butorphanol (Stadol)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

What is butorphanol? What is butorphanol used for?

Butorphanol is a synthetic opioid narcotic pain reliever. It prevents pain in a similar way as morphine (MS Contin), hydrocodone (Zohydro), oxycodone (Oxycontin), and other opioids. Like other opioids, it stimulates receptors in the brain to increase the threshold to pain (the amount of stimulation it takes to feel pain) and reduce the perception of pain (the perceived importance of the pain). The FDA approved butorphanol in August 1978.

What brand names are available for butorphanol?

Stadol

Is butorphanol available as a generic drug?

Yes

Do I need a prescription for butorphanol?

Yes

What are the side effects of butorphanol?

The most frequent adverse reactions include drowsiness, dizziness, nausea, vomiting, and nasal congestion and insomnia with the nasal preparation. Patients may also experience palpitations, flushing, anxiety, confusion, euphoria, headache, nervousness, tingling sensation in limbs, cold/clammy skin, sweating, itchiness, anorexia, constipation, stomach pain, dry mouth, tremor, weakness, blurred vision, ringing in ears, and difficulty breathing. Butorphanol is habit forming. Mental and physical dependence can occur when used long-term.

QUESTION

Medically speaking, the term "myalgia" refers to what type of pain? See Answer

What is the dosage for butorphanol?

The initial dose for adults is based on the setting in which it is used, as well as whether it is delivered intramuscularly, intravenously, or through nasal spray. Most initial intravenous doses for pain range between 0.5 to 2 mg, which may be repeated every 3 to 4 hours as needed.

Which drugs or supplements interact with butorphanol?

Combining butorphanol with other agents that cause depression of the central nervous system may lead to increased sedation and confusion.

Alvimopan (Entereg) should not be combined with butorphanol because it increases levels of butorphanol.

Butorphanol should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase, for example, linezolid (Zyvox). Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. Butorphanol should not be administered within 14 days of stopping an MAOI.

Is butorphanol safe to take if I'm pregnant or breastfeeding?

Butorphanol is excreted in breast milk. The amount that the infant may receive is very low and insignificant.

What else should I know about butorphanol?

What preparations of butorphanol are available?

Solution with or without preservatives: 1 or 2 mg/mL in 1, 2, 10 mL; Nasal solution: 10 mg/ mL in 2.5 mL bottle.

How should I keep butorphanol stored?

Butorphanol solution should be stored at room temperature, between 15 C to 30 C (59 F to 86 F) and protected from light. Nasal spray should be stored at room temperature between 20 C to 25 C (68 F to 77 F).

Summary

Butorphanol (Stadol) is a synthetic opioid (narcotic) pain reliever prescribed to treat severe pain, preoperative or preanesthetic pain management, and manage pain during labor. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed before using this medication.

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Medically Reviewed on 8/21/2019
References
FDA Prescribing Information.

Medscape. butorphanol (Rx) - Stadol.
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