What Medications Can You Not Take with Suboxone? Discover the Risks!9 min read

Are you considering Suboxone treatment for opioid addiction? While Suboxone can be effective in helping individuals overcome opioid dependence, it’s crucial to be aware of potential medication interactions that could pose serious risks. In this article, we will explore the medications that should not be taken with Suboxone, providing you with essential information to make safe and informed decisions on your recovery journey.

  • Potentially Dangerous Interactions: Learn about medications that, when combined with Suboxone, can lead to adverse effects and health risks.
  • Medications that Increase the Risk of Overdose: Discover certain drugs that, when taken along with Suboxone, may heighten the risk of an overdose.
  • Drugs that Reduce the Effectiveness of Suboxone: Find out about specific substances that can diminish the efficacy of Suboxone in treating opioid addiction.
  • Other Substances to Avoid: Explore additional substances, including alcohol and illicit drugs, that should be avoided during Suboxone treatment.
  • Safe Medications to Take with Suboxone: Find comfort in knowing there are medications that can be safely used alongside Suboxone for certain conditions.
  • Consult Your Healthcare Provider: Understand the importance of discussing your medical history and any potential drug interactions with your healthcare provider.

Understanding Potentially Dangerous Interactions

Suboxone, containing buprenorphine and naloxone, can interact negatively with various medications, particularly those that depress the central nervous system. Opioid painkillers like codeine, benzodiazepines such as Xanax, sedatives, and sleeping pills like Ambien, anti-anxiety medications such as Klonopin, and muscle relaxants like Flexeril are some of the medications that can lead to dangerous interactions. When combined, these drugs can cause excessive sedation, respiratory depression, and even fatal overdoses.

Exploring Medications that Increase the Risk of Overdose

Certain antidepressants and antipsychotic medications can amplify the risk of an overdose when taken with Suboxone. Drugs like amitriptyline and risperi may interfere with Suboxone’s effects, leading to potentially harmful outcomes. It is vital for individuals undergoing Suboxone treatment to inform their healthcare providers about all medications they are taking to avoid these risks.

Examples of Antidepressants and Antipsychotic Medications:

  • Amitriptyline
  • Nortriptyline
  • Trazo
  • Abilify
  • Risperdal
  • Zyprexa

Understanding Drugs that Reduce the Effectiveness of Suboxone

Suboxone contains buprenorphine, a partial opioid agonist that occupies opioid receptors in the brain, reducing cravings and withdrawal symptoms. However, certain medications, like opioid antagonists (e.g., naltrexone), opioid partial agonists (e.g., buprenorphine itself), and opioid agonists (e.g., oxyco), can interfere with Suboxone’s mechanism of action. Taking these substances together may lead to decreased effectiveness in treating opioid addiction.

Exploring the Impact of Opioid Antagonists

Opioid antagonists, such as naltrexone, block opioid receptors and can reverse the effects of opioids. When combined with Suboxone, they can diminish the benefits of Suboxone treatment and trigger withdrawal symptoms. Individuals should avoid using opioid antagonists while undergoing Suboxone therapy to ensure the treatment’s effectiveness.

Examples of Opioid Antagonists:

  • Naltrexone (ReVia, Vivitrol)

Understanding the Role of Opioid Partial Agonists

Opioid partial agonists, like buprenorphine (the primary component of Suboxone), activate opioid receptors but produce a milder effect compared to full agonists like heroin. Using other opioid partial agonists alongside Suboxone can lead to an intensified opioid effect, potentially causing respiratory depression and other complications.

Examples of Opioid Partial Agonists:

  • Buprenorphine (Subutex)
  • Butorphanol
  • Pentazocine

Examining the Impact of Opioid Agonists

Opioid agonists, like oxyco and hydroco, fully activate opioid receptors, leading to powerful pain relief and euphoria. Combining these drugs with Suboxone can be dangerous, as they can overpower Suboxone’s effects, resulting in increased opioid dependence and potential overdose.

