Drug interactions
Butorphanol + Meperidine
Severity: Moderate
Butorphanol and Meperidine: 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
Butorphanol is a mixed agonist-antagonist that may partly block mu receptors, reducing meperidine analgesia or precipitating withdrawal in opioid-dependent patients. In other patients the two drugs add to sedation and respiratory depression.
What this interaction means in plain words
Butorphanol and Meperidine 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; Meperidine belongs to Musculoskeletal.
Why it happens
Kappa agonism with mu partial agonism or antagonism competes with meperidine, alongside additive CNS depression.
What to do
Avoid using both together in opioid-dependent patients and choose a single opioid regimen where possible. If used together, monitor for withdrawal symptoms, pain control and sedation.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
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 Meperidine?
MediHelp rates the interaction as moderate. Butorphanol and Meperidine 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 is a mixed agonist-antagonist that may partly block mu receptors, reducing meperidine analgesia or precipitating withdrawal in opioid-dependent patients. In other patients the two drugs add to sedation and respiratory depression.
How serious is the interaction between Butorphanol and Meperidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using both together in opioid-dependent patients and choose a single opioid regimen where possible. If used together, monitor for withdrawal symptoms, pain control and sedation.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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