Butorphanol Injection 

What is the most important information I should know about butorphanol? 
 
You should not use butorphanol if you have recently used narcotic medications and have become dependent on them. 
 
Butorphanol may be habit-forming and should be used only by the person it was prescribed for. Butorphanol should never be given to another person, especially someone who  has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get  to it.
 
Do not drink alcohol while you are using butorphanol. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check  your food and medicine labels to  be sure these products do not contain alcohol.
 
Butorphanol can cause side effects that may impair  your thinking or reactions. Be careful if you drive  or do anything that requires you  to be awake and alert.
 
Never use more than your prescribed dose of butorphanol. Tell your doctor if the medicine seems to stop working  as well in relieving your  pain. Do not stop using butorphanol suddenly, or you could have unpleasant withdrawal symptoms. Talk to your  doctor about how to avoid withdrawal symptoms when stopping the medication. 

What is butorphanol? 

Butorphanol is in a group of drugs called narcotic  pain relievers. It is similar  to morphine. 

Butorphanol  is used to treat moderate to severe pain. It is also used as part of anesthesia  for surgery,  or during early labor (if childbirth is expected to be  more than 4 hours away). 

Butorphanol may also be used for purposes other than those listed in this medication guide. 

What should I discuss with my healthcare  provider before  using butorphanol? 
 
Do not use this medication if you have ever had an allergic reaction  to a narcotic medicine.
You should not use butorphanol if you have recently used narcotic medications  and have become dependent on them.
 
Butorphanol may be habit-forming and should be used only by  the person it was prescribed for. Butorphanol should never be shared with another person, especially someone who has a history  of drug abuse or addiction. Keep  the medication in a secure place where others cannot get to it. 

Before using this medication, tell  your doctor if you have 

• asthma, COPD, sleep apnea, or other breathing disorders; 
• liver or kidney disease; 
• a history of head injury or brain tumor; 
• a dependence on narcotic pain medications; 
• heart disease, high blood pressure, recent heart attack; 
• mental illness; or 
• a history of drug or alcohol addiction. 

If  you have any  of these conditions, you may not be able to use  butorphanol or you may require  a dose adjustment or special tests during treatment.
 
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. 

Butorphanol is sometimes used during early labor, but using it just before childbirth can cause breathing problems in a newborn. 
 
Butorphanol passes into breast milk  and may harm a nursing baby. Do not use butorphanol without telling your doctor if  you are breast-feeding a baby. 

Older adults may be more sensitive  to the effects of this medication. 

How should I use butorphanol? 

Use this medication exactly as it was prescribed for you. Never use butorphanol in larger amounts, or use it for longer than recommended by  your doctor. Follow the directions on  your prescription label. Tell your doctor if the medicine seems to stop working as well  in relieving your pain
.
Butorphanol is given as an injection into  a muscle or a vein. Your doctor, nurse, or other healthcare provider will give  you this injection. You may be given instructions on how to inject your medicine at home. Do  not use this medicine at home if you do not fully understand how to give the injection  and properly dispose of needles  and syringes used in giving the medicine. 

Use each disposable needle and syringe only one time. Throw away used needles and syringes in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container  out of the reach of children and pets.
 
Do not stop using butorphanol suddenly, or  you could have unpleasant withdrawal symptoms. Talk to your doctor about  how to avoid withdrawal symptoms when stopping the medication. 

Store butorphanol at room temperature  away from moisture  and heat. 

What happens if I miss a dose? 

Since butorphanol is often used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose. 

What happens if I overdose? 
 
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of butorphanol can be fatal. Overdose symptoms may include extreme drowsiness, pinpoint pupils, confusion, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops. 

What should I avoid while using butorphanol? 
 
Do not drink alcohol while you are using this medication. Dangerous side effects  or death can occur when alcohol is combined with butorphanol. Check  your food and medicine labels to be sure these products do not contain alcohol.
 
This medication can cause side effects that may impair your thinking or reactions. Be careful if  you drive or do anything that requires you  to be awake and alert. 

What are  the possible side effects  of butorphanol? 
 
Get emergency medical help if  you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of  your face, lips, tongue, or throat.
 
Tell  your caregivers at once if you have any of these serious side effects: 

• pounding, or uneven heartbeats; 
• increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure); 
• shallow breathing, slow heartbeat; 
• cold, clammy skin; 
• problems with urination; 
• tremors;
• confusion, feeling like you are floating; or 
• feeling light-headed, fainting. 
• Less serious side effects include: 
• drowsiness, dizziness; 
• constipation;
• nausea, vomiting, loss of appetite; 
• warmth or redness under the skin; 
• dry mouth; 
• blurred vision; 
• ringing in your ear; 

This list is not complete and other side effects may occur. Tell your doctor about any unusual or bothersome side effect. 

What other drugs will affect butorphanol? 
 
You should not use butorphanol with other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Tell your doctor if you need to use any of these other medicines while you are using butorphanol. 

There may be other drugs that can interact with butorphanol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. 

Where can I get more information? 

Your pharmacist can provide more information about butorphanol injection.