Butorphanol is an analgesic opioid.
Release form and composition
The drug is available in the form of a 0.2% solution for injection, in 1 ml of which contains:
- 2 mg of butorphanol tartrate;
- Excipients: sodium chloride, citric acid, Trilon B, sodium citrate, injectable water.
Butorphanol solution is realized in 1 ml ampoules, 5 pcs. Each. in blisters.
Indications for use
According to the instructions to butorphanol, the drug is intended for:
- Elimination of pain syndrome of various genesis of moderate and severe severity, including due to malignant tumors, severe injuries, renal colic, etc .;
- Premedication of the patient before general anesthesia;
- Pain relief during childbirth;
- Carrying out general anesthesia (as one of the components).
The use of butorphanol, according to the instructions, is contraindicated in:
- Hypersensitivity to butorphanol tartrate or any auxiliary component of the drug;
- Traumatic brain injury;
- Respiratory depression;
- Increased intracranial pressure;
- Oppression of the central nervous system;
- Acute alcohol and alcohol psychosis;
- Heart failure;
- Heart rhythm disturbances;
- Acute myocardial infarction;
- Bronchial asthma;
- Renal / hepatic failure;
- Acute surgical diseases of the abdominal organs until the final diagnosis;
- The presence of drug dependence on morphine and morphine-like drugs (including promedol and fentanyl);
- Simultaneous use of MAO inhibitors and for 14 days after their cancellation.
Due to the lack of data on the safety of using butorphanol tartrate, the drug is not prescribed to children and adolescents under 18 years of age, during pregnancy (with the exception of preparation for childbirth and prescribing for pain in childbirth), as well as to breastfeeding women.
Particular caution in the treatment of this drug should be followed by people over 65 years of age and patients against the background of a general depletion of the body.
Dosing and Administration
Butorphanol solution is intended for intravenous or intramuscular administration.
The specific dosage is established by the attending physician, taking into account the age and condition of the patient, the presence of indications and contraindications.
In pain syndrome, the drug is administered in 2 mg intramuscularly or 1 mg intravenously every 3-4 hours as needed.
Elderly patients reduce the dosage of the drug by half, and the interval between injections is increased to 6 hours.
During childbirth for the purpose of pain relief, butorphanol is used in a dose of 1-2 mg, provided that the fetus has no signs of intrauterine pathologies, and the gestation period is at least 37 weeks. The interval between injections should not exceed 4 hours. The last introduction should be made not earlier than 4 hours before delivery.
For sedation, the drug is prescribed in an amount of 2 mg, injected intramuscularly 1-1.5 hours before the operation. Then, in the same dose, the solution is administered intravenously immediately before the start of the surgical procedure.
When performing general anesthesia, butorphanol in the amount of 2 mg is introduced into / in before sodium thiopental. In order to maintain the required depth of anesthesia during surgery add 0.5-1 mg. The total dose of analgesic required for general anesthesia is 4-12.5 mg (which also depends on the duration of the operation).
The most common side effects of this drug are drowsiness (occurs in about 43% of cases), dizziness (observed in 19% of patients), nausea and / or vomiting (characteristic of 13% of patients).
In some cases, the use of butorphanol is accompanied by the following undesirable reactions:
- Since the cardiovascular system: symptoms of vasodilation, lowering blood pressure, fainting;
- On the part of the nervous system: headache, anxiety, insomnia, unusual dreams, sensation of heat, dysphoria, hostility, hallucinations, agitation, paresthesias, tremor, nervousness, confusion, euphoria, asthenia, lethargy, withdrawal syndrome;
- On the part of the digestive system: constipation, anorexia, epigastric pain, dryness of the oral mucosa;
- On the part of the skin: itching, excessive sweating, rash, urticaria;
- From the senses: pain in the eyes, blurred vision, ringing in the ears.
During post-marketing observations, it was noted that in some cases, during the period of use of this drug, apnea, decreased urination, convulsions, delirium, transient difficulty of movement and speech, shallow breathing, depression, increased blood pressure, chest pain, tachycardia were observed. However, it is important to note that the relationship between the development of these undesirable reactions and the use of butorphanol has not been reliably established.
2 mg of Butorphanol, administered intramuscularly, is equivalent to i / m administration of 10 mg of morphine.
During the period of treatment with this drug it is forbidden to drink alcoholic beverages and engage in potentially hazardous activities that require a reaction rate and increased attention.
The following drugs are analogues of butorphanol:
- According to the active substance: Beforal, Vero-Butorphanol, Butorphanol Tartrate, Moradol, Stadol, Torat, Torbugesik, Torbutrol, Torgesic;
- On the mechanism of action: Nalbuphine, Nalbuphine Serb.
Terms and conditions of storage
Butorphanol is a list A drug (narcotic drugs and poisons), which is sold in pharmacies strictly according to the prescription prescribed by the attending physician.
According to the manufacturer’s recommendations, the medication should be stored in a place protected from sunlight. The optimum storage temperature is from 5 to 30 ºС. Under these conditions, the shelf life of the solution is 2 years.