Pain Home > Subsys Drug Interactions

CYP 3A4 Inhibitor Medications
The liver breaks down Subsys using enzymes known as CYP 3A4 enzymes. Medications known as CYP 3A4 inhibitors can decrease the activity of these enzymes. Combining Subsys with one of these CYP 3A4 inhibitors may increase the level of Subsys in your body, increasing your risk for serious side effects, including drowsiness, confusion, and breathing difficulty. Your healthcare provider may monitor you more closely for side effects if you use Subsys with a CYP 3A4 inhibitor.
 
Desmopressin
Subsys can increase the risk of desmopressin side effects. Do not use Subsys with desmopressin without first speaking with your healthcare provider.
 
Grapefruit Juice
Grapefruit juice may increase the amount of Subsys in your blood, potentially increasing your risk for serious side effects, such as drowsiness, confusion, and breathing problems. Talk to your healthcare provider before eating grapefruit or drinking grapefruit juice while you are using this medication.
 
Medications That Cause Drowsiness
Subsys causes significant drowsiness. Taking other medications that cause drowsiness with Subsys may lead to serious side effects, such as extreme sedation, confusion, and breathing problems. Check with your healthcare provider before using Subsys with other medications that may cause drowsiness.
 
Monoamine Oxidase Inhibitors (MAOIs)
Combining Subsys with an MAOI may potentially cause a serious reaction known as serotonin syndrome. It can also lead to low blood pressure. Do not use Subsys if you have taken an MAOI within the past 14 days.
 
Octreotide
Combining octreotide with Subsys may increase the pain-relieving effects of Subsys. Your healthcare provider may monitor your pain response if you take these medications together. You could need a lower Subsys dose.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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