butorphanol vs fentanyl
Side-by-side comparison of butorphanol and fentanyl. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
minor Known Drug Interaction
Examples: Butorphanol, nalbuphine, pentazocine, buprenorphine.
Recommendation: Avoid using these two medicines together. Your doctor may need to adjust your pain management plan.
Stadol
Duragesic, Actiq
Butorphanol nasal spray is a strong pain medicine. It is used when other pain medicines are not strong enough or cannot be tolerated.
Fentanyl Citrate Injection is a strong opioid pain medicine. It is used to provide short-term pain relief, often during and after surgery.
This medicine treats severe pain that requires an opioid pain reliever. It is for use when other pain treatments are not strong enough or cannot be tolerated. Do not use this medicine for a long time unless your pain is still severe and other treatments are still not adequate.
Fentanyl Citrate Injection is used to manage pain during and after surgery. It can be used alone or with other medicines during general or regional anesthesia. It may also be used with oxygen for high-risk patients during certain surgeries.
Butorphanol is an opioid agonist-antagonist. It works by changing how your brain and nervous system respond to pain. It attaches to certain receptors in the brain to reduce pain signals.
Fentanyl is an opioid that works by binding to receptors in the brain and spinal cord. This binding decreases the feeling of pain. It can also cause sleepiness and slow breathing.
- • Sleepiness
- • Dizziness
- • Nausea
- • Vomiting
- • Nasal congestion
- • Nausea
- • Vomiting
- • Dizziness
- • Blurred vision
- Allergic reaction to the drug 48
- Feeling sick to your stomach 25
- Head pain 16
- Discomfort 16
- Itching 16
- Misuse of drugs 10,453
- Pain 7,248
- Drug addiction 6,027
- Harmful effect from drugs 5,847
- Taking too much of a drug 5,722
This medicine has serious warnings. It can cause addiction, abuse, and misuse, which can lead to overdose and death. It can also cause life-threatening breathing problems, especially when you first start using it or after a dose increase. Accidental use, even one dose, can cause a fatal overdose, especially in children. Using this medicine with benzodiazepines or other drugs that can make you sleepy, including alcohol, can cause serious problems, including coma and death. If you use this medicine for a long time during pregnancy, it can cause withdrawal symptoms in the newborn that could be life-threatening if not treated.
Fentanyl Citrate Injection can cause serious and life-threatening risks: * Addiction, abuse, and misuse can lead to overdose and death. Your doctor will assess your risk before prescribing and monitor you regularly. * Life-threatening respiratory depression (slowed or stopped breathing) can occur, especially when starting the medicine or after a dose increase. Proper dosing is essential. * Taking fentanyl with benzodiazepines (like Valium or Xanax) or other CNS depressants (including alcohol) can cause severe sleepiness, slowed breathing, coma, and death. This combination should be avoided unless there are no other options. * Using fentanyl with certain other medicines (CYP3A4 inhibitors or inducers) can change the amount of fentanyl in your blood, leading to dangerous side effects or withdrawal symptoms. Your doctor will monitor you closely if these medicines are used together.
If you need to use this medicine for a long time during pregnancy, it can cause withdrawal symptoms in your newborn. Make sure a newborn specialist is available when you deliver your baby.
Using fentanyl for a long time during pregnancy can cause withdrawal symptoms in the newborn. Fentanyl is not recommended during labor or delivery because it can cause breathing problems in the baby.
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How to Read This butorphanol vs fentanyl Comparison
butorphanol is classified in the Opioid Agonist-Antagonist drug class, while fentanyl sits within the Opioid Analgesic class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, butorphanol has 121 submissions while fentanyl has 35,297. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to butorphanol can block the pain-relieving effects of fentanyl or cause sudden withdrawal symptoms because it works differently on the same brain receptors.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between butorphanol and fentanyl - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.