Revumenib 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
Revumenib
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 opioid-dependence medicine) and revumenib (a cancer medicine) can each affect the timing of your heartbeat, something doctors call the QT interval. When two medicines that do this are used together, that effect can add up, which in rare cases can lead to an abnormal heart rhythm.
This concern is based on how these drugs work rather than on lots of real-world reports, so please don't panic. The good news is your care team can manage this. They may check your heart rhythm with an EKG and keep an eye on your blood salt levels. Never stop either medicine on your own, just talk with your doctor or pharmacist.
Effect: Additive risk of QTc prolongation when buprenorphine (a known QT-prolonging opioid) is combined with revumenib. Both are QT-prolonging agents; the mechanism is pharmacodynamic (additive), not a metabolic prodrug interaction.
Direction/onset: Increased QTc; onset unspecified. Evidence: theoretical. Severity: major.
Management:
- Avoid concomitant use where feasible.
- Correct electrolyte abnormalities (K+, Mg2+, Ca2+) before starting revumenib.
- ECG at least weekly for the first 4 weeks, then at least monthly.
- Interrupt revumenib if QTcF >480 to 60 msec above baseline, resume at lower dose. Permanently discontinue for ventricular arrhythmia or life-threatening arrhythmia symptoms.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
Because coadministration may heighten the likelihood of QT interval prolongation, revumenib should not be used together with medications recognized for prolonging the QTc interval. Any electrolyte disturbances should be corrected before revumenib is started. Obtain an ECG no less than once weekly during the initial 4 weeks of therapy, and thereafter at least once a month. When the QTcF rises above 480 msec but remains under 500 msec, hold revumenib and resume it at the same twice-daily dose once the QTcF has fallen back to 480 msec or below. If the QTcF exceeds 500 msec or rises more than 60 msec above baseline, interrupt revumenib and then reintroduce it twice daily at the reduced dose level after the QTcF has returned to 480 msec or lower. Revumenib must be stopped permanently in patients experiencing ventricular arrhythmias as well as in those whose QTc interval prolongation is accompanied by signs or symptoms of a life threatening arrhythmia1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Both drugs can lengthen the QT interval, so your care team will watch your heart rhythm closely and may prefer to avoid using them together if there is a good alternative.
- Keep taking both as prescribed unless your doctor tells you otherwise.
- Expect an EKG at least weekly for the first 4 weeks of revumenib, then at least monthly.
- Your team will check and correct blood salts (potassium, magnesium, calcium) before starting.
- Revumenib dosing may be interrupted, adjusted, and individualized based on your EKG results.
Tell your doctor or pharmacist right away if you feel fainting, dizziness, or a pounding or irregular heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) During the clinical trials, prolongation of the QTc interval was documented as an adverse reaction in 39 (29%) of 135 patients who received revumenib at the recommended dose for relapsed or refractory acute leukemia carrying a KMT2A translocation; this QTc interval prolongation reached Grade 3 in 12%. The QT interval corrected for heart rate using Fridericia's method (QTcF) exceeded 500 msec in 8%, and the rise from baseline QTcF was more than 60 msec in 18%. A revumenib dose reduction was necessary for 5% because of QTc interval prolongation. QTc prolongation was seen in 16% of the 31 patients under 17 years of age, 33% of the 88 patients aged 17 years to under 65 years, and in 50% of the 16 patients 65 years or older 1.
Common questions
Can I take Revumenib and Buprenorphine together?
Buprenorphine and revumenib can both prolong the QT interval, so combining them may add to that risk. Your care team will typically avoid the combination when possible, correct electrolytes, and monitor your heart with regular EKGs, so keep both medicines going and report any fainting or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Revumenib 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 Revumenib and Buprenorphine interaction managed?
Both drugs can lengthen the QT interval, so your care team will watch your heart rhythm closely and may prefer to avoid using them together if there is a good alternative. Keep taking both as prescribed unless your doctor tells you otherwise. Expect an EKG at least weekly for the first 4 weeks of revumenib, then at least monthly. Your team will check and correct blood salts (potassium, magnesium,… 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 Revumenib 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: REVUFORJ oral tablets, revumenib oral tablets. Syndax Pharmaceuticals, Inc. (per FDA), Waltham, MA, 2024. DailyMed
Keep reading about Buprenorphine
Keep reading about Revumenib
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.
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