Examples of Opioid Agonists:

  • Oxyco (OxyContin, Percocet)
  • Hydroco (Vicodin, Norco)
  • Morphine

Other Substances to Avoid during Suboxone Treatment

Apart from specific medications, there are other substances that individuals undergoing Suboxone treatment should avoid. One crucial substance is alcohol, as it can also depress the central nervous system and interact with Suboxone, leading to increased sedation and respiratory issues. Additionally, illicit drugs, such as cocaine, heroin, and methamphetamine, should be strictly avoided, as they can undermine the recovery process and jeopardize overall health. Furthermore, grapefruit and grapefruit juice may inhibit the metabolism of Suboxone, potentially altering its effectiveness.

Understanding the Risks of Alcohol Use

Alcohol is a central nervous system depressant, and when combined with Suboxone, it can intensify sedation and respiratory depression. This combination can be life-threatening and may lead to severe health consequences. Therefore, individuals receiving Suboxone treatment should refrain from alcohol consumption entirely.

Exploring the Dangers of Illicit Drugs

Illicit drugs like cocaine, heroin, and methamphetamine can counteract the effects of Suboxone and hinder the recovery process. These substances may trigger powerful cravings and reignite addiction, potentially leading to relapse. Individuals in recovery should steer clear of illicit drugs to maintain the progress achieved through Suboxone treatment.

Examples of Illicit Drugs to Avoid:

  • Cocaine
  • Heroin
  • Methamphetamine

Understanding the Grapefruit Interaction

Grapefruit and grapefruit juice contain compounds that can interfere with the enzymes responsible for metabolizing medications, including Suboxone. When these substances are consumed together, the levels of Suboxone in the body may become too high, leading to potential side effects and reduced effectiveness of the treatment.

Safe Medications to Take with Suboxone

While certain medications should be avoided during Suboxone treatment, there are still options for addressing other health issues. Acetaminophen (commonly known as Tylenol) and ibuprofen (Advil, Motrin) are generally safe to use for pain relief when necessary. Antihistamines, like Claritin, Zyrtec, and Allegra, can be used for allergy symptoms without any significant interactions. Additionally, antacids such as Tums, Maalox, and Mylanta can be safely taken for indigestion or heartburn.

Understanding Acetaminophen and Ibuprofen Use

Acetaminophen and ibuprofen are over-the-counter medications commonly used for pain and fever relief. These drugs do not interact significantly with Suboxone and can be safely taken as directed. It is essential to follow the recommended dosages and consult with a healthcare provider if you have any concerns.

Exploring Antihistamine Use with Suboxone

Antihistamines are often used to manage allergy symptoms such as sneezing, runny nose, and itching. They do not have significant interactions with Suboxone and can be used to alleviate allergy discomfort without compromising the effectiveness of Suboxone treatment.

Examples of Antihistamines:

  • Claritin (Loratadine)
  • Zyrtec (Cetirizine)
  • Allegra (Fexofenadine)

Understanding Antacids for Indigestion Relief

Antacids are commonly used to alleviate symptoms of indigestion, heartburn, and acid reflux. These medications do not interact significantly with Suboxone and can be used when needed to relieve gastrointestinal discomfort.

Examples of Antacids:

  • Tums
  • Maalox
  • Mylanta

Consult Your Healthcare Provider

As with any medical treatment, open communication with your healthcare provider is essential during Suboxone therapy. Your doctor needs to be aware of all medications you are taking, including over-the-counter drugs and supplements. Inform them about any pre-existing medical conditions, such as liver or kidney problems, to ensure Suboxone is safe and effective for you. Your healthcare provider can provide personalized guidance, monitor your progress, and make adjustments to your treatment plan if necessary.

Understanding Individual Variations in Medication Response

Every individual responds differently to medications due to variations in metabolism and genetic factors. Suboxone treatment may need to be adjusted based on your unique needs and how your body processes the medication. Your healthcare provider will closely monitor your response to Suboxone to ensure optimal outcomes.

Exploring the Importance of Discussing Pre-existing Medical Conditions

Certain medical conditions can affect how your body interacts with Suboxone. Conditions like liver impairment may require dose adjustments, while certain health issues might contraindicate the use of Suboxone altogether. Providing your healthcare provider with a comprehensive medical history will help them make informed decisions about your treatment.

