Alert

butorphanol (injection)

Pronunciation: bue TOR fa nol

Brand: Stadol

What is the most important information I should know about butorphanol?

MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.

What is butorphanol?

Butorphanol is an opioid pain medication, sometimes called a narcotic.

Butorphanol is used to treat moderate to severe pain. It is also used as part of anesthesia for surgery, or during early labor (if childbirth is expected to be more than 4 hours away).

Butorphanol may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using butorphanol?

You should not use butorphanol if you are allergic to it, or if you have:

  • severe asthma or breathing problems; or
  • a stomach or bowel obstruction (including paralytic ileus).

Tell your doctor if you have ever had:

  • any type of breathing problem or sleep apnea;
  • liver or kidney disease;
  • a head injury, brain tumor, or seizures;
  • heart disease, high blood pressure, recent heart attack; or
  • alcoholism, drug addiction, mental illness.

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with butorphanol and cause a serious condition called serotonin syndrome.

If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.

Butorphanol is sometimes used during early labor, but using it just before childbirth can cause breathing problems in a newborn.

Butorphanol can pass into breast milk and may cause drowsiness or breathing problems in a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is butorphanol given?

Follow the directions on your prescription label and read all medication guides. Never use butorphanol in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of this medicine.

Butorphanol is injected into a muscle or as an infusion into a vein. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.

Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.

Do not stop using butorphanol suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store butorphanol at room temperature away from moisture and heat.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush the unused medicine down the toilet.

What happens if I miss a dose?

Since butorphanol is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A butorphanol overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, very slow breathing, or coma.

What should I avoid while using butorphanol?

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

What are the possible side effects of butorphanol?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Call your doctor at once if you have:

  • noisy breathing, sighing, shallow breathing, breathing that stops during sleep;
  • a slow heart rate or weak pulse;
  • fast or pounding heartbeats;
  • problems with urination;
  • a light-headed feeling, like you might pass out; or
  • confusion, feeling like you are floating.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.

Common side effects include:

  • nausea, vomiting;
  • drowsiness, dizziness;
  • dry mouth; or
  • warmth or redness under the skin.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect butorphanol?

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • other narcotic medications --opioid pain medicine or prescription cough medicine;
  • a sedative like Valium --diazepam, alprazolam, lorazepam, Xanax, Klonopin, Ativan, and others;
  • drugs that make you sleepy or slow your breathing --a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness; or
  • drugs that affect serotonin levels in your body --a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.

This list is not complete. Other drugs may affect butorphanol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about butorphanol injection.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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