Macrolides are predicted to increase the levels of buprenorphine. Note that the
macrolides differ in their ability to inhibit CYP3A4, see
macrolides.
It has been suggested that
macrolides should be avoided when buprenorphine is used parenterally or sublingually as an analgesic. If concurrent use is essential in opioid addiction the manufacturers suggest that the buprenorphine dose should be halved. This interaction does not apply to
azithromycin. Note that additive QT- prolonging effects may occur in predisposed individuals taking
macrolides and high-dose methadone, see drugs that prolong the QT interval.