Drug interactions
Butorphanol + Remimazolam
Severity: Major
Butorphanol and Remimazolam: major 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
Concurrent opioids and remimazolam can produce profound sedation, respiratory depression, coma and death. Labeling specifically warns about this combination.
What this interaction means in plain words
Butorphanol and Remimazolam 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; Remimazolam belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression via opioid receptors and GABA-A potentiation.
What to do
Continuously monitor vital signs and oxygenation during sedation and recovery. Titrate remimazolam carefully, usually at reduced doses, when an opioid is given.
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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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 Remimazolam
Frequently asked questions
Can I take Butorphanol with Remimazolam?
MediHelp rates the interaction as major. Butorphanol and Remimazolam 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. Concurrent opioids and remimazolam can produce profound sedation, respiratory depression, coma and death. Labeling specifically warns about this combination.
How serious is the interaction between Butorphanol and Remimazolam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Continuously monitor vital signs and oxygenation during sedation and recovery. Titrate remimazolam carefully, usually at reduced doses, when an opioid is given.
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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