Drug interactions
Butorphanol + Selegiline
Severity: Major
Butorphanol and Selegiline: 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
Selegiline inhibits MAO, and at transdermal antidepressant doses it is non-selective, so opioid use may cause hypotension, marked sedation, hyperthermia or serotonin toxicity. Butorphanol is weakly serotonergic, but caution is still warranted.
What this interaction means in plain words
Butorphanol and Selegiline 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; Selegiline belongs to Central Nervous System.
Why it happens
MAO inhibition may potentiate opioid CNS and cardiovascular depression and may contribute to serotonergic toxicity; the exact mechanism is not fully established.
What to do
Avoid butorphanol with transdermal selegiline and for 14 days after stopping it; use a non-opioid analgesic. If unavoidable, use a reduced dose and monitor blood pressure, temperature and mental status.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Butorphanol and Selegiline, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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
Other interactions of Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Frequently asked questions
Can I take Butorphanol with Selegiline?
MediHelp rates the interaction as major. Butorphanol and Selegiline 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. Selegiline inhibits MAO, and at transdermal antidepressant doses it is non-selective, so opioid use may cause hypotension, marked sedation, hyperthermia or serotonin toxicity. Butorphanol is weakly serotonergic, but caution is still warranted.
How serious is the interaction between Butorphanol and Selegiline?
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 butorphanol with transdermal selegiline and for 14 days after stopping it; use a non-opioid analgesic. If unavoidable, use a reduced dose and monitor blood pressure, temperature and mental status.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
