Buprenorphine and Probucol: 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
Probucol
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 of these medicines can affect your heart's rhythm. Buprenorphine (a pain and addiction medicine) and probucol (a cholesterol medicine) can each stretch out part of the heartbeat called the QT interval. When you take them together, that effect may add up, which in rare cases can lead to an irregular heartbeat.
To be clear, this concern is based on how the drugs work in theory, not on lots of real-world reports. The risk goes up if you have things like low potassium or magnesium, a slow heartbeat, or a known heart-rhythm problem. Please don't stop either medicine on your own. Talk with your pharmacist or doctor so they can review your heart health and decide the safest plan for you.
Effect: Additive QT-interval prolongation with concurrent buprenorphine and probucol. Both agents independently carry QT-prolongation potential; combined use is pharmacodynamically additive. Neither is a prodrug here, so this is a PD (not PK) interaction. Direction: increased proarrhythmic risk (torsades de pointes).
- Severity: Major; Onset: unspecified; Evidence: theoretical.
- Magnitude: Not quantified; combined risk unknown.
- Management: Avoid concomitant use where possible. If co-prescribed, obtain baseline/follow-up ECG, correct and monitor K+ and Mg2+, and assess added risk factors (bradycardia, CHF, recent AF cardioversion, digitalis therapy, congenital/subclinical long-QT).
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
The simultaneous administration of buprenorphine alongside agents capable of prolonging the QT interval should be avoided342. It remains unknown what risk is posed by pairing buprenorphine with additional QT prolongation drugs. When prescribing buprenorphine to individuals carrying risk factors, including hypokalemia, bradycardia, recent conversion from atrial fibrillation, congestive heart failure, digitalis therapy, baseline QT prolongation, subclinical long-QT syndrome, or severe hypomagnesemia, these findings should be factored into clinical decision-making1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Keep taking both medicines as prescribed unless your care team tells you otherwise. Because these drugs can add to each other's effect on heart rhythm, your team may choose to manage this carefully.
- They may check an ECG (heart tracing) before and during treatment.
- They may monitor your potassium and magnesium levels and keep them in a healthy range.
- They may review other risk factors such as a slow heartbeat, heart failure, or a known long-QT condition.
- In some cases they may pick an alternative medicine.
Tell your pharmacist or doctor if you feel fainting, dizziness, or a fluttering or pounding heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Buprenorphine and Probucol together?
Buprenorphine and probucol can both prolong the QT interval, so combining them may add to the risk of an abnormal heart rhythm; don't change anything yourself, but ask your doctor or pharmacist to review your heart health and electrolytes. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Buprenorphine and Probucol 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 Probucol interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. Because these drugs can add to each other's effect on heart rhythm, your team may choose to manage this carefully. They may check an ECG (heart tracing) before and during treatment. They may monitor your potassium and magnesium levels and keep them in a healthy range. They may review other risk factors such as a sl… 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 Probucol 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 (4)
- Product Information: BRIXADI(TM) subcutaneous extended-release injection, buprenorphine subcutaneous extended-release injection. Braeburn Inc (per FDA), Plymouth Meeting, PA, 2023. DailyMed
- Product Information: BUTRANS(R) transdermal system patch, buprenorphine transdermal system patch. Purdue Pharma L.P. (per FDA), Stamford, CT, 2016. DailyMed
- Product Information: BELBUCA(TM) buccal film, buprenorphine buccal film. Endo Pharmaceuticals Inc. (per FDA), Malvern, PA, 2016.
- Product Information: BUPRENEX(R) intravenous injection, intramuscular injection, buprenorphine HCl intravenous injection, intramuscular injection. Indivior Inc. (per DailyMed), Richmond, VA, 2016. DailyMed
Keep reading about Buprenorphine
Keep reading about Probucol
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist