Suboxone can interact with several different antibiotics.
You should never take an antibiotic while on Suboxone without first talking to a doctor. A doctor you are seeing in urgent care or another context may not be aware that you are taking Suboxone when they prescribe you an antibiotic.
Fortunately, alternative treatments generally exist if you need an antibiotic while on Suboxone or a similar medication.
What Are Antibiotics?
An antibiotic is a medicine designed to combat bacterial infections. Of all medical advances, there is an argument that antibiotics represent one of the single most important accomplishments humanity has ever made, with bacterial infections previously representing a vastly more dangerous threat than they now are.
With this in mind, antibiotics still have many side effects and should be used sparingly. In addition, they can negatively interact with certain medications. There are several different types of antibiotics, but Suboxone is known to interact with at least a few of them.
Common Antibiotics That React With Suboxone
There are a few antibiotic medications that may react with Suboxone. When we say “react” we generally mean “may cause Suboxone to be more slowly or more rapidly metabolized”. This means that the effects of Suboxone may be stronger or weaker than they usually are while on antibiotics. These effects may be negligible and patients may not notice any change to the way their Suboxone makes them feel while taking antibiotics. Conversely, in rare circumstances, they may feel more sedated than usual, or they may feel less effects of the Suboxone and may notice cravings or withdrawal symptoms.
Some antibiotics that can increase the effects of Suboxone include the following:
- Clarithromycin (Biaxin)
- Erythromycin (Ery-Tab)
- Rifampicin (Rifadin)
- Ciprofloxacin 
Seek Medical Advice Before Mixing Any Drug With Suboxone
These days most antibiotics are totally safe to take with Suboxone, and most doctors feel comfortable prescribing all common antibiotics to patients on Suboxone without adjusting their dose.
However, if you do start a course of antibiotics on Suboxone and notice that your medication is either less or more effective than usual, talk to your doctor. It might be worth temporarily raising or lowering your Suboxone dose until you finish your course of antibiotics.  Always let any doctor prescribing antibiotics know that you are taking Suboxone so you can both plan accordingly.
- Buprenorphine/Naloxone (Suboxone). National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Buprenorphine/Buprenorphine-Naloxone-(Suboxone). January 2021. Accessed November 2022.
- Drug Interactions of Clinical Importance Among the Opioids, Methadone and Buprenorphine, and Other Frequently Prescribed Medications: A Review. The American Journal on Addictions. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334287/. January 2010. Accessed November 2022.
- Life-Threatening Drug Interactions: What the Physician Needs to Know. Internal Medicine Journal. https://onlinelibrary.wiley.com/doi/full/10.1111/imj.13404. May 2017. Accessed November 2022.
Medically Reviewed By: Elena Hill, MD, MPH
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