Droperidol 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
Droperidol
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.
Taking buprenorphine and droperidol together needs extra care. Buprenorphine is a strong pain and addiction medicine, and droperidol is often used for nausea or agitation. Both can slow your breathing and make you very sleepy, and both can affect your heart's rhythm (something called QT prolongation). When you combine them, those effects can add up and, in serious cases, lead to dangerously slow breathing or heart rhythm problems.
This does not mean you have to stop either drug on your own. Please don't make any changes yourself. Your doctor and pharmacist can manage this safely by choosing the right doses, watching you more closely, and sometimes checking your heart with an EKG. Reach out to them with any questions.
Effect: Additive QT prolongation plus additive CNS and respiratory depression. Direction is additive pharmacodynamic toxicity; neither agent needs to alter the other's metabolism for the risk to occur.
- Severity/evidence: Major; probable substantiation. Onset unspecified.
- Risks: Profound sedation, respiratory depression, coma, death; torsades-type arrhythmia from combined QT effect.
- Management: Avoid combining buprenorphine with QT-prolonging agents where possible. If coadministration is necessary, use lowest effective doses, monitor closely (consider higher level of care, ECG, and electrolytes), and strongly consider prescribing naloxone. Do not withhold medication-assisted treatment solely due to CNS depressant use.
What happens
An increased risk of QT interval prolongation and an increased risk of CNS and respiratory depression
Interaction Deep Dive
Do not use buprenorphine together with agents that can prolong the QT interval. Combining these medications also heightens the likelihood of respiratory depression, profound sedation, coma, and death. Discontinuing a benzodiazepine or other CNS depressant is favored rather than using it alongside buprenorphine. For some patients, a taper or observation within a higher level of care may be suitable, while for others it may be appropriate to slowly wean the patient off a prescribed benzodiazepine or other CNS depressant, or to reduce the dose to the lowest amount that remains effective. When concurrent use cannot be avoided, exercise caution in monitoring and management; weigh alternative therapies for anxiety or insomnia and give strong consideration to prescribing naloxone for emergency treatment of opioid overdose2. A Swedish epidemiological investigation found that patients on methadone- or buprenorphine-based medication-assisted treatment (MAT) who also received benzodiazepines or other CNS depressants (for instance, agents used for insomnia) face an elevated risk of death. Analysis of aggregate nationwide death certificate records spanning 2010 to 2014 showed that most overdose deaths involving buprenorphine and methadone also involved concurrent CNS depressant use. Whether the risk of overdose death with concomitant CNS depressant drugs varied between buprenorphine and methadone remains unknown 3.
Why it happens (mechanism)
Additive QT interval prolongation; additive CNS depression
How to manage this interaction
Keep taking both exactly as prescribed and do not start, stop, or change either one on your own.
- Your care team will generally try to avoid this combination when possible, or use the lowest effective doses if both are needed.
- They may monitor you more closely, including checking your heart rhythm (EKG) and watching for excess drowsiness or slowed breathing.
- If you are on buprenorphine for opioid use disorder, this treatment should not be stopped just because of this interaction; your team will manage the risk.
- Ask your prescriber whether naloxone should be on hand for emergency use.
Get emergency help for severe drowsiness, trouble breathing, fainting, or irregular heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
3 reports — tap to read
a) An epidemiological study conducted in Sweden found that patients on methadone- or buprenorphine-based medication-assisted treatment (MAT) who also took benzodiazepines or other CNS depressants (for example, medications used for insomnia) have an increased risk of death. From July 1, 2005 to December 31, 2012, the risk of fatal overdose, non-overdose related mortality, and all-cause mortality was examined in MAT-treated patients (aged 18 to 50) by comparing periods when CNS depressants were prescribed against periods without CNS depressant therapy. The findings showed a higher risk of all-cause mortality (adjusted hazard ratio (HR) 1.44; 95% CI, 0.93 to 2.23) and non-overdose related mortality (HR 1.74; 95% CI 1.00 to 3.01) with combined MAT and benzodiazepine treatment; however, these data were not regarded as statistically significant. Although the results also indicated a heightened risk of fatal overdose, non-overdose mortality, and all-cause mortality during periods when MAT and non-benzodiazepines were taken together, only the data for fatal overdose and all-cause mortality reached statistical significance; HR 2.34 (95% CI, 1.37 to 3.99) and HR 1.33 (95% CI, 1.12 to 2.45), respectively. No comparison was made between the benzodiazepine cohort and the non-benzodiazepine cohort because the authors did not adjust for the indication of use for the drugs 3.
b) According to a study of pooled nationwide death certificate data spanning 2010 to 2014, 3495 drug overdose deaths were reported in 2014. Methadone and other CNS depressants were commonly cited as contributors to those deaths. Simultaneous ALPRAZolam use was noted in 18.1% of cases, followed by oxyCODONE (10.1%), cocaine (9.6%), heroin (9%), and diazePAM (6.6%). The FDA documented 322 drug overdose deaths in 2014 that involved buprenorphine. Of these 322 deaths, 32.9% involved ALPRAZolam, 17.4% involved clonazePAM, 11.2% involved diazePAM, 11.2% involved heroin, and 9.9% involved fentanyl. The absolute count of methadone-involved deaths was 10 times that of buprenorphine-involved deaths, though confounding factors and differences in drug utilization were not taken into account. Whether the risk of overdose death with concurrent CNS depressant drugs varied between buprenorphine and methadone is unknown 3.
c) Thorough QT studies involving buprenorphine products have shown modest QT prolongation of 15 msec or less 1.
Common questions
Can I take Droperidol and Buprenorphine together?
Buprenorphine and droperidol together add up to more sedation, slowed breathing, and heart-rhythm (QT) risk, so this combo should be avoided when possible. If both are needed, your care team will use the lowest doses, monitor closely, and may keep naloxone available. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Droperidol 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 Droperidol and Buprenorphine interaction managed?
Keep taking both exactly as prescribed and do not start, stop, or change either one on your own. Your care team will generally try to avoid this combination when possible, or use the lowest effective doses if both are needed. They may monitor you more closely, including checking your heart rhythm (EKG) and watching for excess drowsiness or slowed breathing. If you are on buprenorphine for opioid u… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Droperidol 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 (3)
- Product Information: BRIXADI(TM) subcutaneous extended-release injection, buprenorphine subcutaneous extended-release injection. Braeburn Inc (per FDA), Plymouth Meeting, PA, 2023. DailyMed
- Product Information: SUBUTEX(R) sublingual tablets, buprenorphine sublingual tablets. Indivior Inc (per FDA), North Chesterfield, VA, 2021. DailyMed
- US Food and Drug Administration (FDA): Drug Safety Communications: FDA urges caution about withholding opioid addiction medications from patients taking benzodiazepines or CNS depressants: careful medication management can reduce risks. US Food and Drug Administration (FDA). Silver Spring, MD. 2017.
Keep reading about Buprenorphine
Keep reading about Droperidol
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