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Concurrent use of butorphanol with central nervous system depressants (e.g. alcohol, barbiturates, tranquilizers and antihistamine) may result in increased central nervous system depressant effects. When used concurrently with such drugs, the dose of butorphanol should be the smallest effective dose and the frequency of dosing reduced as much as possible when administered concomitantly with drugs that potentiate the actions of opioids.
It is not known if the effects of butorphanol are altered by other concomitant medications that affect hepatic metabolism of drugs (cimetidine, erythromycin, theophylline, etc.), but physicians should be alert to the possibility that a smaller initial dose and longer intervals between doses may be needed.
No information is available about the use of butorphanol concurrently with MAO inhibitors.
