Delamanid and Buprenorphine: 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
Delamanid
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 or addiction medicine) and delamanid (a medicine for tuberculosis) can each stretch out a part of your heartbeat called the QT interval. When you take them together, that effect can add up, which in rare cases can lead to an irregular heartbeat.
This concern is theoretical, meaning it is based on how each drug works rather than lots of real-world reports. Please don't stop either medicine on your own. Your care team can manage this well by checking your heart rhythm and keeping an eye on things, so talk with your pharmacist or doctor about the best plan for you.
Additive QT prolongation. Buprenorphine and delamanid both independently prolong the QT interval; combined use produces an additive effect on cardiac repolarization. Neither is a prodrug here, so this is a pharmacodynamic (not metabolic) interaction, and the direction is increased QT risk.
- Evidence: theoretical; combined risk not quantified.
- Onset: unspecified.
- Management: avoid concomitant use where possible. If co-prescribed, obtain baseline and follow-up ECGs, and correct/monitor electrolytes (K+, Mg2+).
- Higher-risk patients: hypokalemia, hypomagnesemia, bradycardia, CHF, recent cardioversion from AF, digitalis therapy, baseline or congenital long-QT.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
The simultaneous administration of buprenorphine with agents capable of extending the QT interval should be avoided 342. It remains unknown what risk arises from pairing buprenorphine with other QT prolonging drugs. When prescribing buprenorphine to patients who present with 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, clinicians should weigh these considerations in their decisions 1.
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. The documented guidance is to avoid combining these when possible, but if both are needed your team can manage the risk.
- Your team may check your heart rhythm with an ECG and monitor you more closely.
- They may check and correct blood minerals like potassium and magnesium.
- Tell your prescriber if you have heart failure, a slow heartbeat, a known long-QT problem, or recently had your heart rhythm reset.
- Report fainting, dizziness, or a fluttering/racing heartbeat right away.
Bring this up with your pharmacist or doctor so the plan fits you.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Delamanid and Buprenorphine together?
Taking buprenorphine and delamanid together may add up to a higher risk of a heart-rhythm change (QT prolongation); don't change your medicines on your own, but ask your care team about heart monitoring, especially if you have heart or electrolyte issues. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Delamanid and Buprenorphine 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 Delamanid and Buprenorphine interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. The documented guidance is to avoid combining these when possible, but if both are needed your team can manage the risk. Your team may check your heart rhythm with an ECG and monitor you more closely. They may check and correct blood minerals like potassium and magnesium. Tell your prescriber if you have heart fail… 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 Delamanid or Buprenorphine 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 Delamanid
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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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