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Buprenex and Z-Cof HC

Determining the interaction of Buprenex and Z-Cof HC and the possibility of their joint administration.

Check result:

Buprenex <> Z-Cof HC

Relevance: 09.05.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using buprenorphine together with other medications that cause central nervous system depression such as HYDROcodone can lead to serious side effects including respiratory distress, coma, and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Do not drink alcohol or self-medicate with these medications without your doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your doctor. Also, you should avoid driving or operating hazardous machinery until you know how these medications affect you. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Concomitant use of opioids with other central nervous system (CNS) depressants including mixed agonist-antagonist or partial agonist opioids may result in profound sedation, respiratory depression, coma, and death. The risk of hypotension may also be increased. On the other hand, mixed agonist-antagonist or partial agonist opioids can reduce the pharmacologic effects of other opioid agonists. Reduced efficacy or withdrawal symptoms may occur in patients maintained on their opioid regimen following the addition of a mixed agonist-antagonist or partial agonist opioid.

MANAGEMENT: The use of opioids in conjunction with other CNS depressants including mixed agonist-antagonist or partial agonist opioids should generally be avoided unless alternative treatment options are inadequate. If coadministration is necessary (e.g., when initiating a switch from one opioid to the other), the dosage and duration of each drug should be limited to the minimum required to achieve desired clinical effect, and patients should be closely monitored for signs and symptoms of CNS and respiratory depression. Additional caution is advisable when a mixed agonist-antagonist or partial agonist opioid is added to an existing opioid regimen, as there may be an increased risk of withdrawal symptoms (e.g., restlessness, insomnia, sweating, lacrimation, or rhinorrhea) following initiation of the mixed agonist-antagonist or partial agonist opioid. A dosage adjustment for one or both drugs may be required.

References

"Product Information. Buprenex (buprenorphine)." Reckitt and Colman Pharmaceutical, Richmond, VA.
Gilman AG, Rall TW, Nies AS, Taylor P, eds. "Goodman and Gilman's the Pharmacological Basis of Therapeutics. 8th ed." New York, NY: Pergamon Press Inc. (1990):
"Product Information. Suboxone (buprenorphine-naloxone)." Reckitt and Colman Pharmaceuticals Inc, Richmond, VA.
"Product Information. Butrans (buprenorphine)." Purdue Pharma LP, Stamford, CT.
"Product Information. Subutex (buprenorphine)." Reckitt and Colman Pharmaceuticals Inc, Richmond, VA.
"Product Information. Dalgan (dezocine)." Astra USA, Westborough, MA.
Moldenhauer CC, Roach GW, Finlayson DC, et al. "Nalbuphine antagonism of ventilatory depression following high-dose fentanyl anesthesia." Anesthesiology 62 (1985): 647-50
Strain EC, Preston KL, Liebson IA, Bigelow GE "Precipitated withdrawal by pentazocine in methadone-maintained volunteers." J Pharmacol Exp Ther 267 (1993): 624-34
"Product Information. Nubain (nalbuphine)." Endo Laboratories, Texarkana, TX.
"Product Information. Talwin NX (pentazocine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
"Product Information. Stadol (butorphanol)." Allscrips Pharmaceutical Company, Vernon Hills, IL.

Buprenex

Generic Name: buprenorphine

Brand name: Buprenex, Belbuca, Probuphine, Butrans, Sublocade, Subutex

Synonyms: Buprenex (injection - Buprenex)

What is Buprenex?

Z-Cof HC

Generic Name: chlorpheniramine / hydrocodone / phenylephrine

Brand name: B-Tuss, De-Chlor HC, DroTuss-CP, Hydron CP, Hydro-PC II, Poly-Tussin HD, Relasin-HC, Triant-HC, Z-Cof HC, Poly-Tussin, Endagen-HD, Chemdal HD, Iodal HD, Rindal-HD, Ed-TLC, Efasin-HD, Guiaphen HD, Vanex-HD, Chemdal HD Plus, Nasatuss, Atuss HD, Iotussin HC, Chlorgest HD, Ed-Tuss HC, Cyndal HD, Hyphen-HD, Tuss-PD, KG-Dal HD, Endotuss-HD, Ditussin-HC, Chemtussin HC, Exo-Tuss, Endal-HD Plus, Enplus-HD, Comtussin HC, Tuss-HC, Ventuss Syrup, Maxi-Tuss SA, Maxi-Tuss HC, Histinex HC, KG-Dal HD Plus, Highland HC, Uni Tuss HC, H-C Tussive, Histussin-HC, Cytuss HC, Tuss-DS, Efasin-HD Plus, Quindal HD Plus, Quindal HD, Hi-Tuss HC, Chlorphen HD, Duradal HD, Liquitussin HC Syrup, HYDROcodone CP, HYDROcodone HD, Tussive HC, De-Chlor HD, Atuss MS, Relacon-HC, Hydro-PC II Plus, Uni-Tricof HC, Rindal HD Plus, Echotuss-HC, Phendal-HD, Relacon-HC NR, Tusana-D, Maxi-Tuss HCX, Neo HC, Liquicough HC, Mintuss MS, Coughtuss

Synonyms: n.a.

What is Z-Cof HC?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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