Drug interactions
Amitriptyline + Butorphanol
Severity: Moderate
Amitriptyline and Butorphanol: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Tricyclic antidepressants add to the sedative and respiratory depressant effects of opioids. Patients may become excessively drowsy or confused, particularly older adults.
What this interaction means in plain words
Amitriptyline and Butorphanol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Butorphanol belongs to Musculoskeletal.
Why it happens
Additive CNS depression via opioid receptor activity plus antihistaminic and anticholinergic effects of the tricyclic.
What to do
Use the lowest effective doses and monitor for oversedation and respiratory depression. Reduce the butorphanol dose if excessive drowsiness occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Butorphanol
- Butorphanol + Olanzapine / samidorphan Contraindicated
- Butorphanol + Sodium oxybate Contraindicated
- Alfentanil + Butorphanol Major
- Alprazolam + Butorphanol Major
- Alvimopan + Butorphanol Major
- Amobarbital + Butorphanol Major
Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Frequently asked questions
Can I take Amitriptyline with Butorphanol?
MediHelp rates the interaction as moderate. Amitriptyline and Butorphanol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tricyclic antidepressants add to the sedative and respiratory depressant effects of opioids. Patients may become excessively drowsy or confused, particularly older adults.
How serious is the interaction between Amitriptyline and Butorphanol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor for oversedation and respiratory depression. Reduce the butorphanol dose if excessive drowsiness occurs.
What other medicines interact with Butorphanol?
MediHelp also lists interactions of Butorphanol with, for example, Olanzapine / samidorphan, Sodium oxybate, Alfentanil. The full list is on the Butorphanol page.
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