Butorphanol

Description

Butorphanol is used for the management of moderate to severe pain when the use of opioid analgesics is appropriate. It is used as anesthesia for surgeries, and also for the management of pain during early labor. This medicine is not recommended for use in patients less than 18 years of age.

Side effects

Major & minor side effects for Butorphanol

  • Difficulty in breathing
  • Shortness of breath
  • Chest tightness
  • Wheezing
  • Blurred vision
  • Lightheadedness, dizziness, or fainting
  • Irregular heart beat
  • Drowsiness
  • Stuffy nose

Uses of Butorphanol

What is it prescribed for?

  • Anesthesia
  • Moderate to severe pain
  • Labor pain
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Concerns

Commonly asked questions

  • Onset of action
    The effect of this medicine can be observed within 15 minutes on nasal administration, 5-10 minutes on intramuscular administration, and less than 10 minutes on intravenous administration.
  • Duration of effect
    The effect of this medicine lasts for an average duration of 3-4 hours on intravenous or intramuscular administration and 4-5 hours on nasal administration.
  • Safe with alcohol?
    Consumption of alcohol is not recommended during treatment with this medicine due to the increased risk of severe side effects such as confusion, dizziness, nausea, vomiting, weakness, and fainting. It is advised that you should avoid alcohol and not to perform activities which require high mental alertness like driving a vehicle and operating machinery while receiving this medicine.
  • Is it habit forming?
    Habit forming tendencies have been reported and hence requires careful administration.
  • Usage in pregnancy?
    This medicine is not recommended for use in pregnant women unless absolutely necessary. The risks and benefits should be discussed with the doctor before receiving/using this medicine.
  • Usage while breast-feeding?
    This medicine is not recommended for use in breastfeeding women unless absolutely necessary. The risks and benefits should be discussed with the doctor before receiving/using this medicine.

Allergy

This medicine is not recommended for use if you have a known allergy to Butorphanol or any other inactive ingredients present along with it.

Respiratory depression

This nasal form of this medicine is not recommended for use in patients with respiratory depression due to the risk of worsening of the patient's condition.

Acute or severe bronchial asthma

This nasal form of this medicine is not recommended for use in patients with acute or severe bronchial asthma due to the risk of worsening of the patient's condition.

Gastrointestinal obstruction

The nasal form of this medicine is not recommended for use in patients with a gastrointestinal obstruction due to the risk of worsening of the patient's condition.

Opioid dependence

This medicine is not recommended for use in patients who have developed a dependence on opioids (opioid dependence).
Warnings for special population

Pregnancy

This medicine is not recommended for use in pregnant women unless absolutely necessary. The risks and benefits should be discussed with the doctor before receiving/using this medicine.

Breast-feeding

This medicine is not recommended for use in breastfeeding women unless absolutely necessary. The risks and benefits should be discussed with the doctor before receiving/using this medicine.
General warnings

Urinary retention

This medicine should be used with caution in patients suffering from urinary retention due to the risk of worsening of the patient's condition. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Withdrawal symptoms

This medicine may cause withdrawal symptoms if the usage is stopped abruptly. Gradual withdrawal is suggested in case you have been using this medicine for long.

Hypertension

This medicine should be used with caution in patients with hypertension due to the risk of worsening of the patient's condition. Close monitoring of blood pressure levels is necessary while receiving this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Head Injury and Increased Intracranial Pressure

This medicine should be used with extreme caution in patients with head injury and increased intracranial pressure due to the risk of worsening of the patient's condition. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Cardiovascular diseases

This medicine should be used with caution in patients with cardiovascular diseases due to the increased risk of worsening of the patient's condition. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Use in Children

This medicine is not recommended for use in patients less than 18 years of age since the safety and efficacy of use are not clinically established.

Hypothyroidism

This medicine should be used with caution in patients with hypothyroidism due to the risk of worsening of the patient's condition. Close monitoring of thyroid function tests is necessary while receiving this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Infectious diarrhea

This medicine should be used with caution in patients with infectious diarrhea since it may worsen diarrhea on prolonged use. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Seizure disorders

This medicine should be used with caution in patients with or predisposed to seizures due to the risk of worsening of the patient's condition. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Driving or Operating machinery

The nasal form of this medicine may cause dizziness or drowsiness in some patients. It is advised that you do not perform any activities that require high mental alertness like driving a vehicle or operating machinery if you experience any of these symptoms during treatment with this medicine. Since the parenteral form of this medicine is used before the surgery, this warning is not applicable.

