Drug interactions
Butorphanol + Diazepam
Severity: Major
Butorphanol and Diazepam: 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
Concomitant opioids and benzodiazepines can cause profound sedation, respiratory depression, coma and death. Regulators have issued boxed warnings for this combination with opioid analgesics.
What this interaction means in plain words
Butorphanol and Diazepam 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; Diazepam belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression via opioid receptors and GABA-A potentiation.
What to do
Reserve the combination for patients with no alternative, using the lowest doses and shortest duration. Monitor closely for sedation and respiratory depression and counsel patients and caregivers on warning signs.
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 Diazepam
Frequently asked questions
Can I take Butorphanol with Diazepam?
MediHelp rates the interaction as major. Butorphanol and Diazepam 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. Concomitant opioids and benzodiazepines can cause profound sedation, respiratory depression, coma and death. Regulators have issued boxed warnings for this combination with opioid analgesics.
How serious is the interaction between Butorphanol and Diazepam?
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 the combination for patients with no alternative, using the lowest doses and shortest duration. Monitor closely for sedation and respiratory depression and counsel patients and caregivers on warning signs.
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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