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butorphanol (Stadol, Stadol NS)
Tradename: Stadol.
Indications:
- treatment of moderate to severe pain
- sedation in conjunction with anesthesia, general anesthesia [4]
Contraindications: Caution:
1) avoid use in opiate dependent patient may precipitate opiate withdrawal
2) use with caution in patients with hepatic or renal impairment
Dosage:
1) 0.5-2 mg IV every 3-4 hours PRN
2) 1-4 mg IM every 3-4 hours PRN
Injection: 1 mg/mL (1 mL), 2 mg/mL (1, 2, 10 mL).
Nasal spray: Tradename: Stadol NS. 1 spray every 3-4 hours. 1 mg/spray.
Pharmacokinetics:
1) onset of action:
a) IV: 4-5 minutes
b) IM: 30-60 minutes
2) duration of action:
a) IV: 2-4 hours
b) IM: 3-4 hours
Adverse effects:
1) common (> 10%)
- drowsiness
2) less common (1-10%)
- increased sweating, flushing of the face, decreased urination, dizziness, lightheadedness, headache, hypotension, anorexia, nausea/vomiting
3) uncommon (< 1%)
- skin rash, shortness of breath, troubled breathing, paradoxical CNS stimulation, confusion, bradycardia, tachycardia, hallucinations, painful urination, hypertension, mental depression, stomach cramps, tinnitus, blurred vision, constipation, dry mouth, false sense of well being, malaise, restlessness, nightmares, weakness, CNS depression, respiratory depression, dependence with prolonged use
4) other
- may elevate CSF pressure
- may increase cardiac workload
Overdose:
1) support airway
2) establish IV access
3) naloxone 2 mg IV (0.1 mg/kg for children)
4) repeat naloxone as necessary up to 10 mg
Drug interactions:
1) CNS depressants
2) pancuronium
3) barbiturates
Interactions
drug interactions
drug adverse effects (more general classes)
General
opioid receptor agonist (narcotic)
Properties
MISC-INFO: elimination route LIVER
pregnancy-category C
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Deprecated Reference
- Department of Veterans Affairs, VA National Formulary