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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
  • 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
  • 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


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.[Ref]

Nervous system

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


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.[Ref]


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


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


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


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


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


Ocular effects including blurred vision have been reported.[Ref]


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


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.[Ref]


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

2. Wagner JM, Cohen S "Fibrous myopathy from butorphanol injections." J Rheumatol 18 (1991): 1934-5

Some side effects of butorphanol may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.