Drug interactions
Butorphanol + Calcium / magnesium / potassium / sodium oxybates
Severity: Major
Butorphanol and Calcium / magnesium / potassium / sodium oxybates: 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
Oxybates are potent CNS depressants, and opioids such as butorphanol add to sedation and respiratory depression. The combination can cause profound sedation, coma or death.
What this interaction means in plain words
Butorphanol and Calcium / magnesium / potassium / sodium oxybates 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 receptor and GABA-B/GHB receptor activity.
What to do
Avoid concurrent use where possible. If it cannot be avoided, use the lowest effective doses, reduce oxybate dose as needed and monitor closely for respiratory depression 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 Butorphanol with Calcium / magnesium / potassium / sodium oxybates?
MediHelp rates the interaction as major. Butorphanol and Calcium / magnesium / potassium / sodium oxybates 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. Oxybates are potent CNS depressants, and opioids such as butorphanol add to sedation and respiratory depression. The combination can cause profound sedation, coma or death.
How serious is the interaction between Butorphanol and Calcium / magnesium / potassium / sodium oxybates?
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 possible. If it cannot be avoided, use the lowest effective doses, reduce oxybate dose as needed and monitor closely for respiratory depression 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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