Butorphanol nasal

Since butorphanol nasal is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with butorphanol nasal.

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how butorphanol will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Like other narcotic medicines, butorphanol can slow your breathing. Death may occur if breathing becomes too weak.

Call your doctor at once if you have:

• weak or shallow breathing, slow heart rate;

• pounding or uneven heartbeats;

• problems with urination;

• tremors, numbness or tingling;

• severe dizziness, confusion, feeling like you are floating;

• a light-headed feeling, like you might pass out;

• infertility, missed menstrual periods;

• impotence, sexual problems, loss of interest in sex;

• dangerously high blood pressure--severe headache, blurred vision, pounding in your neck or ears, nosebleed, anxiety, confusion, severe chest pain, shortness of breath, irregular heartbeats; or

• low cortisol levels-- nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects include:

• drowsiness, dizziness;

• sleep problems (insomnia);

• nausea, vomiting; or

• stuffy nose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In the U.S.

• Stadol NS

Available Dosage Forms:

• Spray

Therapeutic Class: Analgesic

Pharmacologic Class: Opioid Agonist/Antagonist

Chemical Class: Opioid

Butorphanol nasal spray is used to relieve pain that is not relieved by other pain medicines. It belongs to the group of medicines called narcotic analgesics (pain medicines). Butorphanol acts on the central nervous system (CNS) to relieve pain.

When butorphanol is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

butorphanol is available only with your doctor's prescription.

butorphanol should come with a Medication Guide and patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

butorphanol is for use only in the nose. Do not get any of it in your eyes or on your skin. If it does get on these areas, rinse it off right away.

To use the nasal spray:

• Blow your nose gently to clear the nostrils.
• Take the cap off of the bottle and remove the clip from the neck of the pump.
• If you are using the medicine for the first time, you will need to prime the spray pump.
• To do this, hold the spray bottle with your thumb on the bottom of the bottle and your index and middle fingers on the 2 flaps on the side of the pump.
• Push down with your index and middle fingers. Keep pumping until you see the medicine spray from the bottle.
• Put the tip of the spray pump into your nostril.
• Close the other nostril with your finger and lean your head slightly forward.
• Sniff gently and push down on the 2 flaps to spray the medicine into your nose. Keep your mouth closed as you are breathing in.
• Take the spray pump out of your nostril and tilt your head back. Sniff a few more times.

After using the nasal spray, wipe the tip of the bottle with a clean tissue and put the cap back on.

Dosing

The dose of butorphanol will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of butorphanol. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For nasal dosage form (spray):
  • For pain:
    • Adults—1 milligram (mg) or 1 spray in one nostril. A second spray may be taken 60 to 90 minutes after the first dose if needed. This may be repeated every 3 to 4 hours as needed.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of butorphanol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

After you stop using the nasal spray, unscrew the cap, rinse the bottle, and place the parts in a waste container.