Applies to the following strength(s): 2 mg/mL1 mg/mL10 mg/mL
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Anesthesia
The preoperative dosage of butorphanol should be individualized. However, the following guidelines may be helpful.
Initial dose: 2 mg intramuscularly 60 to 90 minutes before surgery
Initial dose: 2 mg intravenously shortly before induction and/or 0.5 mg to 1 mg in increments during anesthesia. The increments may be higher, up to 0.06 mg/kg (4 mg/70 kg) depending on the previous sedative, analgesic, and hypnotic drugs administered.
The total dose needed will vary. However, patients have generally been reported to have needed between a total dosage of 4 mg to 12.5 mg (approximately 0.06 to 0.18 mg/kg).
Because butorphanol nasal spray has not been studied for use in induction or maintenance anesthesia, use of the nasal spray for anesthesia is not recommended.
Usual Adult Dose for Labor Pain
For use In the treatment of patients at full term early in labor:
Initial dose: 1 or 2 mg intravenously or intramuscularly once.
This dose may be repeated in 4 hours if necessary.
Alternative analgesia should be used for pain associated with delivery or if delivery is expected to occur within 4 hours.
Because butorphanol nasal spray has not been studied for use in labor, use of the nasal spray for labor is not recommended.
Usual Adult Dose for Pain
Initial dose: 1 mg intravenously once. Depending on the severity of the pain, effective intravenous doses range from 0.5 to 2 mg.
An initial dose of 2 mg of butorphanol intramuscularly once may be appropriate for patients who will be able to remain recumbent if drowsiness or dizziness occurs. Depending on the severity of the pain, effective intramuscular doses range from 1 to 4 mg.
Alternatively, an initial dose of 1 mg of butorphanol by nasal administration (1 spray in one nostril) once. Adherence to this dose has been reported to have led to a reduced incidence of drowsiness and dizziness. If adequate pain relief is not achieved within 60 to 90 minutes, an additional 1 mg dose may be administered. Depending on the severity of the pain, an initial dose of 2 mg (1 spray in each nostril) may be appropriate in patients who will be able to remain recumbent if drowsiness or dizziness occurs.
Initial doses may be repeated after 3 to 4 hours if necessary. (This includes the initial dosage sequence of 1 mg by nasal administration followed by a second 1 mg dose in 60 to 90 minutes if necessary. This sequence may be repeated 3 to 4 hours after the second dose if necessary.)
Subsequent doses may be determined by patient response, rather than being scheduled at fixed dosing intervals.
Renal Dose Adjustments
Dose adjustments may be needed in patients with renal dysfunction.
Liver Dose Adjustments
Dose adjustments may be needed for patients with liver dysfunction.
Because of the potential for respiratory depression in the infant, extra caution is recommended when butorphanol is administered during labor.
Induction of general anesthesia should only be performed by experienced individuals who have been specifically trained in the management of anesthetized patients.
Safety and effectiveness have not been established in pediatrics (less than 18 years of age).
Data not available
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