Buprenorphine and Lasmiditan: 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
Lasmiditan
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 (a pain and opioid-dependence medicine) and lasmiditan (Reyvow, for migraines) can both nudge up a brain chemical called serotonin. When two medicines do this together, there is a small chance of a reaction called serotonin syndrome. Signs can include a fast heartbeat, high blood pressure, fever, sweating, muscle twitching or stiffness, shivering, agitation, or feeling confused.
The good news is that this is a theoretical concern, meaning it is based on how the drugs work rather than lots of real reports. Many people use both safely. Please don't stop either one on your own. Just let your pharmacist or doctor know you take both so they can keep an eye on you.
Effect: Additive serotonergic activity may increase the risk of serotonin syndrome (hypertension, hyperthermia, myoclonus, altered mental status).
- Mechanism: Lasmiditan is a 5-HT1F agonist; buprenorphine has weak serotonergic properties. Combined use gives additive serotonergic tone. This is a pharmacodynamic interaction, not a PK/enzyme one; neither is a prodrug relevant here.
- Direction/magnitude: Increased serotonergic effect; magnitude not quantified.
- Onset: Unspecified.
- Evidence: Theoretical; severity rated major.
- Management: Use lasmiditan with caution; monitor for serotonergic signs and discontinue lasmiditan if serotonin syndrome is suspected.
What happens
Increased risk of serotonin syndrome (hypertension, hyperthermia, myoclonus, mental status changes)
Interaction Deep Dive
As a serotonin agonist, lasmiditan carries an elevated potential for serotonin syndrome when given together with another serotonergic drug. Exercise caution when lasmiditan is combined with agents that raise serotonin levels, and stop lasmiditan should serotonin syndrome be suspected1.
Why it happens (mechanism)
Additive serotonergic effects
How to manage this interaction
Both medicines can be used together, and your care team can manage this safely.
- Keep taking both as prescribed unless your prescriber tells you otherwise.
- Your team may monitor you more closely and use lasmiditan with caution while you are on buprenorphine.
- Watch for warning signs: rapid heartbeat, high blood pressure, fever, heavy sweating, shivering, muscle twitching or stiffness, agitation, or confusion.
- If these occur, seek medical care promptly; lasmiditan may be stopped if serotonin syndrome is suspected.
- Tell your pharmacist about all serotonergic medicines (including antidepressants) you take.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Buprenorphine and Lasmiditan together?
Taking buprenorphine with lasmiditan can slightly raise the theoretical risk of serotonin syndrome, so watch for symptoms like fever, fast heartbeat, muscle twitching, or confusion. Keep taking both as prescribed and report any of these to your care team right away. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Buprenorphine and Lasmiditan 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 Lasmiditan interaction managed?
Both medicines can be used together, and your care team can manage this safely. Keep taking both as prescribed unless your prescriber tells you otherwise. Your team may monitor you more closely and use lasmiditan with caution while you are on buprenorphine. Watch for warning signs: rapid heartbeat, high blood pressure, fever, heavy sweating, shivering, muscle twitching or stiffness, agitation, or… 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 Lasmiditan 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: REYVOW(TM) oral tablets, lasmiditan oral tablets. Lilly USA LLC (per manufacturer), Indianapolis, IN, 2019. DailyMed
Keep reading about Buprenorphine
Keep reading about Lasmiditan
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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