Missed Dose

Injection: Since this medicine is administered in the hospital or clinical setting by a qualified healthcare professional, the likelihood of a missed dose is very low. Nasal Spray: Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not double your dose to make up for the missed one.

Overdose

Injection: Since this medicine is administered in the hospital or clinical setting by a qualified healthcare professional, the likelihood of an overdose is very low. However, emergency medical treatment will be initiated by the doctor if an overdose is suspected. Nasal Spray: Seek emergency medical treatment or contact the doctor in case of an overdose.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

N/A

Instructions

Consumption of alcohol is not recommended during treatment with this medicine due to the increased risk of severe side effects such as confusion, dizziness, nausea, vomiting, weakness, and fainting. It is advised that you should avoid alcohol and not to perform activities which require high mental alertness like driving a vehicle and operating machinery while receiving this medicine.
Interaction with Medicine

Atazanavir

Alprazolam

Ziprasidone

Clotrimazole

Baclofen

Clozapine

Chlorpromazine

Conivaptan

Asenapine

Disease interactions

Hepatic impairment

This medicine should be used with caution in patients with liver diseases due to the increased risk of severe adverse effects. Close monitoring of liver function tests is necessary while receiving this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Renal Dysfunction

This medicine should be used with caution in patients with kidney diseases due to the increased risk of severe adverse effects. Close monitoring of kidney function tests is necessary while receiving this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Acute myocardial infarction

This medicine should be used with extreme caution in patients with acute myocardial infarction due to the increased risk of worsening of the patient's condition. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Food interactions
Information not available.
Lab interactions
Information not available.
Injection: This medicine should be administered by a qualified healthcare professional. Inform the doctor if you have a known history of allergy to this medicine. Report to the doctor all your current medicines as well as your medical conditions before receiving this medicine. Nasal Spray: Follow all the instructions given by your doctor and administer this medicine exactly as advised. Do not administer in larger or smaller amounts than prescribed. Seek emergency medical treatment in case of any severe side effects. Ensure that the course of treatment is completed. Do not stop the use of this medicine without consulting your doctor.
Miscelleneous

Usage does not depend on food timings

To be taken as instructed by doctor

Causes sleepiness

How it works
It acts on certain specific pain receptors in the brain and inhibits the response to the pain
Legal Status

Approved

Approved

Unknown

Unknown

Classification

Category

Narcotic analgesics

Schedule

Schedule H

DailyMed - Butorphanol Tartrate- butorphanol tartrate injection, solution [Internet]. Dailymed.nlm.nih.gov. 2018 [cited 24 December 2018]. Available from:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=75d3fd4e-9dc3-8bbc-140e-0213ef135ab0

Butorphanol - DrugBank [Internet]. Drugbank.ca. 2018 [cited 24 December 2018]. Available from:

https://www.drugbank.ca/drugs/DB00611

Butorphanol Nasal Spray: MedlinePlus Drug Information [Internet]. Medlineplus.gov. 2018 [cited 24 December 2018]. Available from:

https://medlineplus.gov/druginfo/meds/a601204.html

Prescribing Information Rx Only Butorphanol Tartrate Nasal Spray USP, 10 mg/mL CIV [Internet]. Dailymed.nlm.nih.gov. 2018 [cited 24 December 2018]. Available from:

https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=b8e48063-0b40-ee43-85c1-4ef2de80c404&type=display

DailyMed - Butorphanol Tartrate- butorphanol tartrate spray [Internet]. Dailymed.nlm.nih.gov. 2019 [cited 21 January 2019]. Available from:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b8e48063-0b40-ee43-85c1-4ef2de80c404

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Information on this page was last updated on 21 May 2019

Disclaimer

We’ve made all possible efforts to ensure that the information provided here is accurate, up-to-date and complete, however, it should not be treated as a substitute for professional medical advice, diagnosis or treatment. Practo only provides reference source for common information on medicines and does not guarantee its accuracy or exhaustiveness. The absence of a warning for any drug or combination thereof, should not be assumed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Practo does not assume any responsibility for any aspect of healthcare administered with the aid of information provided above. If you have any doubts about your medication then we strongly recommend that you consult with your doctor, nurse or healthcare provider. See detailed T&C here.