Butorphanol
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Analogs
- 8. Terms and conditions of storage
Butorphanol is a drug of the group of opioid non-narcotic analgesics for relief of pain syndromes of various etiologies.
Release form and composition
Colorless, transparent or slightly opalescent solution of 2 mg / ml for intramuscular or intravenous administration. Produced in:
- Ampoules, 1 ml, transparent or dark glass (in blisters of 5 pieces, in a cardboard box 1, 2, 4, 10 or 20 packs, the packs are equipped with an ampoule knife);
- Syringe tubes, 1 ml (in a cardboard box 1, 2 or 5 syringe tubes).
The active ingredient is butorphanol tartrate.
Auxiliary components: Trilon B, sodium citrate, citric acid, sodium chloride, water for injection.
Indications for use
Butorphanol is indicated:
- For pain caused by malignant neoplasms;
- With severe pain syndromes of various origins (including during surgical interventions, as well as in the preoperative and postoperative periods);
- During childbirth (if the fetus has no signs of intrauterine pathology).
Contraindications
Contraindications to the use of Butorphanol are:
- Increased intracranial pressure;
- Respiratory depression;
- Traumatic brain injury;
- Depression of the central nervous system;
- Alcoholic psychosis and acute alcoholic conditions;
- Convulsions;
- Renal and hepatic impairment;
- Bronchial asthma;
- Arterial hypertension;
- Heart failure;
- Violation of the rhythm of heart contractions;
- Acute myocardial infarction;
- Acute surgical diseases of the abdominal organs (before the diagnosis is established);
- Drug dependence on morphine-like drugs (Promedol, Morphine, Fentanyl).
- Hypersensitivity to drug components;
- Pregnancy and lactation (except for relieving pain during childbirth and preparing for them);
- Age under 18.
The drug is not prescribed during treatment with MAO inhibitors, as well as within 2 weeks after their cancellation.
Use with caution in the elderly (after 65 years).
Method of administration and dosage
The drug is administered intravenously or intramuscularly. The dose of the drug is determined individually by the attending physician.
Depending on the age and condition of the patient, the drug is administered in the following dosages:
- For pain relief - 1 mg intravenously or 2 mg intramuscularly, every 3-4 hours as needed;
- For premedication - 2 mg intramuscularly 1-1.5 hours before the operation or the same dose intravenously just before the operation;
- When carrying out general anesthesia - 2 mg intravenously, before the introduction of sodium thiopental, then add 0.5-1 mg to maintain the required depth of anesthesia. The total dose of butorphanol required for general anesthesia can range from 4 to 12.5 mg;
- During childbirth - 1-2 mg of the drug intramuscularly or intravenously, for women in labor at a gestational age of at least 37 weeks, only in the absence of signs of intrauterine pathology in the fetus. More often than 1 time in 4 hours, the drug should not be injected, the last injection should be done at least 4 hours before delivery.
Elderly people (over 65 years old) are recommended to reduce the dose by 2 times, and increase the interval between injections to 6 hours.
Side effects
The most common use of butorphanol can cause dizziness, drowsiness, nausea and vomiting. Other side effects from organs and systems are rarely possible:
- Organs of the gastrointestinal tract: rarely - constipation, anorexia, dryness of the oral mucosa, epigastric pain;
- Cardiovascular system and blood (hemostasis, hematopoiesis): rarely - palpitations, vasodilation; extremely rare - fainting, decrease or increase in blood pressure, chest pain, tachycardia;
- Nervous system and sensory organs: rarely - euphoria, confusion, anxiety, nervousness, insomnia, drowsiness, paresthesia, headache, asthenia, tremors, ringing in the ears, pain in the eyes, blurred vision, lethargy; extremely rare - agitation, hostility, unusual dreams, dysphoria, hallucinations, vertigo, depression, withdrawal syndrome;
- Allergic reactions: extremely rare - urticaria, rash;
- Other: rarely - itching, excessive sweating, feeling of heat; extremely rarely - shallow breathing, decreased urination.
Also in the process of post-marketing observations were noted: convulsions, apnea, delirium, transient difficulty in movement and speech (associated with excessive drug influence), drug dependence.
Side effects that an overdose of Butorphanol can cause: hypothermia, arterial hypotension, cardiovascular failure, hypoventilation, stupor or coma. In case of overdose, it is required to maintain adequate pulmonary ventilation, systemic hemodynamics and body temperature. With respiratory depression, it is possible to introduce a specific opioid antagonist Naloxone - 0.4-2 mg intravenously. The patient should be provided with continuous observation, if necessary, carry out artificial ventilation.
special instructions
Before starting therapy with Butorphanol, it is necessary to carry out a set of measures aimed at the complete elimination of narcotic substances from the body in patients with drug addiction in history.
In the process of preparing for childbirth, the drug can be prescribed only with careful medical supervision.
During the period of treatment, one should not engage in potentially hazardous types of work that require increased attention and high speed of psychomotor reactions.
Ethanol should not be consumed throughout the course of treatment.
It is not recommended to use the drug as an anesthetic for short-term surgical interventions, as long-term post-anesthetic respiratory depression is possible.
You should not combine taking the drug with taking other opioid analgesics, since there is a high likelihood of weakening analgesia and provoking a withdrawal syndrome in patients with opioid dependence.
Against the background of the use of hypnotics and drugs for general anesthesia, in order to avoid excessive suppression of the activity of the respiratory center and increased depression of the central nervous system, the drug is taken in reduced doses and under close medical supervision.
It should be borne in mind that Butorphanol:
- Pharmaceutically incompatible with barbiturates, diazepam;
- Loses effectiveness when used simultaneously with local vasoconstrictors administered intranasally;
- Enhances the effect of drugs that depress the central nervous system (anxiolytics, barbiturates, antipsychotics, ethanol, histamine H1 receptor blockers).
Analogs
Analogs of Butorphanol are: Stadol, Vero-Butorphanol.
Terms and conditions of storage
Keep out of the reach of children, protected from light, at a temperature of 5-30 ° C. Do not freeze.
The shelf life of the solution is 2 years.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
