Buprenorphine and Adagrasib: 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
Adagrasib
Buprenorphine
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 adagrasib (Krazati) and buprenorphine can affect your heart's electrical rhythm in a way called QT prolongation. When two medicines that do this are taken together, the effect can add up, which slightly raises the risk of a dangerous, irregular heartbeat.
This concern is based on how these drugs work rather than lots of real-world reports, but it is still taken seriously. The good news is your care team can manage it. They may check your heart rhythm with an EKG and keep an eye on your blood minerals like potassium and magnesium. Please don't stop or change either medicine on your own. Just talk with your doctor or pharmacist about the best plan for you.
Effect: Additive QTc prolongation, increasing risk of torsade de pointes, polymorphic VT, and other serious arrhythmias.
Mechanism: Both agents prolong the QTc interval; effect is pharmacodynamic (additive), not a prodrug/PK interaction.
Evidence: Theoretical; severity rated major. Onset unspecified.
Management:
- Avoid concomitant use where possible.
- If unavoidable, obtain baseline and periodic ECG plus electrolytes (K+, Mg2+), especially with CHF, bradyarrhythmia, or electrolyte abnormalities.
- Withhold adagrasib if QTc >500 msec or change >60 msec; resume at next lower dose once QTc
What happens
An increased risk of QT interval prolongation, torsade de pointes, polymorphic ventricular tachycardia, other serious arrhythmias
Interaction Deep Dive
Do not use adagrasib together with other agents recognized for their capacity to lengthen the QTc interval. Adagrasib itself prolongs the QTc interval. When taken alongside other products that prolong the QTc interval, the combination can produce a larger increase in the QTc interval as well as adverse reactions linked to QTc interval prolongation, such as torsade de pointes, other serious arrhythmias, and sudden death. In patients who have congestive heart failure, bradyarrhythmias, or electrolyte abnormalities, and in those unable to steer clear of concomitant medications known to prolong the QT interval, obtain an electrocardiogram and electrolyte measurements before beginning adagrasib, throughout concomitant use, and whenever clinically warranted. Hold adagrasib when the QTc interval exceeds 500 msec or when the change from baseline exceeds 60 msec, continuing to withhold until the QTc interval falls below 481 msec or returns to baseline. Then restart adagrasib at the next lower dose level. Adagrasib should be stopped permanently if torsade de pointes, polymorphic ventricular tachycardia, or signs or symptoms of a serious or life-threatening arrhythmia occur1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Whenever possible, this combination is avoided. If your care team decides you need both, they can manage it safely.
- Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise.
- Your team may check an EKG (heart tracing) and blood levels of potassium and magnesium before and during treatment.
- Your adagrasib dose may be adjusted and individualized by your care team based on your EKG results.
- Get medical help right away if you feel a fast, pounding, or irregular heartbeat, dizziness, or fainting.
Raise any heart or medication questions with your pharmacist or prescriber.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Buprenorphine and Adagrasib together?
Adagrasib and buprenorphine can each prolong the QT interval, so together they raise the risk of a dangerous heart rhythm. This combination is generally avoided, but if both are needed, your care team can manage it with EKG and electrolyte monitoring. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Buprenorphine and Adagrasib 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 Buprenorphine and Adagrasib interaction managed?
Whenever possible, this combination is avoided. If your care team decides you need both, they can manage it safely. Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise. Your team may check an EKG (heart tracing) and blood levels of potassium and magnesium before and during treatment. Your adagrasib dose may be adjusted and individualized by your care team based… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Buprenorphine or Adagrasib 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 (1)
- Product Information: KRAZATI(TM) oral tablets, adagrasib oral tablets. Mirati Therapeutics Inc (per FDA), San Diego, CA, 2024. DailyMed
Keep reading about Adagrasib
Keep reading about Buprenorphine
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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