Drug interactions
Butorphanol + Oxycodone
Severity: Major
Butorphanol and Oxycodone: 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 that can reduce oxycodone analgesia and precipitate withdrawal in opioid-dependent patients. It also adds sedation and respiratory depression.
What this interaction means in plain words
Butorphanol and Oxycodone 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; Oxycodone belongs to Musculoskeletal.
Why it happens
Kappa agonist and partial mu antagonist or agonist activity competes with oxycodone at opioid receptors, plus additive CNS depression.
What to do
Avoid combining in opioid-tolerant patients; choose one agent. If used together, monitor for withdrawal, pain control, and respiratory depression.
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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate 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 Oxycodone?
MediHelp rates the interaction as major. Butorphanol and Oxycodone 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 that can reduce oxycodone analgesia and precipitate withdrawal in opioid-dependent patients. It also adds sedation and respiratory depression.
How serious is the interaction between Butorphanol and Oxycodone?
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 in opioid-tolerant patients; choose one agent. If used together, monitor for withdrawal, pain control, and respiratory depression.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone page.
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