Drug Interaction Report

Pasireotide 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

Belbuca Brixadi Buprenex BuTrans Simbadol Sublocade Zorbium
+

Pasireotide

Signifor
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Jul 2, 2026
LinkedIn
Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 64 documented Pasireotide interactions, 62 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
At a glance + Theoretical Effects may be stronger
The Bottom Line
Buprenorphine and pasireotide can each prolong the QT interval, so combining them may add up and raise the risk of a dangerous heart rhythm; your care team may avoid the combination or monitor your ECG and electrolytes closely. Do not stop either medicine on your own.

Both of these medicines can affect your heart's rhythm. Buprenorphine (a pain or opioid-treatment medicine) and pasireotide (Signifor) can each stretch out a part of your heartbeat called the QT interval. When two medicines that do this are taken together, the effect can add up, and a very long QT can rarely lead to a dangerous irregular heartbeat.

This concern is based on how the drugs work rather than a lot of real-world reports, so it may never cause you a problem. Please don't stop either one on your own. Talk with your doctor or pharmacist, especially if you have heart trouble or low potassium or magnesium, so they can keep an eye on things.

Effect: Additive QT-interval prolongation from concomitant buprenorphine and pasireotide. Both agents independently prolong the QT interval; the pharmacodynamic effect is additive. Neither is a prodrug relevant here, and this is a PD (not PK) interaction.

  • Direction: Increased risk of QTc prolongation / torsades de pointes.
  • Evidence: Theoretical; combined risk not quantified.
  • Onset: Unspecified.
  • Management: Avoid concomitant use where possible. If used, obtain baseline and follow-up ECGs, correct and monitor electrolytes (K+, Mg2+), and assess additional risk factors (bradycardia, CHF, congenital long-QT, recent AF conversion, digitalis therapy).
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

An increased risk of QT interval prolongation

Interaction Deep Dive

Buprenorphine should not be used together with medications capable of prolonging the QT interval342. It remains unknown what risk arises from pairing buprenorphine with other agents that prolong the QT interval. When prescribing buprenorphine to patients who carry 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 considerations should factor into clinical decisions1.

Why it happens (mechanism)

Additive QT interval prolongation

How to manage this interaction

Your care team can manage this. Because both drugs can lengthen the QT interval, prescribers often try to avoid using them together when there is another option. If both are needed, expect closer monitoring.

  • Keep taking both exactly as prescribed unless your doctor tells you otherwise.
  • Your team may check an ECG and blood levels of potassium and magnesium, and correct them if low.
  • Tell your prescriber if you have heart failure, a slow or irregular heartbeat, or a family history of long-QT.
  • Seek care for fainting, palpitations, or dizziness.

Raise any questions with your pharmacist or doctor before making changes.

Management is individual — confirm any change with your pharmacist or prescriber.

Common questions

Can I take Pasireotide and Buprenorphine together?

Buprenorphine and pasireotide can each prolong the QT interval, so combining them may add up and raise the risk of a dangerous heart rhythm; your care team may avoid the combination or monitor your ECG and electrolytes closely. Do not stop either medicine on your own. Always confirm with your pharmacist or prescriber before making any change.

How serious is the Pasireotide 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 Pasireotide and Buprenorphine interaction managed?

Your care team can manage this. Because both drugs can lengthen the QT interval, prescribers often try to avoid using them together when there is another option. If both are needed, expect closer monitoring. Keep taking both exactly as prescribed unless your doctor tells you otherwise. Your team may check an ECG and blood levels of potassium and magnesium, and correct them if low. Tell your prescr… 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 Pasireotide 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)

  1. Product Information: BRIXADI(TM) subcutaneous extended-release injection, buprenorphine subcutaneous extended-release injection. Braeburn Inc (per FDA), Plymouth Meeting, PA, 2023. DailyMed
  2. Product Information: BUTRANS(R) transdermal system patch, buprenorphine transdermal system patch. Purdue Pharma L.P. (per FDA), Stamford, CT, 2016. DailyMed
  3. Product Information: BELBUCA(TM) buccal film, buprenorphine buccal film. Endo Pharmaceuticals Inc. (per FDA), Malvern, PA, 2016.
  4. Product Information: BUPRENEX(R) intravenous injection, intramuscular injection, buprenorphine HCl intravenous injection, intramuscular injection. Indivior Inc. (per DailyMed), Richmond, VA, 2016. DailyMed
Was this write-up helpful?
Beyond drug–drug

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.

Coming soon

The instant two-drug checker is on its way.

In the meantime, browse the directory below to look up any drug and see its documented interactions.

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
This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.