenorphine, and other frequently prescribed medications: a review. Am J Addict 2010 Jan-Feb; 19(1):4-16.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.