Drug interactions
Butorphanol + Flurazepam
Severity: Major
Butorphanol and Flurazepam: 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
Combining an opioid with a benzodiazepine such as flurazepam markedly increases the risk of profound sedation, respiratory depression, coma and death. Flurazepam's long-acting active metabolite prolongs the exposure, which is a particular concern in older adults.
What this interaction means in plain words
Butorphanol and Flurazepam 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
Avoid the combination where possible; otherwise use the lowest doses for the shortest duration. Monitor sedation and breathing closely, especially after dose changes.
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 Flurazepam?
MediHelp rates the interaction as major. Butorphanol and Flurazepam 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. Combining an opioid with a benzodiazepine such as flurazepam markedly increases the risk of profound sedation, respiratory depression, coma and death. Flurazepam's long-acting active metabolite prolongs the exposure, which is a particular concern in older adults.
How serious is the interaction between Butorphanol and Flurazepam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible; otherwise use the lowest doses for the shortest duration. Monitor sedation and breathing closely, especially after dose changes.
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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