Drug interactions
Butorphanol + Chlordiazepoxide-clidinium
Severity: Major
Butorphanol and Chlordiazepoxide-clidinium: 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
Combining a benzodiazepine with an opioid agonist-antagonist such as butorphanol can produce additive sedation, impaired psychomotor performance and respiratory depression. Regulatory labeling warns about profound sedation and respiratory depression with opioid-benzodiazepine combinations.
What this interaction means in plain words
Butorphanol and Chlordiazepoxide-clidinium 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.
Butorphanol belongs to Musculoskeletal; Chlordiazepoxide-clidinium belongs to Gastrointestinal Tract.
Why it happens
Additive central nervous system and respiratory depression via GABA-A potentiation and opioid receptor activity.
What to do
Avoid the combination where possible; if needed, use the lowest effective doses for the shortest duration and monitor sedation and respiratory rate. Counsel patients to avoid alcohol and driving.
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 Chlordiazepoxide-clidinium
- Alfentanil + Chlordiazepoxide-clidinium Major
- Alprazolam + Chlordiazepoxide-clidinium Major
- Amobarbital + Chlordiazepoxide-clidinium Major
- Belladonna and opium + Chlordiazepoxide-clidinium Major
- Benzhydrocodone / acetaminophen + Chlordiazepoxide-clidinium Major
- Brexanolone + Chlordiazepoxide-clidinium Major
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 Chlordiazepoxide-clidinium?
MediHelp rates the interaction as major. Butorphanol and Chlordiazepoxide-clidinium 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. Combining a benzodiazepine with an opioid agonist-antagonist such as butorphanol can produce additive sedation, impaired psychomotor performance and respiratory depression. Regulatory labeling warns about profound sedation and respiratory depression with opioid-benzodiazepine combinations.
How serious is the interaction between Butorphanol and Chlordiazepoxide-clidinium?
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 the combination where possible; if needed, use the lowest effective doses for the shortest duration and monitor sedation and respiratory rate. Counsel patients to avoid alcohol and driving.
What other medicines interact with Chlordiazepoxide-clidinium?
MediHelp also lists interactions of Chlordiazepoxide-clidinium with, for example, Alfentanil, Alprazolam, Amobarbital. The full list is on the Chlordiazepoxide-clidinium page.
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