| Drug Index |
| GENERIC NAME : |
| butorphanol |
| BRAND NAMES : |
| Stadol Injection, Stadol NS (nasal spray) |
| STREET NAMES : |
| none known |
| BRIEF DESCRIPTION : |
| Butorphanol tartrate (Stadol) is a synthetic opioid agonist-antagonist analgesic (pain killer) of the phenanthrene series. It is supplied in liquid form for intravenous and intramuscular use and in a nasal spray. Butorphanol is not a pure opioid antagonist like naloxone. It is a partial antagonist that is capable of producing partial opioid agonist effects (by attachment to the mu-opiate receptors), and can therefore produce analgesia when administered at recommended dosages to opioid-naive individuals (individuals who have no history of recent opiate use or past heavy or prolonged opiate use). In individuals who have recently been using complete opiate agonists (examples would include: oxymorphone, hydrocodone, oxycodone, morphine, and methadone), use of butorphanol can precipitate an immediate opiate withdrawal syndrome. |
| INDICATIONS FOR USE : |
| Butorphanol is indicated for the relief of moderate to severe pain. It can also be used as a supplement to balanced anesthesia (during surgery) and for preoperative and postoperative analgesia. The nasal spray is often prescribed a adjunctive treatment of migraine headache. |
| ABUSE AND ADDICTIVE POTENTIAL : |
Butorphanol poses a risk for addiction. Usually it is used short term in emergency rooms, hospitals, surgery, and labor and delivery. Medical professionals are a special population at risk for addiction to butorphanol because they have access to it in medical offices or institutions. A symptom that is easily detected with opiate use is pinpoint pupils (miosis). Psychological dependence may occur early in use of this medication, but physical dependence and tolerance may develop upon repeated administration over several weeks or months (requiring larger or more frequent dosages of butorphanol to produce relief of pain or achieve a state of euphoria). . When butorphanol is abused, the individual is seeking the euphoric effect ("high"). When butorphanol is used in any individual for weeks consecutively, dependence is likely. As with all opiates, individuals with a history of drug addiction or alcoholism are at much higher risk for addiction to butorphanol when used beyond the short term management of pain. Abrupt discontinuation of butorphanol after prolonged use can cause a classic opiate withdrawal syndrome which may include: • Abdominal pain • Muscle aches • Joint pain • Sleep problems (insomnia) • Agitation, Restlessness • Diarrhea • Dilated pupils • Goose bumps • Nausea • Runny nose • Sweating • Vomiting • Restlessness • Yawning • Loss of appetite (anorexia) • Rapid heart rate • Elevated blood pressure • Rapid breathing • Eyes or nose watering Withdrawal of butorphanol is best handled by a physician that is skilled at assisting patients with opiate detoxification. Medications are often necessary to help control symptoms of withdrawal. |
| OVERDOSAGE : |
| Acute overdose of butorphanol can cause respiratory depression, extreme drowsiness or prolonged sleeping, stupor or coma, muscle flaccidity, cold/clammy skin, constricted pupils, slow heart rate (bradycardia), low blood pressure (hypotension), and death. Because of the dangers associated with overdose, immediate medical attention should be sought. |
| CAUTIONS : |
| Physical dependence and tolerance are not unusual with chronic butorphanol therapy. Caution is advised when prescribing this medication to anyone with a history of drug addiction, alcoholism or suicide attempts. When butorphanol is used in combination with alcohol or other central nervous system depressants, the two drugs potentiate one another and can greatly enhance the risk for overdose. Because the drug is metabolized in the liver and eliminated via the kidneys, caution is advised when prescribing this medication to individuals with impaired liver or kidney function. |
| SIDE EFFECTS : |
| The most common side effect is sedation. Others observed include sweaty/clammy, nausea/vomiting, dizziness, dry mouth, headache, mood changes, anxiety, tingling, numbness, confusion, abnormal changes in blood pressure or heart rate, asthma, itching, rash, blurred vision, and urinary retention Butorphanol, like other mixed agonist-antagonists with a high affinity for the kappa-receptor, may produce unpleasant psychotomimetic effects (behaviors that mimic the symptoms of psychosis, including delusions and/or hallucinations) in some individuals. This is not s complete list if side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. |
| FOR MORE INFORMATION : |
For More Information: *This is a condensed description of Butorphanol. For more details check with your physician, pharmacist, or resources such as The Physicians' Desk Reference (PDR) http://www.rxlist.com/script/main/hp.asp |
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