What the FDA labels say about taking them together
Butorphanol and tapentadol
Tapentadol's FDA label of February 26, 2026 names butorphanol in its drug interactions section; butorphanol's label does not name tapentadol itself but warns about its class (Opioids (opioid agonists)). The tapentadol label: “May reduce the analgesic effect of tapentadol tablets and/or precipitate withdrawal symptoms.”
Check it at the source: the butorphanol FDA label on DailyMed (effective January 2, 2026, Hospira, Inc.); the tapentadol FDA label on DailyMed (effective February 26, 2026, Hikma Pharmaceuticals USA Inc.).
What does the butorphanol label say about tapentadol?
Butorphanol's label does not name tapentadol 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 tapentadol label say about butorphanol?
Tapentadol label, drug interactionsClinical Impact: May reduce the analgesic effect of tapentadol tablets and/or precipitate withdrawal symptoms. Intervention: Avoid concomitant use. Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Muscle Relaxants
Tapentadol label, warnings and precautionsAdditionally, avoid 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 tapentadol tablets.
Tapentadol label (Hikma Pharmaceuticals USA Inc., February 26, 2026), warnings and precautionsAdditionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who have received or are receiving a course of therapy with a full opioid agonist analgesic, including tapentadol extended-release tablets.
Source: FDA drug label (Tapentadol, NDA200533), Hikma Pharmaceuticals USA Inc., effective February 26, 2026 (SPL set 38de863e-56ff-4c43-9ab8-9b3e1ba82858), via openFDA
Source: FDA drug label (TAPENTADOL), Hikma Pharmaceuticals USA Inc., effective February 26, 2026 (SPL set 863f3fd3-1e8d-41b0-855f-8f9a29237cda), 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 | Tapentadol | |
|---|---|---|
| Labeled for | Pain | Pain |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $15.46 per mL 10 mg/mL spray | $14.48 per tablet 100 mg tablet |
| Shortage now | No current entry | No current entry |
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