Drug interactions
Butorphanol + Doxepin
Severity: Moderate
Butorphanol and Doxepin: 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
Doxepin is a sedating tricyclic antidepressant with strong antihistaminic activity, and butorphanol is an opioid analgesic. Together they increase drowsiness, psychomotor impairment and the risk of respiratory depression, particularly in older or frail patients.
What this interaction means in plain words
Butorphanol and Doxepin 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; Doxepin belongs to Dermatology.
Why it happens
Additive CNS depression from opioid receptor agonism and histamine H1 and other receptor blockade.
What to do
Start with reduced doses of either drug and monitor sedation and respiratory rate. Counsel patients to avoid driving and other hazardous tasks.
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 Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Butorphanol with Doxepin?
MediHelp rates the interaction as moderate. Butorphanol and Doxepin 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. Doxepin is a sedating tricyclic antidepressant with strong antihistaminic activity, and butorphanol is an opioid analgesic. Together they increase drowsiness, psychomotor impairment and the risk of respiratory depression, particularly in older or frail patients.
How serious is the interaction between Butorphanol and Doxepin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with reduced doses of either drug and monitor sedation and respiratory rate. Counsel patients to avoid driving and other hazardous tasks.
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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