What the FDA labels say about taking them together
Buprenorphine and tapentadol
Tapentadol's FDA label of February 26, 2026 names buprenorphine in its drug interactions section; buprenorphine's label does not name tapentadol itself but warns about its class (Opioids (opioid agonists)). The tapentadol label: “MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity”
Check it at the source: the buprenorphine FDA label on DailyMed (effective June 5, 2026); the tapentadol FDA label on DailyMed (effective February 26, 2026, Hikma Pharmaceuticals USA Inc.).
What does the buprenorphine label say about tapentadol?
Buprenorphine's label does not name tapentadol 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 tapentadol label say about buprenorphine?
Tapentadol label, drug interactionsMonoamine Oxidase Inhibitors (MAOIs) Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (…) … titration of small doses of other opioids (such as oxycodone, hydrocodone, oxymorphone, hydrocodone, or buprenorphine) to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression. Examples: phenelzine, tranylcypromine, linezolid
Tapentadol 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 tapentadol tablets.
Tapentadol label (Hikma Pharmaceuticals USA Inc., February 26, 2026), drug interactionsClinical Impact: May reduce the analgesic effect of tapentadol extended-release tablets and/or precipitate withdrawal symptoms. Intervention: Avoid concomitant use. Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Muscle Relaxants
Tapentadol label (Hikma Pharmaceuticals USA Inc., February 26, 2026), 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 have received or are receiving a course of therapy with a full opioid agonist analgesic, including tapentadol extended-release tablets.
Source: FDA drug label (Tapentadol, NDA200533), Hikma Pharmaceuticals USA Inc., effective February 26, 2026 (SPL set 38de863e-56ff-4c43-9ab8-9b3e1ba82858), via openFDA
Source: FDA drug label (TAPENTADOL), Hikma Pharmaceuticals USA Inc., effective February 26, 2026 (SPL set 863f3fd3-1e8d-41b0-855f-8f9a29237cda), 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 | Tapentadol | |
|---|---|---|
| Labeled for | Opioid use disorder, Pain | Pain |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.277 per tablet 2 mg tablet sl | $14.48 per tablet 100 mg tablet |
| Shortage now | No current entry | No current entry |
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