What the FDA labels say about taking them together
Butorphanol and meperidine
Meperidine's FDA label of November 29, 2025 names butorphanol in its drug interactions section; butorphanol's label does not name meperidine itself but warns about its class (Opioids (opioid agonists)). The meperidine label: “May reduce the analgesic effect of DEMEROL Injection and/or precipitate withdrawal symptoms.”
Check it at the source: the butorphanol FDA label on DailyMed (effective January 2, 2026, Hospira, Inc.); the meperidine FDA label on DailyMed (effective November 29, 2025, EPIC PHARMA, LLC).
What does the butorphanol label say about meperidine?
Butorphanol's label does not name meperidine itself; it warns about its class (Opioids (opioid agonists)):
Butorphanol label, warningsLife-Threatening Respiratory Depression Serious, life-threatening, or fatal respiratory depression has been reported with the use of opioids, even when used as recommended.
Butorphanol label, boxed warningSERIOUS AND LIFE-THREATENING RISKS FROM USE OF BUTORPHANOL TARTRATE INJECTION Addiction, Abuse, and Misuse Because the use of Butorphanol Tartrate Injection exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient’s risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions [see WARNINGS ].
Source: FDA drug label (Butorphanol Tartrate), Hospira, Inc., effective January 2, 2026 (SPL set 9822ca3f-aee2-46e5-8a96-495400e65d10), via openFDA; the full label on DailyMed
What does the meperidine label say about butorphanol?
Meperidine label, drug interactionsClinical Impact: May reduce the analgesic effect of meperidine hydrochloride tablets and/or precipitate withdrawal symptoms. Intervention: Avoid concomitant use. Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Muscle Relaxants
Meperidine label, warnings and precautionsAdditionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist
Demerol label (Hospira, Inc., July 20, 2026), warnings and precautionsAvoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including DEMEROL Injection.
Source: FDA drug label (Demerol, NDA021171), Hospira, Inc., effective July 20, 2026 (SPL set b31d1308-28c3-43f4-e0a6-2f3ed76b8975), via openFDA
Source: FDA drug label (Meperidine Hydrochloride), EPIC PHARMA, LLC, effective November 29, 2025 (SPL set fae5cc34-5917-4445-9516-25f97ffca8db), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Butorphanol | Meperidine | |
|---|---|---|
| Labeled for | Pain | Pain |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $15.46 per mL 10 mg/mL spray | $0.157 per mL 50 mg/5 mL solution |
| Shortage now | No current entry | Listed; available |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once