Drug interactions
Butalbital + Butorphanol
Severity: Major
Butalbital 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
Butalbital is a barbiturate, and combined with butorphanol it can produce marked sedation and respiratory depression. Risks are greater with higher doses, alcohol or respiratory disease.
What this interaction means in plain words
Butalbital 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 and respiratory depression via opioid receptors and barbiturate enhancement of GABA-A activity.
What to do
Avoid concurrent use where feasible; if needed, use minimal doses and monitor respiration and sedation.
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 Butalbital with Butorphanol?
MediHelp rates the interaction as major. Butalbital 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. Butalbital is a barbiturate, and combined with butorphanol it can produce marked sedation and respiratory depression. Risks are greater with higher doses, alcohol or respiratory disease.
How serious is the interaction between Butalbital 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: Avoid concurrent use where feasible; if needed, use minimal doses and monitor respiration and sedation.
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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