Drug interactions
Butorphanol + Diphenoxylate
Severity: Moderate
Butorphanol and Diphenoxylate: 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
Diphenoxylate is an opioid antidiarrheal and can add CNS depression to butorphanol at higher doses. Butorphanol's antagonist activity may also reduce effect or provoke withdrawal in opioid-dependent patients.
What this interaction means in plain words
Butorphanol and Diphenoxylate 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 belongs to Gastrointestinal Tract.
Why it happens
Additive opioid-mediated CNS depression with partial mu antagonism by butorphanol.
What to do
Avoid combining in opioid-dependent patients and keep diphenoxylate to labeled doses. Monitor sedation and respiratory status.
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 Diphenoxylate
Frequently asked questions
Can I take Butorphanol with Diphenoxylate?
MediHelp rates the interaction as moderate. Butorphanol and Diphenoxylate 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. Diphenoxylate is an opioid antidiarrheal and can add CNS depression to butorphanol at higher doses. Butorphanol's antagonist activity may also reduce effect or provoke withdrawal in opioid-dependent patients.
How serious is the interaction between Butorphanol and Diphenoxylate?
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 keep diphenoxylate to labeled doses. Monitor sedation and respiratory status.
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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