butorphanol (nasal)

Pronunciation: byoo TOR fa nole

Brand: Stadol NS

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

You should not use butorphanol if you have severe asthma or breathing problems, or a blockage in your stomach or intestines.

Butorphanol can slow or stop your breathing, and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Using this medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

What is butorphanol nasal?

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

Butorphanol is used to treat moderate to severe pain.

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

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

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).

To make sure this medicine is safe for you, tell your doctor if you have ever had:

  • any type of breathing problem or lung disease;
  • 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.

Some medicines can interact with butorphanol and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

If you use butorphanol nasal 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 habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Butorphanol nasal 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 should I use butorphanol nasal?

Follow all directions on your prescription label. Butorphanol can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never use butorphanol nasal in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Butorphanol may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away butorphanol is against the law.

Read all patient information, medication guides, and instruction sheets provided to you. 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 nasal suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using butorphanol nasal.

Store at room temperature away from moisture and heat.

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 nasal is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

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 nasal?

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

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how butorphanol will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

What are the possible side effects of butorphanol nasal?

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

Like other narcotic medicines, butorphanol can slow your breathing. Death may occur if breathing becomes too weak. 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, or shallow breathing
  • slow heart rate or weak pulse;
  • fast or pounding heartbeats;
  • problems with urination;
  • tremors, numbness or tingling;
  • confusion, feeling like you are floating;
  • a light-headed feeling, like you might pass out; or
  • low cortisol levels --nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

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.

Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.

Common side effects include:

  • drowsiness, dizziness;
  • sleep problems (insomnia);
  • nausea, vomiting; or
  • stuffy nose.

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 nasal?

Narcotic (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, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others; or
  • drugs that make you sleepy or slow your breathing --a sleeping pill, muscle relaxer, tranquilizer, antidepressant, or antipsychotic medicine.

This list is not complete. Other drugs may interact with butorphanol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about butorphanol nasal.


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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