Suboxone and Butorphanol (Stadol): Dangerous Combination?

No. Mixing butorphanol (Stadol) with buprenorphine in Suboxone (which contains buprenorphine and naloxone) increases the risk of serious side effects, including respiratory depression, coma, or death.

Butorphanol is metabolized by the liver enzyme CYP2D6. Buprenorphine can alter this metabolism:

• Drugs that inhibit CYP2D6 slow butorphanol breakdown, increasing side effect risk.
• Drugs that induce CYP2D6 accelerate breakdown, reducing butorphanol effectiveness.

Therefore, avoid taking buprenorphine and butorphanol concurrently.