Mixing Buprenorphine (Suboxone) and Codeine (lean)
Caution
Buprenorphine largely blocks codeine, so the codeine does little. Do not keep escalating it.
Buprenorphine largely blocks codeine's effect. The realistic outcome is that codeine does nothing useful, plus mild withdrawal if buprenorphine has not fully settled — not danger so much as a wasted dose and a reason not to keep escalating.
The risk here is to the body — breathing, heart, temperature or organs. Set limits before you start, because this kind of harm does not announce itself in time to react.
Headspace vs physical riskCan you mix Buprenorphine (Suboxone) and Codeine (lean)?
MixSafe rates mixing Buprenorphine and Codeine as "Caution" — carries risk that is worth understanding before combining. Reduce doses and do not use alone. Source: MixSafe research. Educational information, not medical advice.
- Buprenorphine
- Partial agonist — displaces other opioids off the receptor
- Codeine
- Weak, but metabolised unpredictably between people
- Buprenorphine also called
- subutex, suboxone, bupe, bup, buprenorphine/naloxone, zubsolv
- Codeine also called
- lean, purple drank, co-codamol, dihydrocodeine
- Buprenorphine precipitated opioid withdrawal: Prevention and management in the ED setting. https://www.sciencedirect.com/science/article/abs/pii/S0735675722003126
- Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. https://pmc.ncbi.nlm.nih.gov/articles/PMC11437388/
- Practice-Based Guidelines: Buprenorphine in the Age of Fentanyl. SAEM. https://www.saem.org/education/substance-use/practice-based-guidelines-buprenorphine-in-the-age-of-fentanyl
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Checking more than two?
Combinations of three or more carry risks that no pair-by-pair chart can show. The checker rates every pair at once and flags the whole-mix ones on top.
Open this in the checkerRelated combinations
All combinations →Rated caution. Educational information only, not medical advice. Absence of a documented interaction is not evidence of safety.