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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:

In addition to its needed effects, some unwanted effects may be caused by butorphanol. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking butorphanol, check with your doctor or nurse immediately:

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

If any of the following symptoms of overdose occur while taking butorphanol, get emergency help immediately:

Symptoms of overdose:
  • Change in consciousness
  • extremely shallow or slow breathing
  • irregular heartbeats
  • loss of consciousness
  • shortness of breath
  • swelling in hands and feet

Minor Side Effects

Some of the side effects that can occur with butorphanol may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Dizziness
  • nausea
  • sleepiness or unusual drowsiness
  • vomiting
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

Not all side effects for butorphanol may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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