A reduction in dose of the CNS depressant may also be needed. Butorphanol should be used cautiously in any patient receiving these agents, which may include zolpidem. Initially, 5 mg PO immediately before bedtime and with at least 7 to 8 hours remaining before the planned time of awakening; this is also the recommended dose for debilitated adults. However, data show that the risk for next-morning impairment is higher for the extended-release than the immediate-release formulation. Moderate Concurrent use of tetrabenazine and drugs that can cause CNS depression, such as anxiolytics, sedatives, and hypnotics, can increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, dizziness, and orthostatic hypotension. Moderate Phenothiazines are CNS depressant drugs that may have cumulative effects when administered with other CNS depressant drugs and they should be used cautiously with anxiolytic, sedative, and hypnotics. A coma could result in some circumstances.
ASH 2014: Understanding Treatment for MDS/MPN
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