When you start taking any medication, it’s important to be aware of potential interactions. An interaction occurs when a food, beverage, or other medication reacts with the drug you’re taking and changes how it acts in the body. It’s easy to accidentally provoke an adverse reaction if you’re not aware of the ways the drugs you’re taking interact with other substances.
Knowing which drugs and substances to stay away from while on a specific treatment regimen is vital to protecting your health. If you’re taking Suboxone® (important safety information), there are certain drugs and substances you’ll have to avoid.
What medications can’t you take with Suboxone?
Sedating antihistamines
Sedating antihistamines, such as Benadryl® and Dramamine®, are allergy and motion sickness medications that cause drowsiness. These medications are often available over the counter and can have interactions with Suboxone.
When taking Suboxone, avoid taking sedating antihistamines. Some of the side effects of the interaction between these two medications can be life-threatening, such as:
- Loss of consciousness
- Extreme drowsiness
- Slowed breathing
- Coma
If you need one, ask your doctor to recommend a different allergy or motion sickness drug while on Suboxone. For example, a non-sedating antihistamine, like cetirizine (Zyrtec®), could be a safe alternative. As always, discussing changes to your established treatment protocol is vital to managing other substances while on Suboxone.
Benzodiazepines
Benzodiazepines (e.g., Xanax®, Ativan®, Klonopin®) are prescription sedative drugs for treating anxiety, insomnia, and seizures. Like Suboxone, they act on the central nervous system. Combining these drugs can produce dangerous side effects like respiratory depression and extreme sleepiness.
Doctors generally avoid prescribing benzodiazepines to someone taking Suboxone and vice versa. If no other suitable treatment is available and your doctor prescribes both, they will likely adjust your dose to be as low as possible. Your doctor will also monitor you for concerning side effects.
Opioids
Although Suboxone contains an opioid, combining it with other opioids can increase the risk of opioid overdose and provoke serious side effects. Some opioids to avoid while using Suboxone include oxycodone, hydrocodone, and morphine.
These opioids generally treat severe pain. If you need pain relief while taking Suboxone, your doctor may recommend alternative pain relief methods or adjust your dose of Suboxone and prescribe a low dose of opioids. Suboxone treatment shouldn’t begin until other opioids are out of your system. Taking Suboxone while other opioids remain in your system can cause withdrawal symptoms.
Other Medications
Outside of these three broad categories of medications that may interact with Suboxone, some other medications that can cause reactions when combined with Suboxone include:
- Antifungals
- Antibiotics
- Rifampin
- Antidepressants
- St. John’s wort
- Gabapentinoids
- Protease inhibitors
Other Substances to Avoid While on Suboxone
Suboxone drug interactions aren’t limited to other medications. Recreational substances and common foods and drinks can also interfere with your treatment.
Alcohol
Alcohol can have harmful interactions with a variety of medications, including Suboxone. If you combine alcohol and Suboxone, you can experience side effects that include:
- Nausea and vomiting
- Changes in blood pressure
- Increased risk of heart attack
- Impaired thinking processes
- Headaches
- Dizziness
Combined use of both alcohol and Suboxone over an extended period can cause even more severe conditions. The following are possible side effects of long-term combined use:
- Weakened immune system
- Increased risk of cardiovascular disease
- Decreased blood flow, leading to issues and organ damage
- Decreased breathing rate, causing possible respiratory infections and brain damage
- Altered thinking, such as depressive thoughts or intentional self-harm
- Coma or death due to decreased breath and heart rate
Avoid excessive alcohol consumption while taking Suboxone. The consequences of mixing these two substances can be deadly.
Grapefruit
Another substance that people taking Suboxone should avoid is grapefruit. Grapefruit (and close relative citrus fruits) can interact with various common medications, including Suboxone. These fruits contain metabolic chemicals that disrupt the body’s normal processes for breaking down medications and make them more concentrated in the bloodstream.
Large amounts of grapefruits or grapefruit juice produce these effects while you’re on Suboxone, so limit your consumption of the fruit as much as possible. The grapefruit can stay in your system for several days; it’s not enough to simply space out taking your Suboxone and consuming grapefruit.
Managing Treatment for Opioid Use Disorder
Keeping track of all these restrictions—as well as the other details of treatment for opioid use disorder—can be overwhelming. Working with a dedicated care team can help.
Ophelia offers at-home opioid addiction treatment with medication and unrivaled support from your personal care team. All visits are conducted online and on your terms, so you don’t have to sacrifice privacy or convenience to receive treatment.
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