Examples of Pre-existing Medical Conditions to Discuss:

  • Liver Disease
  • Kidney Disease
  • Respiratory Issues

Understanding Potential Interactions with Herbal Supplements and Vitamins

Even natural supplements and vitamins can have interactions with Suboxone. St. John’s Wort, for example, can reduce the effectiveness of Suboxone, while high doses of certain vitamins might impact its metabolism. Always disclose all supplements and vitamins you are taking to your healthcare provider to avoid potential complications.

Examples of Herbal Supplements to be Cautious with:

  • St. John’s Wort
  • Kava
  • Valerian Root


Taking Suboxone for opioid addiction is a critical step towards recovery, but it’s vital to be aware of potential medication interactions. Avoid combining Suboxone with opioid painkillers, benzodiazepines, sedatives, anti-anxiety medications, and muscle relaxants, as they can lead to dangerous outcomes. Certain antidepressants and antipsychotics may increase the risk of overdose when used with Suboxone. Opioid antagonists, opioid partial agonists, and opioid agonists can reduce Suboxone’s effectiveness. Also, steer clear of alcohol, illicit drugs, and grapefruit products during Suboxone treatment. On the other hand, acetaminophen, ibuprofen, antihistamines, and antacids are safe options to use alongside Suboxone. Always consult your healthcare provider, share your medical history, and discuss any herbal supplements or vitamins you are taking to ensure safe and successful Suboxone therapy.

Frequently Asked Questions (FAQs)

Q1: Can I take opioid painkillers with Suboxone?

A1: No, it is not safe to take opioid painkillers like codeine, hydroco, or morphine while on Suboxone. Combining these medications can lead to respiratory depression and increase the risk of overdose.

Q2: Are there alternative medications for anxiety during Suboxone treatment?

A2: Yes, there are alternative medications that do not interact with Suboxone, such as buspirone. It is essential to consult your healthcare provider to find a suitable option.

Q3: Can I use over-the-counter sleep aids with Suboxone?

A3: It is generally not recommended to take over-the-counter sleep aids, as many of them can cause sedation and interact with Suboxone. Discuss safer alternatives with your doctor.

Q4: Is it safe to take antidepressants with Suboxone?

A4: Some antidepressants may have interactions with Suboxone, leading to increased risks of adverse effects. Your healthcare provider can help determine the best antidepressant options for you.

Q5: Can I still receive pain relief if I need surgery while on Suboxone?

A5: Yes, it is possible to manage pain during surgery while on Suboxone. Your healthcare team will work together to develop a pain management plan that considers your Suboxone treatment.

Q6: Are there any herbal supplements safe to use with Suboxone?

A6: While some herbal supplements may have minimal interactions, it is crucial to consult your doctor before taking any, as certain herbs can affect Suboxone’s efficacy.

Q7: Can I drink alcohol in moderation while on Suboxone?

A7: It is not recommended to consume alcohol while on Suboxone, even in moderation, as it can intensify side effects and increase the risk of respiratory issues.

Q8: What should I do if I accidentally took a medication that interacts with Suboxone?

A8: If you suspect you have taken a medication that interacts with Suboxone, seek immediate medical attention. Inform the healthcare provider about your Suboxone treatment to ensure appropriate care.

Q9: Can Suboxone interact with birth control pills?

A9: Suboxone does not have significant interactions with most birth control pills. However, it is essential to discuss this with your doctor to ensure the safety and effectiveness of both medications.

Q10: Can Suboxone cause allergic reactions with other medications?

A10: While Suboxone can cause allergic reactions in some individuals, it is essential to inform your healthcare provider about any allergies you have to avoid potential interactions with other medications.


As you embark on your Suboxone treatment journey, it’s natural to have questions about potential medication interactions. Avoid combining Suboxone with specific drugs, and always seek guidance from your healthcare provider. Remember that open communication and informed decision-making are essential for safe and successful Suboxone therapy.