Drug interactions
Butorphanol + Opium tincture
Severity: Major
Butorphanol and Opium tincture: 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
Butorphanol is a mixed agonist-antagonist opioid and opium tincture is a full mu-agonist. Together they can add to sedation and respiratory depression. In patients who are physically dependent on opioids, butorphanol may displace the full agonist and precipitate withdrawal or reduce analgesia.
What this interaction means in plain words
Butorphanol and Opium tincture 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, plus partial mu-receptor antagonism by butorphanol opposing the full agonist.
What to do
Avoid combining them; choose a single opioid strategy. If unavoidable, use the lowest doses, monitor sedation and respiratory rate, and watch for withdrawal in opioid-dependent patients.
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 Opium tincture?
MediHelp rates the interaction as major. Butorphanol and Opium tincture 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 is a mixed agonist-antagonist opioid and opium tincture is a full mu-agonist. Together they can add to sedation and respiratory depression. In patients who are physically dependent on opioids, butorphanol may displace the full agonist and precipitate withdrawal or reduce analgesia.
How serious is the interaction between Butorphanol and Opium tincture?
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 combining them; choose a single opioid strategy. If unavoidable, use the lowest doses, monitor sedation and respiratory rate, and watch for withdrawal in opioid-dependent patients.
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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