Butorphanol Injection and Tranylcypromine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Tranylcypromine
Butorphanol Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of serotonin syndrome and an increased risk of CNS depression
Interaction Deep Dive
Concurrent use of tranylcypromine and a serotonergic CNS depressants is contraindicated, as it may lead to severe or life-threatening reactions including serotonin syndrome and may also increase the risk of CNS depression. Discontinue serotonergic agent and wait at least 1 week or 4 to 5 half-lives (whichever is longer) of serotonergic agent before initiating tranylcypromine. The potential for interactions persists after discontinuation of tranylcypromine until MAO activity has sufficiently recovered. Inhibition of MAO may persist up to 10 days following discontinuation1.
Why it happens (mechanism)
Additive serotonergic effects; additive CNS depression
Common questions
Can I take Butorphanol Injection and Tranylcypromine together?
An increased risk of serotonin syndrome and an increased risk of CNS depression Always confirm with your pharmacist or prescriber before making any change.
How serious is the Butorphanol Injection and Tranylcypromine interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Butorphanol Injection or Tranylcypromine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: Tranylcypromine oral tablets, tranylcypromine oral tablets. Solco Healthcare US, LLC (per DailyMed), Somerset, NJ, 2024. DailyMed
Keep reading about Tranylcypromine
Keep reading about Butorphanol Injection
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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