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Buprenorphine and naloxone oral/sublingual and Quin-G

Determining the interaction of Buprenorphine and naloxone oral/sublingual and Quin-G and the possibility of their joint administration.

Check result:
Buprenorphine and naloxone oral/sublingual <> Quin-G
Relevance: 17.09.2022 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:

The following interaction applies only if you are receiving buprenorphine in the form of a skin patch: Talk to your doctor before using buprenorphine together with quiNIDine. Combining these medications can increase the risk of an irregular heart rhythm that may be serious. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with these medications, whether together or alone. 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: Buprenorphine administered transdermally at a higher than recommended dosage has been associated with prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. In healthy volunteers, there was no difference in the effect of buprenorphine 10 mcg/hr administered transdermally on the QT interval compared to placebo. However, buprenorphine 40 mcg/hr (twice the maximum recommended dosage) was associated with a mean prolongation of the QT interval of 5.9 msec compared to placebo. Buprenorphine 20 mcg/hr was not studied. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).

MANAGEMENT: According to the product labeling, use of buprenorphine transdermal films should be avoided in patients treated with class IA (e.g., disopyramide, quinidine, procainamide) or class III (e.g., amiodarone, dofetilide, sotalol) antiarrhythmic agents. A dosage of 20 mcg/hr should not be exceeded in patients receiving the buprenorphine transdermal system. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, or syncope.

References
  • Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."
  • "Product Information. Butrans (buprenorphine)." Purdue Pharma LP, Stamford, CT.
Buprenorphine and naloxone oral/sublingual

Generic Name: buprenorphine / naloxone

Brand name: Bunavail, Suboxone, Zubsolv

Synonyms: Buprenorphine and naloxone (oral/sublingual), Buprenorphine and Naloxone

Quin-G

Generic Name: quinidine

Brand name: Quin-G, Cardioquin, Quinora, Quinidex Extentabs, Quinaglute Dura-Tabs, Quin-Release

Synonyms: n.a.

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.