butorphanol tartrate

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Related to butorphanol tartrate: Stadol

butorphanol tartrate

APO-Butorphanol (CA), PMS-Butorphanol (CA), Stadol

Pharmacologic class: Opioid agonist-antagonist

Therapeutic class: Opioid analgesic

Controlled substance schedule IV Pregnancy risk category C


Alters perception of and emotional response to pain by binding with opioid receptors in brain, causing CNS depression. Also exerts antagonistic activity at opioid receptors, which reduces risk of toxicity, drug dependence, and respiratory depression.


Injection: 1 mg/ml, 2 mg/ml

Nasal spray: 10 mg/ml

Indications and dosages

Moderate to severe pain

Adults: 1 to 4 mg I.M. q 3 to 4 hours as needed, not to exceed 4 mg/dose. Or 0.5 to 2 mg I.V. q 3 to 4 hours as needed. With nasal spray, 1 mg (one spray in one nostril) q 3 to 4 hours, repeated in 60 to 90 minutes if needed.

Labor pains

Adults: 1 to 2 mg I.V. or I.M., repeated after 4 hours as needed

Preoperative anesthesia

Adults: 2 mg I.M. 60 to 90 minutes before surgery

Balanced anesthesia

Adults: 2 mg I.V. shortly before anesthesia induction, or 0.5 to 1 mg I.V. in increments during anesthesia

Dosage adjustment

• Renal or hepatic impairment

• Elderly patients

Off-label uses

• Headache

• Symptomatic relief of ureteral colic


• Hypersensitivity to drug


Use cautiously in:

• head injury, ventricular dysfunction, coronary insufficiency, respiratory disease, renal or hepatic dysfunction

• history of drug abuse.


• Make sure solution is clear and free of particulates before giving.

• When using nasal spray, insert tip of the sprayer about ¼″ into nostril, point tip backwards, and administer one spray.

• Be aware that I.V. route is preferred for severe pain.

Know that drug may cause infant respiratory distress in neonate of pregnant patient, especially if given within 2 hours of delivery.

Adverse reactions

CNS: drowsiness, sedation, dizziness, tremor, irritability, syncope, stimulation

CV: hypertension, hypotension, palpitations, bradycardia, tachycardia, extrasystole, arrhythmias

EENT: blurred vision, nasal congestion or dryness, dry or sore throat

GI: nausea, vomiting, constipation, epigastric distress, dry mouth, GI obstruction

GU: urinary retention or hesitancy, dysuria, early menses, decreased libido, erectile dysfunction

Hematologic: hemolytic anemia, hypoplastic anemia, thrombocytopenia, agranulocytosis, leukopenia, pancytopenia

Respiratory: thickened bronchial secretions, chest tightness, wheezing

Skin: urticaria, rash, diaphoresis

Other: increased or decreased appetite, weight gain, local stinging, anaphylactic shock, hypersensitivity reaction (with I.V. use)


Drug-drug. CNS depressants: additive CNS effects

Drugs-herbs. Kava, St. John's wort, valerian: increased CNS depression

Drug-behaviors. Alcohol use: additive CNS effects

Patient monitoring

• Monitor respiratory status closely, especially after I.V. administration.

• Watch for signs and symptoms of withdrawal in long-term use and in opioid-dependent patients.

• Assess elderly patient closely for sensitivity to drug.

Patient teaching

• Teach patient how to use nasal spray properly.

• Emphasize importance of using drug exactly as prescribed.

• Caution patient that drug may be habit-forming.

• Advise patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.


McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved
References in periodicals archive ?
Pharmacokinetics of butorphanol tartrate in a long-acting poloxamer 407 gel formulation administered to Hispaniolan Amazon parrots (Amazona ventralis).
Postoperatively single IM doses of either butorphanol tartrate 0.73 mg (0.5mg base), 1.46 mg (1 mg base), or 2.92mg (2 mg base) or morphine sulfate 5 mg or 10 mg were administered.
Analgesic effects of carprofen and liposome-encapsulated butorphanol tartrate in Hispaniolan Amazon parrots (Amazona ventralis) with experimentally induced arthritis.
Once the periocular tissues were well demarcated (13 days after admission), the kestrel was premedicated with butorphanol tartrate (1 mg/kg IM) and midazolam (0.5 mg/kg IM) for surgical debridement of the devitalized right-sided periocular tissues with enucleation.
(1) Butorphanol tartrate (Torbugesic, Fort Dodge Animal Health, Fort Dodge, IA, USA) has been shown to act by binding [kappa] opioid receptors in the peripheral and central nervous systems and mimicking the activities of endogenous opioids.
African grey parrots were found to have an increased threshold to an electric stimulus after butorphanol was administered at a dose of 2 mg/kg IMT; however, in another study, Hispaniolan Amazon parrots receiving the same dose of intramuscular butorphanol tartrate did not demonstrate a change in foot withdrawal at 30 minutes after drug administration.
The goals of this study in Hispaniolan Amazon parrots were to 1) evaluate the pharmacokinetics of butorphanol tartrate after IV, IM, and oral (PO) administration, and 2) determine the bioavailability of butorphanol tartrate after oral administration.
For the IV study, anesthesia was induced and maintained with isoflurane (delivered in oxygen at 1 L/min via facemask) administered at 5% and 2%, respectively, to facilitate administration of butorphanol tartrate 1% (5 mg/kg; Torbugesic) in the basilic vein.
A standard curve of butorphanol tartrate (Cerilliant Corp, Round Rock, TX, USA), which bracketed the range of concentration, was prepared by spiking 100 [micro]L of blank parrot plasma.
(6-9) Butorphanol tartrate was found to provide analgesia in African grey parrots (Psittacus erithacus) and Hispaniolan Amazon parrots (Amazona ventralis); for preoperative or postoperative analgesia, the recommended dose was 1-3 mg/kg IM.
Butorphanol tartrate is a synthetically derived partial agonist opioid.
Birds were randomly assigned to receive butorphanol tartrate (2 mg/kg in the pectoral muscle; Torbugesic, Fort Dodge, Fort Dodge, IA, USA) either 20 minutes before induction of anesthesia with sevoflurane (B-S group, n = 11) or immediately after the anesthetic period (S group, n = 11).