Ziftomenib 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
Ziftomenib
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 addiction medicine) and ziftomenib (a cancer medicine) can each slightly stretch out a part of your heartbeat called the QT interval. When you take them together, that effect can add up, which in rare cases can lead to a dangerous irregular heartbeat.
This concern is based mostly on how these drugs work rather than lots of real-world reports, but it is worth taking seriously. The good news is your care team can manage this. They may check your heart with an EKG and keep a closer eye on you. Please keep taking both exactly as prescribed and talk with your doctor or pharmacist before making any changes.
Effect: Additive QTc prolongation, with increased theoretical risk of torsade de pointes and serious arrhythmias.
Mechanism: Both agents independently prolong the QT interval; effects are additive (a pharmacodynamic interaction, not metabolic). Neither is a prodrug relevant here.
- Severity/Evidence: Major; substantiation is theoretical.
- Onset: Unspecified.
- Management: Avoid coadministration where possible. If unavoidable, obtain baseline and periodic ECGs. Interrupt ziftomenib if QTc exceeds 500 ms or increases more than 60 ms from baseline. Correct electrolytes and review other QT-prolonging agents.
What happens
An increased risk of QT interval prolongation and torsade de pointes
Interaction Deep Dive
Do not give ziftomenib together with other agents recognized to have the capacity to prolong the QTc interval. When such combined use is unavoidable, perform ECGs at the start of therapy, throughout the period of concomitant administration, and whenever clinically warranted. Discontinue ziftomenib if the QTc interval exceeds 500 ms or if the increase from baseline exceeds 60 ms. Such concurrent use can additionally produce adverse reactions linked to QTc interval prolongation, such as torsades de pointes, additional serious arrhythmias, and sudden death1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Your care team can manage this safely. Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise.
- Your team may avoid using these together if there is another option, or watch you more closely if both are needed.
- Expect heart tracing checks (EKGs) when starting, during treatment, and as needed.
- Your ziftomenib may be paused if your EKG shows too much QT change.
Tell your pharmacist or doctor about all your other medicines, and report symptoms like fainting, dizziness, a racing or pounding heartbeat, or palpitations right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Ziftomenib and Buprenorphine together?
Combining buprenorphine and ziftomenib can add up to prolong the QT interval and raise the risk of a dangerous heart rhythm, so your care team will typically avoid the combination or monitor you with EKGs. Keep taking both as prescribed and report any fainting or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ziftomenib 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 Ziftomenib and Buprenorphine interaction managed?
Your care team can manage this safely. Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise. Your team may avoid using these together if there is another option, or watch you more closely if both are needed. Expect heart tracing checks (EKGs) when starting, during treatment, and as needed. Your ziftomenib may be paused if your EKG shows too much QT change. Tell y… 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 Ziftomenib 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: KOMZIFTI™ oral capsules, ziftomenib oral capsules. Kura Oncology, Inc (per manufacturer), San Diego, CA, 2025. DailyMed
Keep reading about Buprenorphine
Keep reading about Ziftomenib
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