Buprenorphine and Terodiline: 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
Terodiline
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.
Let me explain this one simply. Buprenorphine is an opioid pain and addiction medicine, and one of its common effects is slowing down your gut and making constipation more likely. Terodiline has anticholinergic effects, which also slow the gut and can make it harder to empty your bladder.
When you take both, those slowing effects can add up. In rare cases, the bowel can slow down so much that it nearly stops. This is called paralytic ileus. You could also have trouble urinating. The good news is your care team can watch for this and manage it, so please don't stop either medicine on your own. Just let them know if you notice these problems.
Effect: Additive risk of severe constipation, urinary retention, and potentially paralytic ileus.
Mechanism: Pharmacodynamic (additive), not pharmacokinetic. Buprenorphine reduces GI motility via mu-opioid agonism; terodiline adds anticholinergic suppression of gastric/bladder motility. Neither is a prodrug relevant here.
- Direction: Additive slowing of gut and bladder function.
- Onset: Unspecified.
- Evidence: Theoretical.
- Severity: Major.
- Management: Monitor for reduced gastric motility, abdominal distension, and urinary retention. Encourage hydration/fiber; consider bowel regimen. Dose may be individualized and monitoring intensified by the care team.
What happens
An increased risk of paralytic ileus
Interaction Deep Dive
Using buprenorphine together with an anticholinergic drug can lead to urinary retention or severe constipation that progresses to paralytic ileus. When these two are given at the same time, watch patients for indications of urinary retention or decreased gastric motility1.
Why it happens (mechanism)
Additive effects on gastric motility
How to manage this interaction
This combination can add up in a way that slows your bowels and bladder, so your care team may keep a closer eye on you.
- Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise.
- Watch for warning signs: no bowel movement for days, a bloated or painful belly, nausea/vomiting, or trouble urinating.
- Report these promptly to your pharmacist or doctor.
- Ask whether a bowel routine (fluids, fiber, or a stool softener/laxative) is right for you.
Your team can adjust and individualize your treatment and monitoring to manage this safely.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Buprenorphine and Terodiline together?
Taking buprenorphine with terodiline can add up to cause severe constipation or urinary retention, and rarely a stalled bowel (paralytic ileus). Keep taking both as prescribed and tell your care team right away if your bowels or bladder stop working normally. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Buprenorphine and Terodiline 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 Terodiline interaction managed?
This combination can add up in a way that slows your bowels and bladder, so your care team may keep a closer eye on you. Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise. Watch for warning signs: no bowel movement for days, a bloated or painful belly, nausea/vomiting, or trouble urinating. Report these promptly to your pharmacist or doctor. Ask whether a… 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 Terodiline 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: BRIXADI(TM) subcutaneous extended-release injection, buprenorphine subcutaneous extended-release injection. Braeburn Inc (per FDA), Plymouth Meeting, PA, 2023. DailyMed
Keep reading about Buprenorphine
Keep reading about Terodiline
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