Unsafe
Starting buprenorphine while tianeptine is active can bring on sudden withdrawal.
It is the usual treatment for stopping tianeptine, so start it with a prescriber.
What to do
- Say what was taken and how much.Responders need it, and in most US states Good Samaritan laws protect both of you from drug possession charges when you call for an overdose.
- Unresponsive: put them on their side, tilt the head back, and stay until help arrives.Never leave someone alone to “sleep it off”.
- Give naloxone (Narcan) if you have it.It is sold over the counter in every US state and does no harm if opioids turn out not to be involved.
- Never Use Alone 1-800-484-3731Stays on the line and sends help if you stop responding.
- Full steps: what to do if it is already happeningOverdose signs, the recovery position, what to say on the call, and whether you can be charged for making it.
- Poison Control 1-800-222-1222Free and 24/7, for “is this bad?” before it becomes an emergency.
What “Unsafe” means
Risk of serious physical or psychological harm. Not recommended under any circumstances.
How the ratings workThe longer explanation
Buprenorphine binds more tightly than tianeptine and does less once it is there, so starting it while tianeptine is still active can bring on sudden withdrawal, as it can after other full opioids. Tianeptine taken on top of buprenorphine mostly does nothing, which invites escalating doses. If you are trying to stop tianeptine, buprenorphine is the usual treatment, and clinicians have used low-dose starts to get around exactly this; start it with a prescriber.
Sources (3)
- Use of Buprenorphine-Naloxone in the Treatment of Tianeptine Use Disorderpubmed.ncbi.nlm.nih.gov
- Microdose Induction of Buprenorphine in a Patient Using Tianeptinepubmed.ncbi.nlm.nih.gov
- Saldana et al. Tianeptine Misuse, Dependence, and Clinical Management: Three Case Reports and Literature Review. Case Rep Psychiatry. 2026pmc.ncbi.nlm.nih.gov
Think this is wrong, or know a better source? Send it.
Other names
- Buprenorphine
- subutex, suboxone, bupe, bup, buprenorphine/naloxone, zubsolv
- Partial agonist — displaces other opioids off the receptor
- Tianeptine
- gas station heroin, tianaa, zaza red, neptune's fix, pegasus, td red
- Sold as a supplement — at the doses people take, a full opioid
Related combinations
Can you mix Buprenorphine (Suboxone) and Tianeptine (gas station heroin)?
MixSafe rates mixing Buprenorphine and Tianeptine as "Unsafe" — risk of serious physical or psychological harm. Not recommended under any circumstances. Source: MixSafe research. Educational information, not medical advice.