Drug interactions
Butorphanol + Diphenoxylate-atropine
Severity: Moderate
Butorphanol and Diphenoxylate-atropine: 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
Butorphanol is a mixed agonist-antagonist opioid that may add to the sedative effects of diphenoxylate. In opioid-dependent patients it can precipitate withdrawal by blocking mu receptors. Atropine adds anticholinergic burden.
What this interaction means in plain words
Butorphanol and Diphenoxylate-atropine 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; Diphenoxylate-atropine belongs to Gastrointestinal Tract.
Why it happens
Additive opioid CNS depression, with mu-receptor antagonism by butorphanol that may precipitate withdrawal.
What to do
Avoid combining in opioid-dependent patients and monitor for sedation and respiratory depression in others. Use a non-opioid antidiarrheal if feasible.
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 Diphenoxylate-atropine
- Diphenoxylate-atropine + Isocarboxazid Contraindicated
- Diphenoxylate-atropine + Phenelzine Contraindicated
- Diphenoxylate-atropine + Tranylcypromine Contraindicated
- Alfentanil + Diphenoxylate-atropine Major
- Alvimopan + Diphenoxylate-atropine Major
- Amitriptyline + Diphenoxylate-atropine 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 Diphenoxylate-atropine?
MediHelp rates the interaction as moderate. Butorphanol and Diphenoxylate-atropine 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 is a mixed agonist-antagonist opioid that may add to the sedative effects of diphenoxylate. In opioid-dependent patients it can precipitate withdrawal by blocking mu receptors. Atropine adds anticholinergic burden.
How serious is the interaction between Butorphanol and Diphenoxylate-atropine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining in opioid-dependent patients and monitor for sedation and respiratory depression in others. Use a non-opioid antidiarrheal if feasible.
What other medicines interact with Diphenoxylate-atropine?
MediHelp also lists interactions of Diphenoxylate-atropine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Diphenoxylate-atropine page.
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