Drug interactions
Butorphanol + Clorazepate
Severity: Major
Butorphanol and Clorazepate: 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
Opioids combined with benzodiazepines such as clorazepate can cause profound sedation, respiratory depression, coma and death. The long-acting active metabolite prolongs the period of risk.
What this interaction means in plain words
Butorphanol and Clorazepate 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; Clorazepate belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression via opioid receptors and GABA-A potentiation.
What to do
Reserve for patients lacking alternatives, using minimal doses and durations. Monitor for sedation and respiratory depression, especially in older adults.
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
Other interactions of Clorazepate
- Calcium / magnesium / potassium / sodium oxybates + Clorazepate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
- Alfentanil + Clorazepate Major
- Alprazolam + Clorazepate Major
- Amobarbital + Clorazepate Major
- Belladonna and opium + Clorazepate Major
Frequently asked questions
Can I take Butorphanol with Clorazepate?
MediHelp rates the interaction as major. Butorphanol and Clorazepate 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. Opioids combined with benzodiazepines such as clorazepate can cause profound sedation, respiratory depression, coma and death. The long-acting active metabolite prolongs the period of risk.
How serious is the interaction between Butorphanol and Clorazepate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve for patients lacking alternatives, using minimal doses and durations. Monitor for sedation and respiratory depression, especially in older adults.
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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