butorphanol (Injection route)

Pronunciation

bue-TOR-fa-nol

Commonly used brand name(s)

In the U.S.

  • Stadol

Available Dosage Forms:

  • Solution

Therapeutic Class: Analgesic

Pharmacologic Class: Opioid Agonist/Antagonist

Chemical Class: Opioid

Uses For butorphanol

Butorphanol injection is used to relieve pain. It may also be given before a surgery, when giving birth, or with general anesthesia before an operation.

Butorphanol injection belongs to the group of medicines called narcotic analgesics (pain medicines). It acts on the central nervous system (CNS) to relieve pain.

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When butorphanol injection is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

butorphanol is available only with your doctor's prescription.

Before Using butorphanol

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For butorphanol, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to butorphanol or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of butorphanol injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of butorphanol injection in the elderly. However, elderly patients may be more sensitive to the effects of butorphanol than younger adults, and are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving butorphanol injection.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving butorphanol, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using butorphanol with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfentanil
  • Alphaprodine
  • Carbinoxamine
  • Codeine
  • Dihydrocodeine
  • Fentanyl
  • Fospropofol
  • Hydrocodone
  • Hydromorphone
  • Levorphanol
  • Meclizine
  • Meperidine
  • Methadone
  • Morphine
  • Morphine Sulfate Liposome
  • Oxycodone
  • Oxymorphone
  • Propoxyphene
  • Sufentanil
  • Tapentadol

Using butorphanol with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Perampanel

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of butorphanol. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse, or history of or
  • Breathing problems (e.g., chronic obstructive pulmonary disease [COPD], cor pulmonale, hypoxia) or
  • CNS diseases or
  • Drug dependence, especially narcotic abuse or dependence, history of—Use with caution. May increase risk for more serious side effects.
  • Brain tumor or
  • Head injuries or
  • Increased pressure in the head—Some of the side effects of butorphanol injection can cause serious problems in people who have these medical problems.
  • Heart attack or
  • Heart or blood vessel problems or
  • Hypertension (high blood pressure)—Use with caution. May make these conditions worse.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of butorphanol

A nurse or other trained health professional will give you butorphanol. butorphanol is given as a shot into a muscle or through a needle placed in one of your veins.

Precautions While Using butorphanol

It is very important that your doctor check your progress while you are using butorphanol. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it.

butorphanol will add to the effects of alcohol and other CNS depressants (medicines that can make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds; sedatives, tranquilizers, or sleeping medicine; other prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the other medicines listed above while you are using butorphanol.

butorphanol may make you dizzy, drowsy, confused, or disoriented. Make sure you know how you react to butorphanol before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent worsening of your condition and reduce the possibility of withdrawal symptoms, such as abdominal or stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble with sleeping.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

butorphanol Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common
  • Cough producing mucus
  • difficulty breathing
  • shortness of breath
  • tightness in chest
  • wheezing
Rare
  • Blurred vision
  • chest pain
  • confusion
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • fast, pounding, or irregular heartbeat or pulse
  • nervousness
  • pounding in the ears
  • slow or fast heartbeat
Incidence not known
  • Bluish lips or skin
  • false beliefs that cannot be changed by facts
  • not breathing
  • seizures

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
  • Change in consciousness
  • extremely shallow or slow breathing
  • irregular heartbeats
  • loss of consciousness
  • shortness of breath
  • swelling in hands and feet

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Dizziness
  • nausea
  • sleepiness or unusual drowsiness
  • vomiting
Less common
  • Bad unusual or unpleasant (after) taste
  • bloody nose
  • body aches or pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in taste
  • clammy skin
  • congestion
  • continuing ringing or buzzing or other unexplained noise in ears
  • cough
  • dry mouth
  • dryness or soreness of throat
  • ear pain
  • false or unusual sense of well-being
  • fear or nervousness
  • feeling of warmth or heat
  • fever
  • floating feeling
  • flushing or redness of skin, especially on face and neck
  • headache
  • hearing loss
  • heat sensation on body
  • hoarseness
  • loss of appetite
  • nasal irritation
  • runny nose
  • shakiness
  • skin itching
  • sleeplessness
  • sneezing
  • stomach pain
  • stuffy nose
  • tender, swollen glands in neck
  • trouble in swallowing
  • trouble sleeping
  • unable to sleep
  • voice changes
  • weight loss
Rare
  • Sweating
  • unusual tiredness or weakness
Incidence not known
  • Dizziness or lightheadedness
  • feeling of constant movement of self or surroundings
  • lack or loss of strength
  • problems in speaking
  • sensation of spinning

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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