If you’re taking Suboxone, you’re on a path toward the future you want. Suboxone is a commonly used medicine that helps people manage opioid dependence. It works by gently filling spots in your brain that opioids used to, which can help stop cravings and withdrawal symptoms. Just like with any medicine, it’s essential to know how to use it safely, especially when you’re taking other medicines.
This guide is here to help you understand what medicines may not mix well with Suboxone. We want to make sure you stay safe and healthy, not scare you. The most important thing is to always talk to your doctor or a health care provider about all the medicines you take, even the ones you buy without a prescription.
Why do medicines interact?
When you take more than one medicine, they affect different areas of your body. Some medicines can change how others are absorbed, broken down, or removed. This can make one medicine work too well or not well enough.
When taken with Suboxone, certain medications can:
- Increase drowsiness or sedation
- Slow your breathing
- Make side effects worse
- Stop Suboxone from working the right way
Your liver plays a big role in helping to break down medications. If two drugs use the same liver enzymes, they may compete and stay in your body too long or not long enough.
Not all interactions are dangerous, and some can be managed safely. But it’s always important to check with your provider or pharmacist to make sure your medications work well together.
Medicines to be careful about while taking Suboxone
Knowing which medications to avoid or talk about with your provider can help you stay safe and get the best results from your treatment. Medications you should be cautious with include:
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Benzodiazepines (like Xanax, Klonopin, and Valium)
These medicines are often used to treat anxiety, panic attacks, and sometimes trouble sleeping. Both Suboxone and benzodiazepines can make you feel drowsy and slow down your breathing.
Taking them together can make these effects much stronger, which can be very dangerous. It can slow your breathing too much, which can lead to serious problems, like not getting enough air to your brain or even going into a coma.
Always tell your doctor if you’re taking any benzodiazepines or if a doctor tries to prescribe them to you. Your doctor may need to adjust your doses or find a different way to help you with anxiety or sleep.
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Alcohol
Just like with benzodiazepines, alcohol is a depressant. This means it slows down your brain and body, including your breathing. Mixing alcohol with your Suboxone can make you very drowsy, dizzy, and can dangerously slow down your breathing. Even small amounts of alcohol can cause problems. It’s best to avoid alcohol completely while on Suboxone. If you’re struggling with drinking alcohol, tell your doctor so they can help you with that too.
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Other opioid pain medicines (like Oxycodone, Vicodin, Morphine, or Tramadol)
These are strong pain relievers, often given after surgery or for serious injuries. Suboxone is designed to block other opioids from attaching to your brain’s opioid receptors. This means if you take other opioid pain medicines, they may not work as well for pain, or may not work at all. Trying to take more opioid pain medicine to feel it can be very dangerous and lead to an overdose.
Also, if you take full opioids and then start Suboxone, it can cause something called precipitated withdrawal, which is a sudden and unpleasant form of withdrawal. Talk to your doctor right away if you need pain relief for any reason while on Suboxone. They can help you find safe ways to manage your pain that won’t interfere with your Suboxone treatment.
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Muscle relaxers (like Flexeril, Soma, or Zanaflex)
These medicines help relax tight muscles, often used for back pain or muscle spasms. Similar to benzodiazepines or alcohol, muscle relaxers can make you drowsy and slow down your breathing. Combining them with Suboxone can make these effects much stronger and riskier.
If you’re experiencing muscle pain and think you need a muscle relaxer, talk to your doctor first. They can help you decide if it’s safe and what dose to take.
- Certain cold and allergy medicines
Many over-the-counter cold and allergy medicines contain ingredients that can make you drowsy, like diphenhydramine, found in Benadryl and some nighttime cold medicines like NyQuil.
When you take these medicines with Suboxone, you can become more drowsy, confused, or even dizzy. This can make it unsafe to drive or do other activities.
Read the labels carefully on cold and allergy medicines. If they say they cause drowsiness, or if you’re not sure, ask your pharmacist or doctor before taking them. There are often other cold and allergy medicines that won’t make you sleepy.
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Certain antidepressants
These medicines help to balance chemicals in your brain that affect your mood. Some antidepressants, especially older types called tricyclic antidepressants and some newer ones, can increase a chemical in your brain called serotonin.
Suboxone can also have a small effect on serotonin. If serotonin levels get too high, it can lead to a rare but serious condition called serotonin syndrome, which can cause symptoms like a fast heartbeat, sweating, confusion, or stiff muscles.
If you’re taking antidepressants or your doctor wants to start you on one, make sure they know you’re on Suboxone. Often, taking these medicines together is safe under a doctor’s care, but they may need to watch you closely or adjust doses.
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Sleep aids (like Ambien or Lunesta)
These are medicines that help you fall asleep. Like other sedatives, sleep aids can make you very drowsy. When combined with Suboxone, the drowsiness can be much stronger, increasing your risk of falls and other accidents.
If you’re having trouble sleeping, tell your doctor. They can help you find safe ways to improve your sleep without causing dangerous interactions with Suboxone.
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Certain antibiotics and antifungals
These medicines fight infections caused by bacteria or fungi. Some antibiotics and antifungals can change how your body breaks down Suboxone.
This can lead to more Suboxone staying in your body, which may increase its effects or side effects. On the other hand, some antibiotics can make Suboxone work less effectively. .
Always tell your doctor who is prescribing an antibiotic or antifungal that you’re taking Suboxone. They will know which ones are safe to use or if they need to adjust your Suboxone dose.
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Herbal supplements and grapefruit juice
Even though they seem natural, some herbal supplements, such as St. John’s Wort, can make Suboxone less effective. Other herbal supplements can make you sleepier when taken with Suboxone. Grapefruit juice can also make the effects of Suboxone stronger by interfering with how it’s broken down in the liver and intestines, potentially increasing its concentration in your body.
It’s essential to tell your doctor about all herbal supplements you take. It’s also best to avoid grapefruit and grapefruit juice while on Suboxone.
- Over-the-counter pain relievers
You may be wondering about some common pain relievers you can buy without a prescription. Tylenol (acetaminophen) and Advil/Motrin (ibuprofen) are generally considered safe to use with Suboxone for everyday aches and pains.
Topical pain relievers, creams, or patches you put on your skin, like those with lidocaine, are also generally safe.
However, it’s always a good idea to mention to your doctor that you’re using these, especially if you take them regularly.
Information can help you stay safer
Suboxone is a powerful tool to help you on your recovery journey. By being informed and working closely with your health care team, you can use it safely and effectively. You’re doing a great job taking care of yourself, and understanding these interactions is a big part of that. Keep the lines of communication open with your doctor, and you’ll be well on your way to a healthier, safer life.
Staying safer on your recovery journey with Groups
At Groups, we’re here to walk alongside you on your recovery journey. Our program includes medication management, weekly group therapy, and kind, judgment-free support from medical professionals who care. Whether you need help understanding your medications or just someone to talk to, we’re here.
Give our Recovery Support Specialists a call today for more information or to begin your recovery. We provide treatment across the country — and we’re always expanding. See if we offer care in your state, either online or at one of our 130+ local offices. If Groups doesn’t offer treatment in your area, you can locate other treatment options here.
