Drug interactions
Butorphanol + Oxymorphone
Severity: Major
Butorphanol and Oxymorphone: 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 the effect of a full mu agonist like oxymorphone. In opioid-dependent patients it may precipitate withdrawal, and it can also add to sedation and respiratory depression.
What this interaction means in plain words
Butorphanol and Oxymorphone 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; Oxymorphone belongs to Musculoskeletal.
Why it happens
Kappa agonism with mu-receptor partial antagonism or agonism, competing with oxymorphone, plus additive CNS depression.
What to do
Avoid concurrent use in opioid-tolerant patients and choose a single opioid strategy. If unavoidable, monitor for withdrawal, loss of analgesia and sedation.
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 Oxymorphone
- Alvimopan + Oxymorphone Contraindicated
- Ethanol + Oxymorphone Contraindicated
- Isocarboxazid + Oxymorphone Contraindicated
- Olanzapine / samidorphan + Oxymorphone Contraindicated
- Oxymorphone + Phenelzine Contraindicated
- Oxymorphone + Selegiline transdermal 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 Oxymorphone?
MediHelp rates the interaction as major. Butorphanol and Oxymorphone 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 the effect of a full mu agonist like oxymorphone. In opioid-dependent patients it may precipitate withdrawal, and it can also add to sedation and respiratory depression.
How serious is the interaction between Butorphanol and Oxymorphone?
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 concurrent use in opioid-tolerant patients and choose a single opioid strategy. If unavoidable, monitor for withdrawal, loss of analgesia and sedation.
What other medicines interact with Oxymorphone?
MediHelp also lists interactions of Oxymorphone with, for example, Alvimopan, Ethanol, Isocarboxazid. The full list is on the Oxymorphone page.
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