Buprenorphine and Clothiapine: 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
Clothiapine
No brand names on record
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 and clothiapine can affect the timing of your heartbeat. Doctors call this the QT interval. When two medicines that do this are taken together, the effect can add up, and in rare cases that can lead to an irregular heartbeat.
I want to be honest with you: this is based on how the drugs work in theory, not on lots of real-world reports. Many people take medicines like these safely. The important thing is that your care team knows about it. They can keep an eye on your heart, sometimes with an ECG, and adjust things if needed. Please don't stop either medicine on your own. Just check in with your doctor or pharmacist.
Effect: Additive QTc prolongation, increasing theoretical risk of ventricular arrhythmias (including torsades de pointes) when buprenorphine is combined with clothiapine.
Mechanism: Both agents can prolong the QT interval; effects are additive (pharmacodynamic). Neither is a prodrug relevant here.
- Direction: Additive PD effect, not a PK change
- Onset: Unspecified
- Evidence: Theoretical
- Severity: Major
Management: Use cautiously together. Consider baseline and periodic ECG, correct electrolytes (K+, Mg2+), review other QT-prolonging agents, and individualize dosing. Monitor for palpitations, syncope, or dizziness.
What happens
Increased risk of cardiac arrhythmias
Interaction Deep Dive
Exercise caution when clothiapine is given alongside any agent recognized for prolonging the QTc interval. When drugs that prolong the QT interval are used together, their effects may combine with the QTc-prolonging action of clothiapine, thereby heightening the likelihood of cardiac arrhythmias1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Your care team can manage this combination safely with some attention:
- Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Your team may check your heart rhythm with an ECG and review your other medicines that can affect the heartbeat.
- They may check electrolytes like potassium and magnesium, since low levels raise the risk.
- Doses may be adjusted and individualized by your care team, and they may monitor you more closely.
Tell your pharmacist or doctor right away if you notice fainting, dizziness, or a pounding or irregular heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Buprenorphine and Clothiapine together?
Buprenorphine and clothiapine can both prolong the QT interval, so together they may raise the risk of an irregular heartbeat. This is a theoretical concern that your care team can manage with monitoring and dose adjustments, so keep taking both as prescribed and report any fainting or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Buprenorphine and Clothiapine 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 Clothiapine interaction managed?
Your care team can manage this combination safely with some attention: Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Your team may check your heart rhythm with an ECG and review your other medicines that can affect the heartbeat. They may check electrolytes like potassium and magnesium, since low levels raise the risk. Doses may be adjusted and individualized b… 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 Clothiapine 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: ENTUMIN(R) oral tablets, clotiapine oral tablets. Taro International Ltd (per Ministry of Health), Haifa Bay, Israel, 2020.
Keep reading about Buprenorphine
Keep reading about Clothiapine
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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