Atazanavir with
ritonavir can increase the levels of
buprenorphine and increase its adverse effects such as sedation. Other
protease inhibitors may also be expected to interact similarly but there seems little documented about these effects in practice.
The manufacturers recommend avoiding concurrent use as the magnitude of the interaction is unknown. However if concurrent use is needed in patients taking
protease inhibitors, the initial dose of
buprenorphine should be halved.