Butorphanol Side Effects

Brand Names: Stadol, Stadol NS

Please note - some side effects for Butorphanol may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of Butorphanol - for the Consumer

Butorphanol Solution

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Butorphanol Solution:

Dizziness; drowsiness; dry mouth; light-headedness; nasal irritation; nausea; runny nose; sore throat; stuffy nose; trouble sleeping; unpleasant taste; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Butorphanol Solution:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; burning, numbness, or tingling; change in the amount of urine produced; chest pain; confusion; ear pain; fainting; fast, slow, or irregular heartbeat; flushing; hallucinations; mental or mood changes (eg, agitation, anxiety, depression); restlessness; ringing in the ears; seizures; severe or persistent dizziness, drowsiness, or light-headedness; severe or persistent headache or trouble sleeping; shortness of breath; slow, shallow, or difficult breathing; tremors; unusual swelling.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

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Butorphanol Side Effects - for the Professional

Butorphanol

Clinical Trial Experience

A total of 2446 patients were studied in premarketing clinical trials of Butorphanol. Approximately half received Butorphanol tartrate injection with the remainder receiving Butorphanol tartrate nasal spray. In nearly all cases the type and incidence of side effects with Butorphanol by any route were those commonly observed with opioid analgesics.

The adverse experiences described below are based on data from short-term and long-term clinical trials in patients receiving Butorphanol by any route. There has been no attempt to correct for placebo effect or to subtract the frequencies reported by placebo treated patients in controlled trials.

The most frequently reported adverse experiences across all clinical trials with Butorphanol tartrate injection and nasal spray were somnolence (43%), dizziness (19%), nausea and/or vomiting (13%). In long-term trials with the nasal spray only, nasal congestion (13%) and insomnia (11%) were frequently reported.

The following adverse experiences were reported at a frequency of 1% or greater in clinical trials, and were considered to be probably related to the use of Butorphanol:

Body as a Whole: asthenia/lethargy, headache, sensation of heat.

Cardiovascular: vasodilation, palpitations.

Digestive: anorexia, constipation, dry mouth, nausea and/or vomiting, stomach pain.

Nervous: anxiety, confusion, dizziness, euphoria, floating feeling, insomnia, nervousness, paresthesia, somnolence, tremor.

Respiratory: bronchitis, cough, dyspnea, epistaxis, nasal congestion, nasal irritation, pharyngitis, rhinitis, sinus congestion, sinusitis, upper respiratory infection.

Skin and Appendages: sweating/clammy, pruritus.

Special Senses: blurred vision, ear pain, tinnitus, unpleasant taste.

The following adverse experiences were reported with a frequency of less than 1% in clinical trials and were considered to be probably related to the use of Butorphanol.

Cardiovascular: hypotension, syncope.

Nervous: abnormal dreams, agitation, dysphoria, hallucinations, hostility, withdrawal symptoms.

Skin and Appendages: rash/hives.

Urogenital: impaired urination.

The following infrequent additional adverse experiences were reported in a frequency of less than 1% of the patients studied in short-term nasal spray trials and under circumstances where the association between these events and Butorphanol administration is unknown. They are being listed as alerting information for the physician.

Body as a Whole: edema.

Cardiovascular: chest pain, hypertension, tachycardia.

Nervous: depression.

Respiratory: shallow breathing.

Postmarketing Experience

Postmarketing experience with Butorphanol tartrate injection and nasal spray has shown an adverse event profile similar to that seen during the premarketing evaluation of Butorphanol by all routes of administration. Adverse experiences that were associated with the use of Butorphanol tartrate injection or nasal spray and that are not listed above have been chosen for inclusion below because of their seriousness, frequency of reporting, or probable relationship to Butorphanol. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. These adverse experiences include apnea, convulsion, delusion, drug dependence, excessive drug effect associated with transient difficulty speaking and/or executing purposeful movements, overdose, and vertigo. Reports of Butorphanol overdose with a fatal outcome have usually but not always been associated with ingestion of multiple drugs.

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Side Effects by Body System - for Healthcare Professionals

Other

The manufacturer has reported that in clinical trials (n=2,446), approximately half of the patients received butorphanol injection and the other half received butorphanol nasal spray. The type and incidence of side effects with butorphanol by either route were consistent with those commonly found with opioid analgesics.

Nervous system

Nervous system effects including somnolence (43%), dizziness (19%), insomnia (11%), anxiety, confusion, euphoria, floating feeling, nervousness, paresthesia, and tremor have been reported.

Respiratory

Respiratory effects including nasal congestion (13%), bronchitis, cough, dyspnea, epistaxis, nasal irritation, pharyngitis, rhinitis, sinus congestion, sinusitis, and upper respiratory infection have all been predominantly reported from long term trials with butorphanol nasal spray.

Gastrointestinal

Gastrointestinal effects including nausea and/or vomiting (13%), anorexia, constipation, dry mouth, and stomach pain have been reported.

General

Asthenia/lethargy, headache, and a sensation of heat have been reported.

Cardiovascular

Cardiovascular effects including vasodilation and palpitations have been predominantly reported from long term trials with butorphanol nasal spray.

Dermatologic

Dermatologic effects including sweating/clammy skin and pruritus have been reported.

Other

Ear pain, tinnitus, and unpleasant taste have been predominantly reported from trials with butorphanol nasal spray.

Ocular

Ocular effects including blurred vision have been reported.

Musculoskeletal

Musculoskeletal effects including a case of fibrous myopathy have been reported in a patient abusing intramuscular butorphanol.

Other

Elderly patients may be more sensitive to the effects of butorphanol. Clinical studies of butorphanol administered via the intranasal route have reported that elderly patients had an increased frequency of headache, dizziness, drowsiness, vertigo, constipation, nausea and/or vomiting, and nasal congestion, compared with younger patients.

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