Name

Butorphanol Tartrate (Stadol®)

Class

Opiod agonist-antagonist analgesic

Description/Mechanism

Butorphanol is a synthetic analgesic that has effects similar to those of morphine (2mg of butorphanol is equivalent to 10 mg of morphine or 80 mg of meperidine). It has both narcotic agonist and antagonist properties, and should be used with caution in patients who are narcotic dependent. At present butorphanol is not restricted under the Controlled Substances Act.

Onset

10 min IM, 1-5 min IV

Duration

3-4 hours

Indications

Relief of moderate to severe pain.

Pre-operative or pre-anesthetic medication

Used to relieve pre-partum pain

Contraindications

Hypersensitivity

Head injury

Use with caution in patients with respiratory depression

Adverse Reactions

Sedation, headache, vertigo, hallucinations, palpitations

Increase or decrease in BP

Respiratory depression (naloxone should be available)

Patient may experience symptoms of withdrawl.

Drug Interactions

Phenothiazines, droperidol, tranquilizers and barbiturates may potentiat the actions of butorphanol.

Supplied

1mg/ml in 1 ml vials

2mg/ml in 1,2,10 ml vials

Dose/Administration

Adult

IM: 2 mg every 3-4 hours as needed (range 1-4 mg)

IV: 1 mg every 3-4 hours (range 0.5 – 2mg)

Pediatric

Safety and efficacy unknown under 18.

Special Consideration

Pregnancy Safety: Unknown

May increase cardiac workload in patients with CHF, MI, ventricular dysfunction or coronary insufficiency.

Use with caution in patients with end-stage liver disease

Has potential for abuse