Drug interactions
Butorphanol + Sufentanil sl
Severity: Major
Butorphanol and Sufentanil sl: 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
Sublingual sufentanil is a full mu-agonist, and butorphanol can partially block it, which may reduce analgesia or precipitate withdrawal in dependent patients. The two also add to sedation and respiratory depression, with a risk of hypotension and coma.
What this interaction means in plain words
Butorphanol and Sufentanil sl 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
Competitive partial antagonism at the mu receptor combined with additive opioid CNS and respiratory depression.
What to do
Avoid combining them. If both are used, monitor respiratory rate, sedation and blood pressure, and watch for withdrawal or inadequate pain control.
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 Sufentanil sl?
MediHelp rates the interaction as major. Butorphanol and Sufentanil sl 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. Sublingual sufentanil is a full mu-agonist, and butorphanol can partially block it, which may reduce analgesia or precipitate withdrawal in dependent patients. The two also add to sedation and respiratory depression, with a risk of hypotension and coma.
How serious is the interaction between Butorphanol and Sufentanil sl?
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 them. If both are used, monitor respiratory rate, sedation and blood pressure, and watch for withdrawal or inadequate pain control.
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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