Drug ID: 2d00000076
Drug Name: Butorphanol
Generic Names: Butrum (1 mg) | Butodol -1 | Butodol (2 mg) | Butrum | Butodol (2 mg) | Butodol | Stadol
Legal Status: Opioid Prescription only drug
Indication for Mother: Category C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Recommended Dose: 1 mg IV or 2 mg IM with repeated doses every 3 to 4 hours, as necessary. 1 mg (one spray in one nostril), it may be increased up to 2mg dose, if needed.
Recommended In: This medication is an opioid analgesic, prescribed to alleviate pain post operatively, migraine, balanced general anesthesia, and used to relieve pain during labor. It blocks the pain sensations.
Directions For Use: It comes as a nasal spray, injection.
Storage: Keep in room temperature and in air tight container. Keep away from children.
Dosage Forms: Nasal Spray | Injection
Side Effects: Body as a Whole- Loss of strength/lethargy, headache and sensation of heat.
Heart- Irregular heartbeat, palpitations and dilatation of blood vessels.
Central Nervous System- Nervousness, a floating feeling, headache, confusion, drowsiness, dizziness, in co-ordination anxiety, seizures, tremor and sleeplessness.
Skin- Itching, sweating/clamminess, rash and hives.
Eye and ENT- Nasal congestion, blurred vision, ear pain, inflammation of pharynx, stuffy nose, ringing in the ear and unpleasant taste.
GI- Nausea, vomiting, loss of appetite, constipation, dry mouth and stomach pain.
Respiratory- Bronchitis, cough, difficulty in breathing, nose bleed, nasal congestion, nasal irritation, sinusitis and upper respiratory tract infection.
Genitourinary- Impaired urination.
In Case of Overdose: The clinical manifestations of butorphanol overdose are those of opioid drugs in general. Consequences of overdose vary with the amount of butorphanol ingested and individual response to the effects of opiates. The most serious symptoms are hypoventilation, cardiovascular insufficiency, coma, and death. Butorphanol overdose may be associated with ingestion of multiple drugs.
The management of suspected butorphanol overdosage includes maintenance of adequate ventilation, peripheral perfusion, normal body temperature, and protection of the airway. Patients should be under continuous observation with adequate serial measures of mental state, responsiveness, and vital signs. Oxygen and ventilatory assistance should be available with continual monitoring by pulse oximetry if indicated. In the presence of coma, placement of an artificial airway may be required. An adequate intravenous portal should be maintained to facilitate treatment of hypotension associated with vasodilation.
The use of a specific opioid antagonist such as naloxone should be considered. As the duration of butorphanol action usually exceeds the duration of action of naloxone, repeated dosing with naloxone may be required.
Avoid If: Avoid prolonged usage and excess dosage.
Since it is a narcotic, it could cause dependence.
Use in narcotic dependent patients should be avoided.
It may cause drowsiness, dizziness. Do not drive a car or operate machinery while taking this medication.
Do not drink alcoholic beverages while using this injection.
Caution needed in patients with history of head injury, any condition that increases the pressure in your brain or skull, problems with brain or nervous system, heart attack, breathing problems, high blood pressure, heart, kidney or liver disease, elderly, pregnancy and lactation.
Drug Interaction: Some products that may interact with this drug include: MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine), narcotic blockers (e.g., naltrexone), nasal decongestants (e.g., oxymetazoline).
The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also affect breathing or cause drowsiness. Therefore, tell your doctor or pharmacist if you are taking other products such as alcohol, medicine for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).
Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about using those products safely.