Butorphanol injection is used to relieve moderate to severe pain. Butorphanol injection is also used to relieve pain during labor and to prevent pain and decrease awareness before or during surgery. Butorphanol is in a class of medications called opioid agonist-antagonists. It works by changing the way the body senses pain.
Side Effects Of Butorphanol Injection
Butorphanol injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- excessive tiredness
- difficulty falling asleep or staying asleep
- unusual dreams
- stomach pain
- feeling hot
- pain, burning, numbness, or tingling in the hands or feet
- uncontrollable shaking of a part of your body
- intense happiness
- feeling of floating
- sad mood
- blurred vision
- ringing in the ears
- ear pain
- unpleasant taste
- dry mouth
- difficulty urinating
Some side effects of butorphanol injection can be serious. If you experience any of these symptoms or those listed in the WARNINGS section, call your doctor immediately or get emergency medical attention:
- agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
- nausea, vomiting, loss of appetite, weakness, or dizziness
- inability to get or keep an erection
- irregular menstruation
- decreased sexual desire
- difficulty breathing
- changes in heartbeat
Butorphanol injection may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
Warnings & Precautions
Before using butorphanol injection:
- tell your doctor and pharmacist if you are allergic to butorphanol, any other medications, or ingredients in butorphanol injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take with butorphanol injection. Be sure to mention any of the following: antidepressants; antihistamines; barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, or secobarbital (Seconal); cyclobenzaprine (Amrix); dextromethorphan (found in many cough medications; in Nuedexta); erythromycin (E.E.S., Eryc, Erythrocin, others); medications for seizures; lithium (Lithobid); medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Alsuma, Imitrex, in Treximet), and zolmitriptan (Zomig); mirtazapine (Remeron); 5HT3 serotonin blockers such as alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), ondansetron (Zofran, Zuplenz), or palonosetron (Aloxi); selective serotonin-reuptake inhibitors such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Prozac, Pexeva), and sertraline (Zoloft); serotonin and norepinephrine reuptake inhibitors such as duloxetine (Cymbalta), desvenlafaxine (Khedezla, Pristiq), milnacipran (Savella), and venlafaxine (Effexor); or tricylic antidepressants (‘mood elevators’) such as amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); theophylline (Theochron, Uniphyl, others); and trazodone (Oleptro). Also, tell your doctor or pharmacist if you are taking or receiving the following monoamine oxidase (MAO) inhibitors or if you have stopped taking them within the past two weeks: isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). Many other medications may also interact with butorphanol injection, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor what herbal products you are taking, especially St. John’s wort or tryptophan.
- tell your doctor if you have or have ever had problems urinating; a heart attack; high blood pressure; or heart, kidney, or liver disease.
- tell your doctor if you are breastfeeding. Some women who use butorphanol injection may have increased amounts of the medication in their breast milk, which can cause serious or life-threatening side effects in their breastfed babies. You should also call your baby’s doctor or get emergency help if your baby is sleepier than usual, has trouble breastfeeding or breathing, or becomes limp.
- you should know that this medication may decrease fertility in men and women. Talk to your doctor about the risks of using butorphanol.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are using butorphanol injection.
- you should know that butorphanol injection may make you drowsy and dizzy. Do not drive a car or operate machinery for at least one hour after you receive a dose. After one hour has passed, do not drive until you are certain that you are not dizzy, drowsy, or less alert than usual.
Dosage Of Butorphanol Injection
Butorphanol injection comes as a liquid to be injected into a muscle or vein. When butorphanol injection is used to relieve pain, it is usually given once every 3 to 4 hours as needed. When butorphanol injection is used to relieve pain during surgery, it may be given 60 to 90 minutes before surgery and then as needed during the surgery. When butorphanol injection is used to relieve pain during labor, it may be given once every 4 hours but should not be given less than 4 hours before delivery is expected.
You may receive butorphanol injection in a hospital, or you may be given the medication to use at home. If you have been told to administer butorphanol injection at home, it is very important that you use the medication exactly as directed. Follow the directions that you are given carefully, and ask your doctor, pharmacist, or nurse if you have any questions or do not understand the directions.
If you have been told to use butorphanol injection at home, do not stop using the medication without talking to your doctor. If you suddenly stop using butorphanol injection, you may experience withdrawal symptoms such as nervousness, agitation, shakiness, diarrhea, chills, sweats, difficulty falling asleep or staying asleep, confusion, loss of coordination, or hallucinations (seeing things or hearing voices that do not exist). Your doctor will probably decrease your dose gradually.
Keep all appointments with your doctor and laboratory. Your doctor will order certain lab tests to check your body’s response to butorphanol.
Before having any laboratory test (especially those that involve methylene blue), tell your doctor and the laboratory personnel that you are receiving butorphanol.
Do not let anyone use your medication. If you continue to have pain after you finish the butorphanol injection, call your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
All information has been provided courtesy of MedLinePlus from the National Library of Medicine and from the FDA.