Bentazepam and Buprenorphine: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Bentazepam
No brand names on recordBuprenorphine
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Both of your medicines slow down the brain and body. Bentazepam is a benzodiazepine, a calming medicine, and buprenorphine is an opioid used for pain or for treating opioid use disorder. When taken together, their sleepy, calming effects add up. This can make you very drowsy, and in serious cases it can slow your breathing dangerously, even to the point of coma or death.
This is not a reason to panic, and it is not a reason to stop either drug on your own. Many people safely take both when their care team keeps a close eye on them. Please talk with your pharmacist or doctor so they can review your doses and watch you carefully.
Effect: Additive CNS and respiratory depression from combining a benzodiazepine (bentazepam) with the opioid partial agonist buprenorphine. Risk includes profound sedation, respiratory depression, coma, and death.
Mechanism: Pharmacodynamic (additive), not a metabolic/PK interaction; neither agent requires activation to a metabolite for this effect. Evidence: Probable; supported by epidemiologic overdose/mortality data. Severity: Major.
- Avoid or minimize concomitant use where feasible.
- Consider tapering the benzodiazepine or using the lowest effective dose; consider alternatives for anxiety/insomnia.
- If co-prescribed, monitor mental status and respiratory function; manage cautiously, possibly in a higher level of care.
- Do not withhold MAT solely due to CNS depressant use; untreated OUD carries its own mortality risk.
What happens
An increased risk of CNS depression and respiratory depression
Interaction Deep Dive
When buprenorphine is given together with a benzodiazepine, the combined CNS depressant effects may occur, raising the likelihood of respiratory depression, deep sedation, coma, and death. Rather than using these agents together, discontinuing the benzodiazepine or other CNS depressant is the preferred approach. Depending on the situation, it may be suitable to observe the patient in a higher level of care or to implement a taper. Alternatively, slowly weaning a patient from a prescribed benzodiazepine or other CNS depressant, or reducing to the lowest effective dose, may be warranted. Should concurrent use be required, watch for respiratory depression and proceed with caution1. A Swedish epidemiological study found that patients on methadone- or buprenorphine-based medication-assisted treatment (MAT) who also take benzodiazepines or other CNS depressants (for example, medications used for insomnia) face a heightened risk of death. An analysis of pooled nationwide death certificate data spanning 2010 to 2014 showed that most overdose deaths involving buprenorphine and methadone also involved concurrent CNS depressant use. Whether the risk of overdose death from concomitant CNS depressant drugs was different for buprenorphine versus methadone remains unknown 3.
Why it happens (mechanism)
Additive CNS depression
How to manage this interaction
Your care team can manage this combination safely with the right precautions. Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise.
- Your team may look at whether the benzodiazepine can be gradually tapered or reduced to the lowest effective dose, or whether a different treatment for anxiety or sleep would work better.
- They may monitor you more closely for excess drowsiness or slowed breathing, sometimes in a higher level of care.
- Tell your pharmacist or doctor about any new sleepiness, confusion, or trouble breathing right away.
Do not stop either drug suddenly on your own, and never add alcohol or other sedating medicines without checking first.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) A Swedish epidemiological study reported that patients undergoing methadone- or buprenorphine-based medication-assisted treatment (MAT) together with benzodiazepines or other CNS depressants (for example, agents used for insomnia) have an increased risk of death. Between July 1, 2005 and December 31, 2012, investigators evaluated the risk of fatal overdose, non-overdose related mortality, and all-cause mortality by comparing periods when CNS depressants were prescribed to periods without CNS depressant therapy among MAT-treated patients (aged 18 to 50). The findings showed a raised risk of all-cause mortality (adjusted hazard ratio (HR) 1.44; 95% CI, 0.93 to 2.23) and non-overdose related mortality (HR 1.74; 95% CI 1.00 to 3.01) with combined MAT and benzodiazepine treatment; however, these data were not deemed statistically significant. Although the results indicated an elevated risk of fatal overdose, non-overdose mortality, and all-cause mortality during periods of concurrent MAT and non-benzodiazepine use, only the fatal overdose and all-cause mortality data reached statistical significance; HR 2.34 (95% CI, 1.37 to 3.99) and HR 1.33 (95% CI, 1.12 to 2.45), respectively. The authors did not compare the benzodiazepine cohort with the non-benzodiazepine cohort because they did not adjust for the indication of use for the drugs 3.
b) A study of pooled nationwide death certificate data spanning 2010 to 2014 identified 3495 drug overdose deaths in 2014. Methadone and other CNS depressants were commonly cited as contributors to those deaths. Concurrent alprazolam use appeared in 18.1% of cases, followed by oxycodone (10.1%), cocaine (9.6%), heroin (9%), and diazepam (6.6%). The FDA documented 322 drug overdose deaths in 2014 involving buprenorphine. Among these 322 deaths, 32.9% involved alprazolam, 17.4% involved clonazepam, 11.2% involved diazepam, 11.2% involved heroin, and 9.9% involved fentanyl. The absolute count of methadone-involved deaths was 10 times that of buprenorphine-involved deaths, though confounding factors and differences in drug utilization were not taken into account. Whether the risk of overdose death with concurrent CNS depressant drugs differed between buprenorphine and methadone remains unknown 3.
Common questions
Can I take Bentazepam and Buprenorphine together?
Combining bentazepam and buprenorphine adds up their sedating effects and raises the risk of dangerously slowed breathing, so keep taking both only as prescribed and have your care team monitor you closely. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Bentazepam and Buprenorphine interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Bentazepam and Buprenorphine interaction managed?
Your care team can manage this combination safely with the right precautions. Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise. Your team may look at whether the benzodiazepine can be gradually tapered or reduced to the lowest effective dose, or whether a different treatment for anxiety or sleep would work better. They may monitor you more closely for exc… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Bentazepam or Buprenorphine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: BRIXADI(TM) subcutaneous extended-release injection, buprenorphine subcutaneous extended-release injection. Braeburn Inc (per FDA), Plymouth Meeting, PA, 2023. DailyMed
- Product Information: SUBUTEX(R) sublingual tablets, buprenorphine sublingual tablets. Indivior Inc (per FDA), North Chesterfield, VA, 2021. DailyMed
- US Food and Drug Administration (FDA): Drug Safety Communications: FDA urges caution about withholding opioid addiction medications from patients taking benzodiazepines or CNS depressants: careful medication management can reduce risks. US Food and Drug Administration (FDA). Silver Spring, MD. 2017.
Keep reading about Bentazepam
Keep reading about Buprenorphine
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