Mixing Buprenorphine and Methadone
- Buprenorphine also called
- subutex, suboxone, bupe, bup, buprenorphine/naloxone
- Methadone also called
- dolophine, methadose, done
Unsafe
Buprenorphine displaces methadone from the receptor and replaces it with less activity, so this precipitates withdrawal in anyone with a meaningful methadone level. Switching between the two is a clinical procedure with a taper, not something to improvise.
The risk here is to the body — breathing, heart, temperature or organs. Set limits before you start, because this kind of harm does not announce itself in time to react.
Can you mix Buprenorphine and Methadone?
Risk of serious physical or psychological harm. Not recommended under any circumstances.
- Buprenorphine
- Partial agonist — displaces other opioids off the receptor
- Methadone
- Long-acting — outlasts its own effects by many hours
- Buprenorphine precipitated opioid withdrawal: Prevention and management in the ED setting. https://www.sciencedirect.com/science/article/abs/pii/S0735675722003126
- Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. https://pmc.ncbi.nlm.nih.gov/articles/PMC11437388/
- Practice-Based Guidelines: Buprenorphine in the Age of Fentanyl. SAEM. https://www.saem.org/education/substance-use/practice-based-guidelines-buprenorphine-in-the-age-of-fentanyl
Checking more than two?
Combinations of three or more carry risks that no pair-by-pair chart can show. The checker rates every pair at once and flags the whole-mix ones on top.
Open this in the checkerRelated combinations
All combinations →Rated unsafe. Educational information only, not medical advice. Absence of a documented interaction is not evidence of safety.