Buprenorphine and Cisapride: 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
Buprenorphine
Cisapride
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 buprenorphine (a pain and addiction medicine) and cisapride can affect the timing of your heartbeat. Doctors call this the QT interval. When two medicines that both stretch out that timing are taken together, the effect can add up and, in rare cases, lead to a dangerous irregular heartbeat.
Because of this risk, using these two together is not recommended. The good news is this is easy to avoid. Please don't stop either medicine on your own. Instead, talk with your pharmacist or doctor. They can look at your full medication list and choose a safer combination for you.
Effect: Additive QT interval prolongation with increased risk of serious ventricular arrhythmias (including torsades de pointes).
Mechanism: Both agents independently prolong cardiac repolarization; the effect is additive (pharmacodynamic, not a metabolic interaction). Neither drug is a prodrug here.
- Direction: Additive QT prolongation.
- Severity: Contraindicated per label.
- Evidence: Theoretical / additive PD risk.
- Onset: Unspecified.
Management: Avoid concomitant use. If unavoidable, individualize therapy and monitor closely with ECG and electrolytes (K+, Mg2+). Consider an alternative to one agent.
What happens
Increased risk of QT interval prolongation
Interaction Deep Dive
Combining cisapride with agents known to prolong the QT interval is contraindicated, since taking them together may heighten the likelihood of QT prolongation and serious ventricular arrhythmias1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Because both medicines can affect your heart's rhythm, taking them together is not advised. Here is how a care team usually handles this:
- They review your full medication list to spot this combination.
- They may choose an alternative medicine for one of the two so you avoid using both together.
- If both are truly needed, they may monitor you more closely, including heart tracings (ECG) and blood mineral levels.
What you should do: Keep taking your medicines as prescribed, and don't stop anything on your own. Contact your pharmacist or doctor promptly so they can adjust your plan.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Buprenorphine and Cisapride together?
Combining buprenorphine and cisapride can add up to raise the risk of a dangerous heart rhythm, so this pairing is generally avoided. Talk to your pharmacist or doctor about a safer option before taking both. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Buprenorphine and Cisapride interaction?
It is rated contraindicated. These should generally not be used together.
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 Cisapride interaction managed?
Because both medicines can affect your heart's rhythm, taking them together is not advised. Here is how a care team usually handles this: They review your full medication list to spot this combination. They may choose an alternative medicine for one of the two so you avoid using both together. If both are truly needed, they may monitor you more closely, including heart tracings (ECG) and blood min… 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 Cisapride 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: PROPULSID(R) oral tablets, oral suspension, cisapride oral tablets, oral suspension. Janssen Pharmaceutica, Titusville, NJ, 2000.
Keep reading about Buprenorphine
Keep reading about Cisapride
These medications also interact with supplements
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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