Is It Safe To Take Suboxone and Klonopin Together?

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Suboxone and Klonopin are both medications from different classes, but both have the side effect of causing decreased respiratory drive, putting a patient at increased risk of respiratory suppression and overdose.

Suboxone is a partial opioid medication used to treat opioid use disorder and, occasionally, also used off label to treat chronic pain.

Klonopin (Clonazepam), is a benzodiazepine medication usually used as an anti-seizure or anti-anxiety medication.

Both medications cause decreased respiratory drive. While they can potentially be used together, doing so should be done under close medical supervision. 

How Long Do Klonopin and Suboxone Stay in The Body?

Suboxone and Klonopin are both long-lasting drugs that stay in your system for several hours to days.

Experts use a "half-life" measurement to determine how long the drugs stay active:

  • Klonopin: This prescription medication has a half-life of up to 40 hours.[1]
  • Suboxone: This prescription medication has a half-life of up to 37 hours.[2]

What Should I Know About Taking Suboxone & Klonopin?

Prescription medications like Suboxone and Klonopin could be critical to your recovery.

If you have a mental illness complicating your addiction recovery, Klonopin could be an important part of managing your anxiety.

Combining these two medications come with some unique risks that you should understand before you get started.

Accidental Injuries

People taking benzodiazepines like Klonopin with Suboxone have three times the risk of accidents when compared to those taking buprenorphine products alone.[3]

Respiratory Depression

Benzodiazepines and buprenorphine products depress the central nervous system, which regulates functions throughout your body, including breathing.[4] Taking them simultaneously does greatly increase your risk of overdose as compared to taking just one of the medications alone. 

Dependence and Addiction 

Benzodiazepines, like opioids, are addictive substances. Experts say that benzodiazepine misuse has reached "epidemic levels."[5] Combining multiple habit forming substances such as Suboxone and benzodiazepines increases the risk of dependence

How Can My Doctor Help?

Your doctor writes prescriptions for both your Klonopin and your Suboxone, and that professional should help you understand how to take your medications properly. But your doctor must offer careful monitoring when you're using both drugs.

Some doctors use regular urine testing to ensure their drug-combo patients aren't misusing their medications.[6] If your doctor employs this strategy, know it's just used to keep you safe.

If using both medications simultaneously makes you feel sedated or slow, talk with your doctor. Adjusting your doses could help avoid over sedation and respiratory suppression.

Never stop or start taking either Suboxone or Klonopin without talking to your doctor first. Both medications cause persistent brain chemistry changes. You must taper doses rather than quitting cold turkey. Your doctor or online suboxone provider can help.

Sources

  1. Klonopin FDA Approved Labeling Text. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/017533s053,020813s009lbl.pdf. October 2013. Accessed July 2022.
  2. Buprenorphine. Psychiatry (Edgmont). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994593/. December 2005. Accessed July 2022.
  3. Benzodiazepine Use During Buprenorphine Treatment for Opioid Dependence: Clinical and Safety Outcomes. Drug and Alcohol Dependence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916951/. October 2014. Accessed July 2022.
  4. FDA Urges Caution About Withholding Opioid Addiction Medications from Patients Taking Benzodiazepines or CBS Depressants: Careful Medication Management Can Reduce Risks. U.S. Food and Drug Administration. https://www.fda.gov/media/127688/download. September 2017. Accessed July 2022.
  5. Benzodiazepine Use, Misuse, and Abuse: A Review. The Mental Health Clinician. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007645/. June 2016. Accessed July 2022.
  6. Should Benzodiazepines and Opioids Be Used Concurrently? Psychiatric Times. https://www.psychiatrictimes.com/view/should-benzodiazepines-opioids-used-concurrently. October 2020. Accessed July 2022.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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