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Butorphanol Side Effects

Medically reviewed by Last updated on Nov 11, 2023.

Applies to butorphanol: injection solution. Other dosage forms:


Injection route (Solution)

Butorphanol tartrate has the potential for addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient's risk before prescribing, and monitor for development of these behaviors or conditions. Serious, life-threatening, or fatal respiratory depression may occur. Monitor closely, especially upon initiation or following a dose increase. Prolonged use of butorphanol tartrate during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available. Concomitant use of opioids with benzodiazepines or other CNS depressants including alcohol, may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for patients with inadequate alternative treatment options. Limit dosages and durations to the minimum required and follow patients for signs and symptoms of respiratory depression and sedation.

Serious side effects of Butorphanol

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


Incidence not known

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

Symptoms of overdose

Other side effects of Butorphanol

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


Incidence not known

For Healthcare Professionals

Applies to butorphanol: injectable solution, nasal spray.


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]


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]


Postmarketing reports: Anaphylaxis

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


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

Nervous system

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]

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


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


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]


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

Common (1% to 10%): Sweating, pruritus

Frequency not reported: Rash/hives[Ref]


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


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


Frequency not reported: Impaired urination


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.


1. Product Information. Stadol (butorphanol nasal). Bristol-Myers Squibb. 2001;PROD.

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.