Substance
What not to mix with Buprenorphine
Opioid
Also calledsubutex, suboxone, bupe, bup, buprenorphine/naloxone
Partial agonist — displaces other opioids off the receptor
Summary
Buprenorphine is checked against 40 other substances — 7 dangerous, 7 unsafe and 8 caution.
Dangerous
7- Buprenorphine and CocaineStimulants increase respiration rate allowing for a higher dose of opiates than normal. If the stimulant wears off first then the opiate may overcome…
- Buprenorphine and DXMCNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes DXM, their tolerance…
- Buprenorphine and GHB / GBLThe two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is…
- Buprenorphine and KetamineBoth substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit…
- Buprenorphine and MXEThis combination can potentiate the effects of the opioid
- Buprenorphine and PregabalinHigh risk of death or life-changing injury. Do not combine.
- Buprenorphine and TramadolConcomitant use of tramadol increases the seizure risk in individuals taking other opioids. These agents are often individually epileptogenic and may…
Unsafe
7- Buprenorphine and AlcoholBuprenorphine's partial agonism puts a ceiling on its own respiratory depression, and alcohol goes around that ceiling through a different receptor…
- Buprenorphine and BenzodiazepinesThe main cause of death in people taking buprenorphine. The ceiling does not extend to GABA-A depression. Prescribed benzodiazepines alongside…
- Buprenorphine and DiphenhydramineBoth substances are CNS depressants, potentiating each other strongly and unpredictably, raising the chances of memory loss, severe ataxia, and…
- Buprenorphine and FentanylNot an overdose risk so much as a specific and very unpleasant trap. Buprenorphine binds the mu receptor more tightly than fentanyl and has low…
- Buprenorphine and MethadoneBuprenorphine displaces methadone from the receptor and replaces it with less activity, so this precipitates withdrawal in anyone with a meaningful…
- Buprenorphine and MethamphetamineA stimulant masking opioid sedation is how people miss the point at which they are overdosing. Methamphetamine's long duration means the opioid is…
- Buprenorphine and OpioidsBuprenorphine outcompetes heroin, oxycodone and morphine at the receptor while producing much weaker signalling than they do, so taking it on top of…
Caution
8- Buprenorphine and AmphetaminesStimulants increase respiration rate, which can allow for a higher dose of opiates normal . If the stimulant wears off first then the opiate may…
- Buprenorphine and CodeineBuprenorphine largely blocks codeine's effect. The realistic outcome is that codeine does nothing useful, plus mild withdrawal if buprenorphine has…
- Buprenorphine and KratomTwo partial agonists competing for the same receptor. Buprenorphine binds far more tightly, so it largely displaces kratom and you mostly get…
- Buprenorphine and LithiumNo direct pharmacokinetic interaction, but additive sedation and any dehydration or reduced kidney perfusion can raise lithium levels. Note that…
- Buprenorphine and MAOIsCoadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse…
- Buprenorphine and MephedroneStimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and…
- Buprenorphine and Nitrous OxideBoth substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While…
- Buprenorphine and PCPPCP can reduce opioid tolerance, increasing the risk of overdose
Low / synergy
1Low / no synergy
17Checking more than one?
This page rates Buprenorphine against one substance at a time. Combinations of three or more carry risks that no pair-by-pair list can show — the checker rates every pair at once and flags the whole-mix ones on top.
Open Buprenorphine in the checkerOther opioids
All combinations →Educational information only, not medical advice. Absence of a documented interaction is not evidence of safety. Combination data from the TripSit drug combination chart, retrieved 2026-08-20.