Triclabendazole 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
Triclabendazole
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 triclabendazole (a medicine that treats a parasite infection) can each affect the timing of your heartbeat, something doctors call the QT interval. When two medicines that do this are taken together, they may add up and slightly raise the chance of an irregular heart rhythm.
I want to be honest with you: this concern is theoretical, meaning it is based on how these drugs work rather than reports of it actually happening. Please don't stop either one on your own. Your care team can watch your heart and adjust things if needed. Just make sure they know you take both.
Effect: Additive risk of QT interval prolongation when buprenorphine is combined with triclabendazole. Both agents have QT-prolonging potential, so the pharmacodynamic effect is additive (not a prodrug or metabolic interaction).
- Direction: Increased combined QT effect.
- Onset: Unspecified.
- Evidence: Theoretical; magnitude of combined risk not established.
- Severity: Major.
Management: Avoid concomitant use where feasible. If co-prescribed, assess baseline risk factors (hypokalemia, hypomagnesemia, bradycardia, CHF, baseline/congenital QT prolongation, digitalis therapy, recent AF conversion), correct electrolytes, and consider ECG monitoring. Individualize based on patient risk.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
The simultaneous use 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 medications that prolong QT. When prescribing buprenorphine for 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 decisions 1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Your care team may take a few sensible steps here:
- They may look for a different medicine where possible, since guidance is to avoid combining these when it can be avoided.
- If both are needed, they may monitor your heart more closely, sometimes with an ECG, and check your potassium and magnesium levels.
- They will pay extra attention if you have heart rhythm issues, a slow heart rate, or take heart medicines like digoxin.
What you can do: Keep taking both exactly as prescribed unless told otherwise. Tell your pharmacist or doctor about all your medicines, and report any fainting, dizziness, or a fluttering or pounding heartbeat right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Triclabendazole and Buprenorphine together?
Taking buprenorphine and triclabendazole together may add up to affect your heart rhythm, so your care team will usually avoid the combination or monitor your heart and electrolytes closely. Keep taking both as prescribed and report any dizziness, fainting, or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Triclabendazole 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 Triclabendazole and Buprenorphine interaction managed?
Your care team may take a few sensible steps here: They may look for a different medicine where possible, since guidance is to avoid combining these when it can be avoided. If both are needed, they may monitor your heart more closely, sometimes with an ECG, and check your potassium and magnesium levels. They will pay extra attention if you have heart rhythm issues, a slow heart rate, or take heart… 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 Triclabendazole 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 Triclabendazole
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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