Drug interactions
Butorphanol + Ketamine
Severity: Moderate
Butorphanol and Ketamine: 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
Ketamine and opioids together increase sedation and analgesia, and can increase the risk of respiratory depression, particularly with rapid or high-dose administration. Ketamine may also raise blood pressure and heart rate, while butorphanol can contribute to dysphoria or hallucinations.
What this interaction means in plain words
Butorphanol and Ketamine 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; Ketamine belongs to Central Nervous System.
Why it happens
Additive CNS depression from NMDA-receptor antagonism and opioid receptor activity.
What to do
Titrate both drugs to effect with reduced doses and monitor respiratory status, oxygenation and hemodynamics. Ensure airway equipment and trained personnel are available during procedural use.
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 Ketamine
Frequently asked questions
Can I take Butorphanol with Ketamine?
MediHelp rates the interaction as moderate. Butorphanol and Ketamine 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. Ketamine and opioids together increase sedation and analgesia, and can increase the risk of respiratory depression, particularly with rapid or high-dose administration. Ketamine may also raise blood pressure and heart rate, while butorphanol can contribute to dysphoria or hallucinations.
How serious is the interaction between Butorphanol and Ketamine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate both drugs to effect with reduced doses and monitor respiratory status, oxygenation and hemodynamics. Ensure airway equipment and trained personnel are available during procedural use.
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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