Drug interactions
Butorphanol + Esketamine intranasal
Severity: Moderate
Butorphanol and Esketamine intranasal: 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
Esketamine causes sedation and dissociation, and butorphanol adds opioid sedation and respiratory depression. Together they can increase CNS depression.
What this interaction means in plain words
Butorphanol and Esketamine intranasal 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.
Why it happens
Additive CNS depressant effects of an NMDA antagonist and an opioid.
What to do
Monitor sedation and respiratory status during and after esketamine administration. Reduce the opioid dose where 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 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 Esketamine intranasal?
MediHelp rates the interaction as moderate. Butorphanol and Esketamine intranasal 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. Esketamine causes sedation and dissociation, and butorphanol adds opioid sedation and respiratory depression. Together they can increase CNS depression.
How serious is the interaction between Butorphanol and Esketamine intranasal?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and respiratory status during and after esketamine administration. Reduce the opioid dose where feasible.
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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