Drug & supplement interaction

Wine + Buprenorphine, Naloxone

Buprenorphine, Naloxone brand names: Zubsolv, Cassipa.

Major Interaction
The bottom line Major

Buprenorphine, Naloxone falls into 2 drug categories that Wine can interact with; the most serious is rated major. Concomitant use may increase sedative and other adverse effects.

Read the full interaction report
SeverityMajor
LikelihoodLikely
Interactions2
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Wine and Buprenorphine, Naloxone

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Wine interacts with whole categories of medication. Buprenorphine, Naloxone falls into 2 of those categories, so it can interact with Wine in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

CNS DEPRESSANTS

1 of 2

Why this applies to Buprenorphine, Naloxone

Buprenorphine, Naloxone falls under CNS DEPRESSANTS — the group Wine interacts with.

Concomitant use may increase sedative and other adverse effects.
Concomitant use of alcohol with CNS depressants can increase sedative and other adverse effects, potentially through inhibition of the metabolism of certain CNS depressants.
Severity Major Likelihood Likely Evidence C

Well-controlled human studies have demonstrated the likely existence of this interaction.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the bottom line: mixing wine with buprenorphine/naloxone (Zubsolv, Cassipa) is a risky combination. Buprenorphine is a partial opioid, and even though it has a bit of a ceiling on its effects, alcohol stacks on top of it. Both slow down your brain and breathing in the same direction, so together they can make you very drowsy, dizzy, confused, or unsteady. In a worst-case scenario, this can dangerously slow your breathing.

Alcohol may also interfere with how some of these medicines are cleared, which can let more drug build up. This is a well-recognized, serious concern, not just a theory. Please don't change anything on your own, but do talk with your pharmacist or doctor about drinking while you're on this medication.

References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
Moderate

NARCOTIC DRUGS

2 of 2

Buprenorphine, Naloxone also falls under NARCOTIC DRUGS.

Concomitant use of large amounts of alcohol may decrease the metabolism of narcotic drugs.
Concomitant consumption of large amounts of alcohol can decrease the metabolism of narcotic drugs.
Severity Moderate Likelihood Possible Evidence C

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

I want to be straight with you about mixing wine with Zubsolv or Cassipa. Buprenorphine is an active opioid medicine (the naloxone is just there to discourage misuse), so it's working as soon as you take it. The concern here is that drinking a good amount of alcohol can slow how your body breaks the medicine down, letting it build up. On top of that, both alcohol and buprenorphine quiet the central nervous system, and that adds up.

What that can look like is heavier drowsiness, dizziness, confusion, and slowed breathing, which in serious cases can be dangerous. Please don't change anything on your own, but do talk with your pharmacist or prescriber about drinking while you're on this medicine.

References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Wine Also Interacts With Other Medications

Wine has 655 major, 270 moderate known drug interactions in our database — the Buprenorphine, Naloxone one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Wine

Covers the 2,830 medications we’ve checked against Wine. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Buprenorphine, Naloxone

This page covers Wine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Buprenorphine, Naloxone page lists 199 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 9 major · 151 moderate · 39 minor.

From our pharmacist’s overview on the Buprenorphine, Naloxone page

“Anything else that sedates is the biggest hazard alongside buprenorphine and naloxone (Zubsolv, Cassipa). Alcohol is rated a major interaction because it deepens an opioid's drowsiness and can slow breathing, and 78 of the 199 ingredients here share that sedating pull, from kava to ordinary sleep aids.”

Reviewed by 2 · Jul 18, 2026

Open the Buprenorphine, Naloxone interaction page

One more smart check

Taking Wine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 8 real supplement products containing Wine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Wine. Your product may carry other ingredients that interact with Buprenorphine, Naloxone too, on top of Wine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Wine and Buprenorphine, Naloxone Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Wine
Top half

#456 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Buprenorphine, Naloxone
Top 25%

#694 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Wine

What is Wine?

  • Social and relaxation use
  • Heart health (popular belief)
  • Antioxidant intake
  • Aiding digestion (traditional use)
  • Culinary flavoring

Wine is an alcoholic beverage made from fermented grapes and is not a true dietary supplement or medicine. Despite popular claims about heart benefits, the alcohol it contains carries real health risks, and no amount of drinking can be recommended to improve health. If you drink, do so in moderation, and avoid alcohol entirely during pregnancy or if you have certain medical conditions.

Read the full Wine monograph & all interactions
Keep checking

Other Drugs & Wine

Browse every other medication we’ve checked against Wine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

655Major
270Moderate
0Minor
1,904No known interaction
Major

655 interactions

Showing 60 of 655 major interactions — see all 655 on the Wine page.

Moderate

270 interactions

Showing 60 of 270 moderate interactions — see all 270 on the Wine page.

No interaction 1,904 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Wine and Buprenorphine, Naloxone Together: Common Questions

Can you take Wine with Buprenorphine, Naloxone?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Wine and Buprenorphine, Naloxone?
Buprenorphine, Naloxone belongs to more than one drug category, and Wine interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Wine and Buprenorphine, Naloxone interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.