Drug interactions
Brexanolone + Butorphanol
Severity: Major
Brexanolone and Butorphanol: major interaction.
Last updated Sources: US FDA label
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
Brexanolone causes excessive sedation and sudden loss of consciousness, and opioids can add to this. The combination raises the risk of profound sedation and respiratory compromise.
What this interaction means in plain words
Brexanolone and Butorphanol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS depression through opioid receptor activity and brexanolone's positive modulation of GABA-A receptors.
What to do
Monitor continuously with pulse oximetry during infusion, and interrupt the infusion if excessive sedation occurs. Consider reducing or withholding the opioid during the infusion.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Butorphanol
- Butorphanol + Olanzapine / samidorphan Contraindicated
- Butorphanol + Sodium oxybate Contraindicated
- Alfentanil + Butorphanol Major
- Alprazolam + Butorphanol Major
- Alvimopan + Butorphanol Major
- Amobarbital + Butorphanol Major
Frequently asked questions
Can I take Brexanolone with Butorphanol?
MediHelp rates the interaction as major. Brexanolone and Butorphanol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Brexanolone causes excessive sedation and sudden loss of consciousness, and opioids can add to this. The combination raises the risk of profound sedation and respiratory compromise.
How serious is the interaction between Brexanolone and Butorphanol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor continuously with pulse oximetry during infusion, and interrupt the infusion if excessive sedation occurs. Consider reducing or withholding the opioid during the infusion.
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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