INTERACTIONS BETWEEN MEDICATION PRESCRIBED FOR SUBSTANCE MISUSE DISORDER AND OTHER MEDICATIONS/ILLICIT DRUGS

Subutex

Methadone

Morphine/ diamorphine

Dexamphetamine

Disulfiram

BZ & Zopiclone

Lofexidine

Metoclopramide

Ibuprofen

Octreoptide

ACE inhibitors

4

Acenocoumarol

3

3

Acetazolamide

1

1

Alcohol

1,3

1,3

1,3

5

1,3

3

Amitriptyline

1,7

Ammonium chloride

2

2

AngiotensineII antag.

4

Antidiabetics

3

Anthistamines (sedative)

1

Antihypertensives

3

4

Antimuscarinics

3

Antipsychotics

1

1

1

1

8

Ascorbic acid (vitC)

2

2

Aspirin

7

3

Atovaquone

4

Baclofen

1

3

Barbiturates

1,2

1

Benzodiazepines

1,3

1,3

1,3

3

3

Bromocriptine

4

3

Buprenorphine

1,2

Cannabis

6

Carbamazepine

2

Cardiac Glycosides

3

Chloral hydrate

1

Chlormethiazole

1

Chlorpromazine

7

2,4

Ciprafloxacin

4

4

4

Ciclosporine

11

4

Cimetidine

1

1

1

1

4

Cisapride

4

4

4

1

Clomipramine

1

Clopidrogrel

3

Corticosteroids

12

CNS depressants

1

Cranberry Juice

2

2

Cytotoxis

3

Desipramine

3

1

Dexamphetamine

1,2

Disulfiram

1

Diuretics

11

Doxepin

7

Erythromycine

1

Esmolol

3

Fluconazole

1

Fluoxetine

1

1

Fluvoxamine

1

1

Fusidic acid

2

Grapefruit juice

1

Haloperidol

7

Heparin

3

Indinavir

1

Indomethacin

7

Isoniazid

1

Ketoconazole

1

Levodopa

4

3

Lithium

2

3

Lofexidine

1

MAOIs

3

3

3

3

Methylphenidate

1,2

Metoclopramide

4

4

4

Metronidazole

5,6

Mexletine

4

4

4

Moclobemide

1

Nabilone

1

Naltrexone

2

Naloxone

2

Naproxen

7

Nasal decongestants

2

Nevirapine

2

Nifedipine

4

Omeprazole

1

1

Opiates

1

1,3

2

Oral contraceptives

2

Paracetamol

3

Paraldehyde

3

Pentoxifylline

12

Pergolide

4

Piroxicam

7

Phenytoin

2

3

3,4

3

Potassium sparing diur.

1,3

Probenecid

1

Protease inhibitors

1,2

Quinolones

9

Rifampicin

2

2

2

Ribabutin

2

Ritonavir

1

2

1

1

1

Sedative antihistamines

1

Sodium bicarbonate

1

SSRIs

Sulphonylyreas

3

Tacrolimus

11

Tetrabenazine

8

Theophylline

3

Thiethylperazine

7

Tizanidine

1

3

Tricyclics

1

3

Warfarin

3

3

Zidovudine

2,3

10

Zopiclone

1,3

1: Increased effect/toxicity of substance misuse prescription; 2: Decreased effect of substance misuse prescription; 3: Increased effect/toxicity of other medication; 4: Decreased effect of other medication; 5: Antabuse-like reaction; 6: Decreased effect of other medication; 7: Myoclonus; 8: Extrapyramidal effects; 9: Seizures; 10: Haemotological toxicity; 11: Nephrotoxicity; 12: Bleeding & gastric ulceration; 13: Hyperkalaemia