Drug interactions
Butorphanol + Diphenhydramine
Severity: Moderate
Butorphanol and Diphenhydramine: moderate interaction.
Last updated
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
Diphenhydramine is a sedating first-generation antihistamine, and combined with an opioid it can cause increased drowsiness, impaired psychomotor performance and, at higher doses, respiratory depression. Elderly patients are more sensitive to confusion and falls.
What this interaction means in plain words
Butorphanol and Diphenhydramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Butorphanol belongs to Musculoskeletal; Diphenhydramine belongs to Respiratory.
Why it happens
Additive CNS depression from opioid receptor activity and central H1-antihistamine and anticholinergic effects.
What to do
Use the lowest effective doses and monitor sedation and respiratory rate. Avoid the combination in frail older patients where possible and counsel against driving.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Diphenhydramine
Frequently asked questions
Can I take Butorphanol with Diphenhydramine?
MediHelp rates the interaction as moderate. Butorphanol and Diphenhydramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Diphenhydramine is a sedating first-generation antihistamine, and combined with an opioid it can cause increased drowsiness, impaired psychomotor performance and, at higher doses, respiratory depression. Elderly patients are more sensitive to confusion and falls.
How serious is the interaction between Butorphanol and Diphenhydramine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor sedation and respiratory rate. Avoid the combination in frail older patients where possible and counsel against driving.
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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