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Butorphanol Side Effects

In Summary

Commonly reported side effects of butorphanol include: dizziness and drowsiness. Other side effects include: lethargy, cold and clammy skin, and diaphoresis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to butorphanol: injection solution

Other dosage forms:

Along with its needed effects, butorphanol 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 while taking butorphanol:

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 while taking butorphanol:

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 of butorphanol 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 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

For Healthcare Professionals

Applies to butorphanol: injectable solution, nasal spray

General

The most commonly reported adverse events have included somnolence, dizziness, nausea, and vomiting. Nasal congestion has been reported with use of the nasal spray.[Ref]

Respiratory

Very common (10% or more): Nasal congestion (13%)
Common (1% to 10%): Epistaxis, nasal congestion, nasal irritation, rhinitis, sinus congestion, sinusitis, nose pain, cough, dyspnea
Frequency not reported: Shallow breathing[Ref]

Hypersensitivity

Anaphylaxis has been reported with ingredients contained in butorphanol nasal spray.

Postmarketing reports: Anaphylaxis

Gastrointestinal

Common (1% to 10%): Nausea, anorexia, constipation, dry mouth, nausea and/or vomiting, diarrhea, stomach pain[Ref]

Nervous system

Concomitant use of opioids and serotonergic drugs have been associated with reports of serotonin syndrome.[Ref]

Very common (10% or more): Somnolence (49%), dizziness (23%)
Common (1% to 10%): Headache, lethargy, confusion, dizziness, paresthesia, somnolence, tremor, unpleasant taste
Postmarketing reports: Serotonin syndrome[Ref]

Psychiatric

Abnormal dreams, agitation, dysphoria, hallucinations, hostility, withdrawal symptoms, and depression have been reported in less than 1% of patients.

Very common (10% or more): Insomnia (11%)
Common (1% to 10%): Anxiety, euphoria, nervousness
Frequency not reported: Abnormal dreams, agitation, dysphoria, hallucinations, hostility, withdrawal symptoms, depression

Cardiovascular

Syncope, chest pain, tachycardia, and edema have been reported in less than 1% of patients.[Ref]

Common (1% to 10%): Hypertension, hypotension, vasodilation, palpitations
Frequency not reported: Syncope, edema, chest pain, tachycardia[Ref]

Dermatologic

Rash/hives have been reported in less than 1% of patients.[Ref]

Common (1% to 10%): Sweating, pruritus
Frequency not reported: Rash/hives[Ref]

Ocular

Common (1% to 10%): Blurred vision[Ref]

Other

Common (1% to 10%): Asthenia, sensation of heat, pain, ear pain, tinnitus[Ref]

Genitourinary

Frequency not reported: Impaired urination

Endocrine

Postmarketing reports: Adrenal insufficiency, androgen deficiency

Cases of adrenal insufficiency have been reported with opioid use, more often following greater than one month of use; Cases of androgen deficiency have occurred with chronic use of opioids.

References

1. "Product Information. Stadol (butorphanol nasal)." Bristol-Myers Squibb, Princeton, NJ.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

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