Does Buprenorphine Naloxone Interact With Ketoconazole?

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 or onset of a withdrawal syndrome in patients who have developed physical dependence to buprenorphine.

Severity: Minor

Severity basis: drug interactions section. Combining Buprenorphine Naloxone (Opioid dependence treatment) and Ketoconazole (Azole antifungal (strong CYP3A4 inhibitor)) is classified as a minor interaction.

What to Do

This is generally a minor interaction, but review it with your pharmacist to be sure it is safe for you.

From the FDA Label

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 or onset of a withdrawal syndrome in patients who have developed physical dependence to buprenorphine.

Source: FDA structured product labeling (set_id 8a5edcf9-828c-4f97-b671-268ab13a8ecd).

Buprenorphine Naloxone

Opioid dependence treatment

Brands: Suboxone, Zubsolv

View Buprenorphine Naloxone safety profile

Ketoconazole

Azole antifungal (strong CYP3A4 inhibitor)

Brands: Nizoral

View Ketoconazole safety profile

Check these against your full medication list in our free Interaction Checker

This information is educational — not medical advice.

This page is provided for general educational purposes and summarizes publicly available data from sources such as the U.S. Food & Drug Administration. It is not a substitute for the judgment of a licensed clinician and should not be used to start, stop, or change any medication. It may be incomplete or out of date, and individual circumstances vary. Always talk with your prescriber or pharmacist about your specific medications and health conditions. If you think you may have a medical emergency, call 911.

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