Drug interactions
Butorphanol + Linezolid
Severity: Major
Butorphanol and Linezolid: 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
Linezolid is a reversible, non-selective MAO inhibitor, and combining it with opioids can lead to serotonin toxicity or exaggerated CNS and respiratory depression and blood pressure changes. Butorphanol has little serotonergic activity, so the risk is probably lower than with agents such as meperidine, but it is not eliminated.
What this interaction means in plain words
Butorphanol and Linezolid 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.
Butorphanol belongs to Musculoskeletal; Linezolid belongs to Anti Bacterial.
Why it happens
Linezolid's MAO inhibition may potentiate opioid CNS depressant and hemodynamic effects and possibly serotonergic toxicity; the mechanism for butorphanol is not well established.
What to do
Prefer an alternative antibiotic or analgesic where possible. If both are required, use the lowest effective butorphanol dose and monitor for agitation, hyperthermia, clonus, sedation and hypotension.
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
Other interactions of Linezolid
- Amoxapine + Linezolid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Benzphetamine + Linezolid Contraindicated
- Brimonidine + Linezolid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion + Linezolid Contraindicated
Frequently asked questions
Can I take Butorphanol with Linezolid?
MediHelp rates the interaction as major. Butorphanol and Linezolid 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. Linezolid is a reversible, non-selective MAO inhibitor, and combining it with opioids can lead to serotonin toxicity or exaggerated CNS and respiratory depression and blood pressure changes. Butorphanol has little serotonergic activity, so the risk is probably lower than with agents such as meperidine, but it is not eliminated.
How serious is the interaction between Butorphanol and Linezolid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antibiotic or analgesic where possible. If both are required, use the lowest effective butorphanol dose and monitor for agitation, hyperthermia, clonus, sedation and hypotension.
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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