Drug interactions
Butorphanol + Estazolam
Severity: Major
Butorphanol and Estazolam: major interaction.
Last updated Sources: US FDA label
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
Opioids and benzodiazepines together produce profound sedation, respiratory depression, coma and death. This risk is recognised in regulatory boxed warnings for opioid and benzodiazepine co-prescription.
What this interaction means in plain words
Butorphanol and Estazolam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS and respiratory depression via opioid receptors and GABA-A potentiation.
What to do
Reserve the combination for patients with no alternative, using the lowest doses and shortest duration. Monitor closely for sedation and respiratory depression and counsel patients and caregivers.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Estazolam?
MediHelp rates the interaction as major. Butorphanol and Estazolam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Opioids and benzodiazepines together produce profound sedation, respiratory depression, coma and death. This risk is recognised in regulatory boxed warnings for opioid and benzodiazepine co-prescription.
How serious is the interaction between Butorphanol and Estazolam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve the combination for patients with no alternative, using the lowest doses and shortest duration. Monitor closely for sedation and respiratory depression and counsel patients and caregivers.
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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