Vilanterol 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
Vilanterol
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.
Both of these medicines can affect your heart's rhythm. Buprenorphine (a pain or opioid-dependence medicine) and vilanterol (a breathing medicine found in some inhalers) can each stretch out a part of your heartbeat called the QT interval. When you take them together, that effect may add up, which in rare cases can lead to an irregular heartbeat.
This is a theoretical concern, meaning it hasn't been clearly proven, so please don't panic. Your risk may be higher if you have a slow heart rate, heart failure, or low potassium or magnesium. Keep taking both as prescribed and check with your pharmacist or doctor so they can make sure this combination is right for you.
Effect: Additive risk of QT-interval prolongation with concomitant buprenorphine and vilanterol.
Mechanism: Pharmacodynamic (additive) QT prolongation; neither agent is dependent on the other's metabolism for this effect. Beta-agonists like vilanterol can also cause hypokalemia, potentially compounding the risk.
- Direction/magnitude: Additive QTc effect; magnitude of combined risk not quantified.
- Onset: Unspecified.
- Evidence: Theoretical.
- Management: Avoid combination where feasible. Assess baseline risk factors (hypokalemia, hypomagnesemia, bradycardia, CHF, baseline/congenital QT prolongation, digitalis therapy). Correct electrolytes; consider ECG monitoring if co-prescribed.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
The simultaneous administration of buprenorphine alongside medications that can lengthen the QT interval should be avoided 342. It remains unknown what risk results from pairing buprenorphine with additional agents that prolong QT. When prescribing buprenorphine to patients who present 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, clinicians should take these observations into account in their decision making 1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Keep taking both medicines as prescribed unless your care team tells you otherwise. This is a precaution about your heart rhythm, not an emergency.
- Your care team may review whether both drugs are needed together, or consider an alternative.
- They may check your potassium and magnesium levels and correct them if low.
- They may monitor your heart rhythm more closely (such as with an ECG), especially if you have heart problems, a slow heart rate, or a known QT issue.
- Tell your pharmacist or prescriber if you feel faint, dizzy, or notice a fluttering or irregular heartbeat.
Share your full medication and health history so your team can tailor this safely.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Vilanterol and Buprenorphine together?
Buprenorphine and vilanterol can each prolong the QT interval, and together the effect may add up, so let your care team know you take both. They can check your electrolytes, monitor your heart rhythm, or consider alternatives if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Vilanterol 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 Vilanterol and Buprenorphine interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. This is a precaution about your heart rhythm, not an emergency. Your care team may review whether both drugs are needed together, or consider an alternative. They may check your potassium and magnesium levels and correct them if low. They may monitor your heart rhythm more closely (such as with an ECG), especially… 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 Vilanterol 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 Vilanterol
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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