Buprenorphine and Givinostat: 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
Givinostat
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 givinostat (Duvyzat) can affect your heart's electrical timing, a change called QT prolongation. When two medicines that do this are taken together, the effect can add up and, in rare cases, trigger a dangerous fast heartbeat.
Please don't stop either medicine on your own. This is something your care team watches for and manages well. They may check your heart with an ECG and keep an eye on things. If you ever feel fainting, a racing or pounding heartbeat, or dizziness, let your doctor or pharmacist know right away.
Effect: Additive QTc prolongation, increasing risk of torsade de pointes and serious arrhythmia.
Mechanism: Pharmacodynamic (additive), not metabolic. Both agents independently prolong the QT interval; neither is a prodrug relevant here.
Evidence: Theoretical; severity rated major. Onset unspecified.
Management:
- Avoid concomitant use where feasible.
- If unavoidable, obtain baseline ECG, especially with underlying cardiac disease or other QT-prolonging drugs.
- Withhold givinostat if QTc >500 ms or increase >60 ms from baseline.
- Correct electrolytes (K+, Mg2+) and reassess other QT-prolonging agents.
What happens
Increased risk of QT interval prolongation and torsade de pointes
Interaction Deep Dive
Because of the heightened likelihood of QTc interval prolongation, additional serious arrhythmias, torsade de pointes, or death, do not administer givinostat together with other agents recognized as capable of prolonging the QTc interval. When such combined use is unavoidable, ECGs should be performed before givinostat therapy is started in individuals with pre-existing cardiac disease or in those receiving other drugs that produce QTc prolongation. Discontinue givinostat if the QTc interval exceeds 500 ms or if the change relative to baseline exceeds 60 ms1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Your care team can manage this safely. Here is what that usually looks like:
- Keep taking both medicines as prescribed unless your prescriber tells you otherwise.
- Your team may prefer to avoid using them together if there is a good alternative.
- If they are used together, expect an ECG before starting and closer heart monitoring, particularly if you have heart disease or take other medicines that affect heart rhythm.
- Tell your pharmacist or doctor about all your medicines and any fainting, dizziness, or palpitations.
Your team may adjust or pause a medicine based on your ECG results.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Buprenorphine and Givinostat together?
Buprenorphine and givinostat can each prolong the QT interval, so combining them raises the risk of a dangerous heart rhythm; your care team may avoid the combination or monitor you with ECGs. Don't change either medicine on your own, and report any fainting or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Buprenorphine and Givinostat 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 Givinostat interaction managed?
Your care team can manage this safely. Here is what that usually looks like: Keep taking both medicines as prescribed unless your prescriber tells you otherwise. Your team may prefer to avoid using them together if there is a good alternative. If they are used together, expect an ECG before starting and closer heart monitoring, particularly if you have heart disease or take other medicines that af… 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 Givinostat 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: DUVYZAT oral suspension, givinostat oral suspension. ITF Therapeutics, LLC (per FDA), Concord, MA, 2024. DailyMed
Keep reading about Buprenorphine
Keep reading about Givinostat
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