Does Buprenorphine Naloxone Interact With Tramadol?

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including tramadol hydrochloride extended-release tablets.

Severity: Major

Severity basis: warnings section (keywords: avoid). Combining Buprenorphine Naloxone (Opioid dependence treatment) and Tramadol (Opioid analgesic) is classified as a major interaction.

What to Do

The label advises avoiding this combination or using it only under close medical supervision. Talk to your prescriber or pharmacist before combining them.

From the FDA Label

Additionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including tramadol hydrochloride extended-release tablets.

Source: FDA structured product labeling (set_id 004de5a4-80f8-4040-a6ea-be5e99352a36).

Buprenorphine Naloxone

Opioid dependence treatment

Brands: Suboxone, Zubsolv

View Buprenorphine Naloxone safety profile

Tramadol

Opioid analgesic

Brands: Ultram, ConZip

View Tramadol 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 It may be incomplete or out of date, and individual circumstances vary.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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