Concurrent use of butorphanol with CNS depressants (eg. alcohol, barbiturates, tranquilizers and antihistamines) may result in increased

CNS depressant effects

It is not known if the effects of butorphanol are altered by concomittant medications that affect hepatic metabolism of drugs (cimetidine, erythromycin, theophylline etc.) but a smaller initial dose and longer intervals between doses may be warranted

Barbiturates anesthetics may increase the respiratory and CNS depression of butorphanol because of additive pharmacolgic activity.

Hypotension, nausea, vomiting, dry mouth, stomach pain.

Somnolence, dizziness, confusion, anxiety, euphoria.

Floating feeling, nervousness, parathesia,

abnormal dreams, agitation. Sweating.

Diarrhea associated with pseudomembraneous colitis

Acute repiratory depression

Special precautions:

Geriatric patients,

renal impairment,

hepatic impairment

Use with caution during labour

Caution is also warranted in patients physically dependent on opoid agonists, in hypertensives (when used preoperatively ) and in patients with acute myocardial infarction.

Indications:

Treatment of moderate to severe pain Adjunct to anaesthesia

Dosage:

IV- 1mg (dosage range 0.5 to 2mg) repeated every 3 to 4 hours as necessary

IM- 2mg (dosage range 1 to 4mg) every 3 to 4 hours as required.

Children- not recommended in children below 18 years of age.

Refer -dectropropoxyphene

1. May cause drowsiness; observe caution while driving or performing other tasks requiring alertness,co-ordination or physical dexterity.

2. Do not use alcohol or other CNS depressants drugs concurrently.

3. Instruct patients on the proper use of nasal spray.

Not reported

Pregnancy:

Safety for use in pregnancy has not been established. Use only when needed.

Lactation:

Butaphanol appears in breast milk following the injectable route.