Generic Name: butorphanol (nasal) (byoo TOR fa nole)Brand names: Stadol NS, Stadol
Butorphanol is in a group of drugs called narcotic pain relievers. It is similar to morphine.
Butorphanol is used to treat moderate to severe pain.
Butorphanol may also be used for purposes other than those listed in this medication guide.
Do not stop using butorphanol suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.What should I discuss with my healthcare provider before using butorphanol nasal?Do not use this medication if you have ever had an allergic reaction to a narcotic medicine.
You should not use butorphanol if you have recently used narcotic medications and have become dependent on them.Butorphanol may be habit-forming and should be used only by the person it was prescribed for. Butorphanol should never be shared with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.
Before using this medication, tell your doctor if you have
asthma, COPD, sleep apnea, or other breathing disorders;
a history of head injury or brain tumor;
heart disease, high blood pressure, recent heart attack;
mental illness; or
a history of drug or alcohol addiction.
If you have any of these conditions, you may not be able to use butorphanol or you may require a dose adjustment or special tests during treatment.FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Butorphanol passes into breast milk and may harm a nursing baby. Do not use butorphanol without telling your doctor if you are breast-feeding a baby.
Older adults may be more sensitive to the effects of this medication.
Use this medication exactly as it was prescribed for you. Never use butorphanol in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
The usual dose of butorphanol nasal for pain is 1 spray into one nostril every 3 to 4 hours. Your dose may be different. Follow your doctor's instructions carefully.
For best results, blow your nose before using the nasal spray.
Before using the spray for the first time, you must prime the spray pump. Remove the protective clip and pump 7 or 8 times into the air until a fine mist appears. Prime the spray pump any time you have not used your nasal spray for longer than 48 hours.Do not stop using butorphanol suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.
Store butorphanol at room temperature away from moisture and heat.
After you are finished using this medication, remove the cap and rinse out the bottle under running water. Throw away the bottle and cap where children or pets cannot get to them.
Since butorphanol is used as needed, you are not likely to be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.
If your prescribed dose is more than 1 spray at a time, you may have severe dizziness. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
pounding, or uneven heartbeats;
increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
shallow breathing, slow heartbeat;
cold, clammy skin;
problems with urination;
tremors, numbness or tingling;
confusion, feeling like you are floating; or
feeling light-headed, fainting.
Less serious side effects include:
nosebleed, stuffy nose, cough;
sleep problems (insomnia);
nausea, vomiting, loss of appetite;
warmth or redness under the skin;
dry mouth, unpleasant taste; or
ringing in your ear.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Anesthesia:
The preoperative dosage of butorphanol should be individualized. However, the following guidelines may be helpful.Preoperative Medication:Initial dose: 2 mg intramuscularly 60 to 90 minutes before surgeryBalanced Anesthesia:Initial dose: 2 mg intravenously shortly before induction and/or 0.5 mg to 1 mg in increments during anesthesia. The increments may be higher, up to 0.06 mg/kg (4 mg/70 kg) depending on the previous sedative, analgesic, and hypnotic drugs administered. The total dose needed will vary. However, patients have generally been reported to have needed between a total dosage of 4 mg to 12.5 mg (approximately 0.06 to 0.18 mg/kg).Because butorphanol nasal spray has not been studied for use in induction or maintenance anesthesia, use of the nasal spray for anesthesia is not recommended.
Usual Adult Dose for Labor Pain:
For use In the treatment of patients at full term early in labor:Initial dose: 1 or 2 mg intravenously or intramuscularly once.This dose may be repeated in 4 hours if necessary.Alternative analgesia should be used for pain associated with delivery or if delivery is expected to occur within 4 hours.Because butorphanol nasal spray has not been studied for use in labor, use of the nasal spray for labor is not recommended.
Usual Adult Dose for Pain:
Initial dose: 1 mg intravenously once. Depending on the severity of the pain, effective intravenous doses range from 0.5 to 2 mg.An initial dose of 2 mg of butorphanol intramuscularly once may be appropriate for patients who will be able to remain recumbent if drowsiness or dizziness occurs. Depending on the severity of the pain, effective intramuscular doses range from 1 to 4 mg.Alternatively, an initial dose of 1 mg of butorphanol by nasal administration (1 spray in one nostril) once. Adherence to this dose has been reported to have led to a reduced incidence of drowsiness and dizziness. If adequate pain relief is not achieved within 60 to 90 minutes, an additional 1 mg dose may be administered. Depending on the severity of the pain, an initial dose of 2 mg (1 spray in each nostril) may be appropriate in patients who will be able to remain recumbent if drowsiness or dizziness occurs.Initial doses may be repeated after 3 to 4 hours if necessary. (This includes the initial dosage sequence of 1 mg by nasal administration followed by a second 1 mg dose in 60 to 90 minutes if necessary. This sequence may be repeated 3 to 4 hours after the second dose if necessary.)Subsequent doses may be determined by patient response, rather than being scheduled at fixed dosing intervals.
There may be other drugs that can interact with butorphanol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.