Buprenorphine and Ethanol: 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
Ethanol
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.
Buprenorphine (found in Belbuca, Suboxone, BuTrans, and others) is a strong medicine that can slow your breathing and make you very sleepy. Alcohol does the same thing. When you combine them, those effects stack on top of each other, and that can become dangerous.
Together they can cause deep sedation, dangerously slow breathing, and in serious cases coma. That is why the safest choice is to avoid alcohol completely while you are on buprenorphine. If you drink, or you are worried about this, please talk with your pharmacist or doctor. They can help you stay safe and answer any questions.
Interaction: Additive CNS and respiratory depression when ethanol is combined with buprenorphine (a partial mu-opioid agonist). Alcohol may also elevate buprenorphine plasma levels.
- Direction: Increased depressant effect (sedation, respiratory depression, potential coma).
- Mechanism: Additive pharmacodynamic CNS depression; possible increase in buprenorphine exposure.
- Onset: Rapid.
- Evidence: Theoretical, but severity rated major given the respiratory-depression risk.
- Management: Advise complete avoidance of alcohol. Counsel on signs of oversedation and respiratory compromise; individualize and monitor as clinically indicated.
What happens
An increased risk of CNS depression and respiratory depression
Interaction Deep Dive
Patients receiving buprenorphine should refrain from drinking alcohol, since doing so can raise plasma concentrations of buprenorphine and heighten the likelihood of CNS depression, such as respiratory depression, deep sedation, and coma21.
Why it happens (mechanism)
Additive CNS depression
How to manage this interaction
The care team's main recommendation here is simple: avoid alcohol while taking buprenorphine. Because both slow the brain and breathing, combining them raises the risk of heavy sedation and dangerously slow breathing.
- Keep taking your buprenorphine as prescribed and do not stop it on your own.
- Do not drink alcohol, including beer, wine, or liquor, while on this medicine.
- Watch for extreme drowsiness, confusion, or slow or shallow breathing, and seek help right away if these occur.
- Tell your pharmacist or prescriber if you drink alcohol, so they can guide you and monitor you more closely if needed.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Buprenorphine and Ethanol together?
Do not drink alcohol while taking buprenorphine, because together they can cause dangerous sedation and slowed breathing. If you drink or have concerns, talk with your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Buprenorphine and Ethanol interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Buprenorphine and Ethanol interaction managed?
The care team's main recommendation here is simple: avoid alcohol while taking buprenorphine. Because both slow the brain and breathing, combining them raises the risk of heavy sedation and dangerously slow breathing. Keep taking your buprenorphine as prescribed and do not stop it on your own. Do not drink alcohol, including beer, wine, or liquor, while on this medicine. Watch for extreme drowsine… 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 Ethanol 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 (2)
- Product Information: BRIXADI(TM) subcutaneous extended-release injection, buprenorphine subcutaneous extended-release injection. Braeburn Inc (per FDA), Plymouth Meeting, PA, 2023. DailyMed
- Product Information: NUCYNTA(R) ER oral extended-release tablets, tapentadol oral extended-release tablets. Depomed, Inc (per FDA), Newark, CA, 2016. DailyMed
Keep reading about Buprenorphine
Keep reading about Ethanol
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