Osimertinib 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
Osimertinib
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 buprenorphine (a pain and addiction medicine) and osimertinib (a cancer medicine) can affect the timing of your heartbeat. Each one can slightly lengthen a part of the heart's electrical cycle 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 is based on how the drugs work rather than lots of real-world reports, so please don't worry or change anything on your own. Your care team can manage this safely, often by checking an ECG (heart tracing) from time to time. Let them know if you ever feel fainting, dizziness, or a racing or pounding heartbeat.
Effect: Additive QTc prolongation with increased theoretical risk of torsades de pointes when buprenorphine and osimertinib are co-administered.
Mechanism: Both agents independently prolong cardiac repolarization; effect is pharmacodynamic (additive), not a PK/enzyme interaction. Neither is a relevant prodrug here.
- Severity: Major
- Evidence: Theoretical
- Onset: Unspecified
Management: Avoid concomitant use where feasible. If required, obtain periodic ECGs, monitor QTc, and correct electrolytes (K+, Mg2+, Ca2+). Review other QT-prolonging agents and bradycardia risk. Individualize monitoring frequency to patient risk factors.
What happens
Increased risk of QT interval prolongation
Interaction Deep Dive
Where feasible, refrain from using this together with medications recognized to lengthen the QTc interval and carry an established risk of torsades de pointes. Should combined use be required, obtain periodic ECG assessments1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
The main concern is that these two medicines can each stretch the QT interval, and together the effect may add up. Your care team knows how to handle this.
- Keep taking both as prescribed unless your doctor tells you otherwise.
- Your team may check an ECG periodically to watch your heart rhythm, especially when starting or changing doses.
- They may also choose an alternative medicine where possible.
- Ask your pharmacist or prescriber whether any of your other medicines also affect the heart rhythm.
Call your care team right away if you feel fainting, dizziness, or a fast or irregular heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Osimertinib and Buprenorphine together?
Combining buprenorphine and osimertinib can add up their effects on heart rhythm (QT prolongation), so care teams often avoid the combo when possible or monitor with periodic ECGs. Keep taking both as prescribed and report any fainting or irregular heartbeat. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Osimertinib 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 Osimertinib and Buprenorphine interaction managed?
The main concern is that these two medicines can each stretch the QT interval, and together the effect may add up. Your care team knows how to handle this. Keep taking both as prescribed unless your doctor tells you otherwise. Your team may check an ECG periodically to watch your heart rhythm, especially when starting or changing doses. They may also choose an alternative medicine where possible.… 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 Osimertinib 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 (1)
- Product Information: TAGRISSO(R) oral tablets, osimertinib oral tablets. AstraZeneca Pharmaceuticals LP (per manufacturer), Wilmington, DE, 2018. DailyMed
Keep reading about Buprenorphine
Keep reading about Osimertinib
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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