Buprenorphine 65circulation when also takingdiazepam. Taking a monoamine oxidase inhibitor
(MAOI—a component in some antidepressants and other medication) may be
risky when using buprenorphine. Evidence exists that the drug may promote
bleeding under the skin when taken with the anti–blood clot medicine phen-
procoumon. Adverse interaction is also reported between buprenorphine and
flunitrazepam. Antihistamines can add to buprenorphine’s general depressant
effects. Another possible drug interaction involvesnicotine; people using bu-
prenorphine tend to increase their tobacco cigarette consumption. Buprenor-
phine should be used with particular carefulness if a person suffers from
enlarged prostrate, urination difficulty, alcoholism, thyroid gland deficiency,
or adrenal gland deficiency.
Cancer.Animal experiments have not indicated that the compound pro-
duces cancer.
Pregnancy.Pregnant rats receiving 1,000 times the normal human dose have
had difficulty when giving birth. Early pregnancy failure and fetal deaths
occurred when rats received 10 to 100 times the normal human dose, but not
if they had 1,000 times the standard dose. No birth defects were seen at any
of those dose levels. More experimentation shows that buprenorphine alters
brain development in fetal rats, but the practical effects of those changes are
unclear. Results from other research demonstrate long-term effects on behav-
ior of offspring if pregnant rats receive high doses of buprenorphine; those
measurements do not indicate what the human outcome would be but none-
theless serve as a warning. Malformations occurred when pregnant rabbits
received 1,000 times the recommended human dose. A case report says no
malformations occurred when a pregnant heroin addict was switched to daily
doses of buprenorphine for several months; the infant showed mild depen-
dence but quickly got through the withdrawal symptoms. One group of re-
searchers who gave daily doses of the drug to pregnant women observed no
withdrawal symptoms in the infants, and offspring also had normal weight.
Another group of researchers found no adverse effect on fetal development
and no harm in infants born to pregnant women who were also using nicotine
andmarijuanain addition to buprenorphine. Buprenorphine has been given
to premature newborns with no apparent ill effect.
Milk production declined after nursing rats received buprenorphine, and
the same effect has been observed in women who received the drug during
Caesarean section. The drug passes into human milk, but a case report indi-
cates the amount is not enough to cause dependence in the infant.
Additional scientific information may be found in:
Agar, M., et al. “Buprenorphine: ‘Field Trials’ of a New Drug.”Qualitative Health Re-
search11 (2001): 69–84.
Bedi, N.S., et al. “Abuse Liability of Buprenorphine—A Study among Experienced
Drug Users.”Indian Journal of Physiology and Pharmacology42 (1998): 95–100.
Hammersley, R., T. Lavelle, and A. Forsyth. “Predicting Initiation to and Cessation of
Buprenorphine and Temazepam Use amongst Adolescents.”British Journal of
Addiction87 (1992): 1303–11.
Heel, R.C. “Buprenorphine: A Review of Its Pharmacological Properties and Thera-
peutic Efficacy.”Drugs17 (1979): 81–110.