Drug interactions
Butorphanol + Pentobarbital
Severity: Major
Butorphanol and Pentobarbital: 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
Barbiturates and opioids together increase the risk of profound sedation, respiratory depression, coma, and death. Pentobarbital also may induce metabolism of some drugs, but the main concern is additive CNS depression.
What this interaction means in plain words
Butorphanol and Pentobarbital 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 via opioid receptor agonism and enhanced GABA-A activity.
What to do
Reserve concurrent use for situations without alternatives, using reduced doses and the shortest duration. Monitor respiratory rate, oxygen saturation, and level of consciousness continuously.
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 Pentobarbital?
MediHelp rates the interaction as major. Butorphanol and Pentobarbital 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. Barbiturates and opioids together increase the risk of profound sedation, respiratory depression, coma, and death. Pentobarbital also may induce metabolism of some drugs, but the main concern is additive CNS depression.
How serious is the interaction between Butorphanol and Pentobarbital?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve concurrent use for situations without alternatives, using reduced doses and the shortest duration. Monitor respiratory rate, oxygen saturation, and level of consciousness continuously.
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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