Drug interactions
Butorphanol + Sufentanil
Severity: Major
Butorphanol and Sufentanil: 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
Butorphanol is a mixed agonist-antagonist, while sufentanil is a potent full mu-agonist. Together they can add to sedation and respiratory depression, and in opioid-dependent patients butorphanol may blunt analgesia or precipitate withdrawal. The effect depends on dose and prior opioid exposure.
What this interaction means in plain words
Butorphanol and Sufentanil 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; Sufentanil belongs to Musculoskeletal.
Why it happens
Additive CNS depression plus partial mu-receptor antagonism by butorphanol competing with the full agonist.
What to do
Avoid concurrent use outside of carefully monitored anesthesia settings. Monitor ventilation, sedation and signs of withdrawal, and titrate doses conservatively.
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 Sufentanil
- Alprazolam + Sufentanil Major
- Amitriptyline + Sufentanil Major
- Amobarbital + Sufentanil Major
- Aripiprazole + Sufentanil Major
- Asenapine + Sufentanil Major
- Baclofen + Sufentanil Major
Frequently asked questions
Can I take Butorphanol with Sufentanil?
MediHelp rates the interaction as major. Butorphanol and Sufentanil 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, while sufentanil is a potent full mu-agonist. Together they can add to sedation and respiratory depression, and in opioid-dependent patients butorphanol may blunt analgesia or precipitate withdrawal. The effect depends on dose and prior opioid exposure.
How serious is the interaction between Butorphanol and Sufentanil?
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 outside of carefully monitored anesthesia settings. Monitor ventilation, sedation and signs of withdrawal, and titrate doses conservatively.
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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