What the FDA labels say about taking them together
Buprenorphine and hydromorphone
Hydromorphone's FDA label of May 14, 2026 names buprenorphine in its drug interactions section; buprenorphine's label does not name hydromorphone itself but warns about its class (Opioids (opioid agonists)). The hydromorphone label: “May reduce the analgesic effect of Hydromorphone Hydrochloride Injection and/or precipitate withdrawal symptoms.”
Check it at the source: the buprenorphine FDA label on DailyMed (effective June 5, 2026); the hydromorphone FDA label on DailyMed (effective May 14, 2026, Rhodes Pharmaceuticals LLC).
What does the buprenorphine label say about hydromorphone?
Buprenorphine's label does not name hydromorphone itself; it warns about its class (Opioids (opioid agonists)):
Buprenorphine label, warnings and precautionsLife-Threatening Respiratory Depression Serious, life-threatening, or fatal respiratory depression has been reported with the use of opioids, even when used as recommended.
Buprenorphine label, boxed warningInstruct patients on proper administration of BUTRANS to reduce the risk. ( 2.1 , 5.2 ) Accidental exposure to BUTRANS, especially in children, can result in fatal overdose of buprenorphine. ( 5.2 ) Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death.
Source: FDA drug label (Buprenorphine HCl), SpecGx LLC, effective June 5, 2026 (SPL set b60d514d-a88a-4fa2-a5b0-30ac29e04973), via openFDA; the full label on DailyMed
What does the hydromorphone label say about buprenorphine?
Hydromorphone label, drug interactionsMixed Agonist/Antagonist and Partial Agonist Opioid Analgesics Clinical Impact: May reduce the analgesic effect of hydromorphone hydrochloride oral solution or hydromorphone hydrochloride tablets and/or precipitate withdrawal symptoms. Intervention: Avoid concomitant use. Examples: Butorphanol, nalbuphine, pentazocine, and buprenorphine.
Hydromorphone label, warnings and precautionsAdditionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including hydromorphone hydrochloride oral solution or hydromorphone hydrochloride tablets.
Source: FDA drug label (Hydromorphone Hydrochloride, NDA019034), Fresenius Kabi USA, LLC, effective July 15, 2026 (SPL set e034eb96-03e0-46e1-8b92-5e1f94555e7b), via openFDA
Source: FDA drug label (Hydromorphone Hydrochloride), Rhodes Pharmaceuticals LLC, effective May 14, 2026 (SPL set 37565441-0d95-4743-a695-d7b3326f58a1), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Buprenorphine | Hydromorphone | |
|---|---|---|
| Labeled for | Opioid use disorder, Pain | Pain |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.277 per tablet 2 mg tablet sl | $0.219 per tablet 4 mg tablet |
| Shortage now | No current entry | In shortage |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once