Drug interactions
Butorphanol + Mirtazapine
Severity: Moderate
Butorphanol and Mirtazapine: 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
Mirtazapine is strongly sedating through histamine blockade, and with butorphanol it can increase drowsiness and psychomotor impairment. Respiratory depression is a concern in higher doses or vulnerable patients.
What this interaction means in plain words
Butorphanol and Mirtazapine 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; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive CNS depression from opioid activity and H1 antagonism of mirtazapine.
What to do
Monitor sedation and breathing, especially at initiation, and reduce doses if drowsiness is excessive. Advise against alcohol and driving.
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 Mirtazapine
- Isocarboxazid + Mirtazapine Contraindicated
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Procarbazine Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
Frequently asked questions
Can I take Butorphanol with Mirtazapine?
MediHelp rates the interaction as moderate. Butorphanol and Mirtazapine 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. Mirtazapine is strongly sedating through histamine blockade, and with butorphanol it can increase drowsiness and psychomotor impairment. Respiratory depression is a concern in higher doses or vulnerable patients.
How serious is the interaction between Butorphanol and Mirtazapine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and breathing, especially at initiation, and reduce doses if drowsiness is excessive. Advise against alcohol and driving.
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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