Summary
Commonly reported side effects of butorphanol include: dizziness and drowsiness. Other side effects include: lethargy, cold and clammy skin, and diaphoresis. Continue reading for a comprehensive list of adverse effects.
Applies to butorphanol: injection solution. Other dosage forms:
- nasal spray
Warning
Injection route (Solution)
Butorphanol tartrate has the potential for addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient's risk before prescribing, and monitor for development of these behaviors or conditions. Serious, life-threatening, or fatal respiratory depression may occur. Monitor closely, especially upon initiation or following a dose increase. Prolonged use of butorphanol tartrate during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available. Concomitant use of opioids with benzodiazepines or other CNS depressants including alcohol, may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for patients with inadequate alternative treatment options. Limit dosages and durations to the minimum required and follow patients for signs and symptoms of respiratory depression and sedation.
Serious side effects of Butorphanol
Along with its needed effects, butorphanol may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking butorphanol:
Less common
- Cough producing mucus
- difficulty breathing
- shortness of breath
- tightness in chest
- wheezing
Rare
- Blurred vision
- chest pain
- confusion
- dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
- fast, pounding, or irregular heartbeat or pulse
- nervousness
- pounding in the ears
- slow or fast heartbeat
Incidence not known
- Bluish lips or skin
- false beliefs that cannot be changed by facts
- not breathing
- seizures
Get emergency help immediately if any of the following symptoms of overdose occur while taking butorphanol:
Symptoms of overdose
- Change in consciousness
- extremely shallow or slow breathing
- irregular heartbeats
- loss of consciousness
- shortness of breath
- swelling in hands and feet
Other side effects of Butorphanol
Some side effects of butorphanol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Dizziness
- nausea
- sleepiness or unusual drowsiness
- vomiting
Less common
- Bad unusual or unpleasant (after) taste
- bloody nose
- body aches or pain
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- change in taste
- clammy skin
- congestion
- continuing ringing or buzzing or other unexplained noise in ears
- cough
- dry mouth
- dryness or soreness of throat
- ear pain
- false or unusual sense of well-being
- fear or nervousness
- feeling of warmth or heat
- fever
- floating feeling
- flushing or redness of skin, especially on face and neck
- headache
- hearing loss
- heat sensation on body
- hoarseness
- loss of appetite
- nasal irritation
- runny nose
- shakiness
- skin itching
- sleeplessness
- sneezing
- stomach pain
- stuffy nose
- tender, swollen glands in neck
- trouble in swallowing
- trouble sleeping
- unable to sleep
- voice changes
- weight loss
Rare
- Sweating
- unusual tiredness or weakness
Incidence not known
- Dizziness or lightheadedness
- feeling of constant movement of self or surroundings
- lack or loss of strength
- problems in speaking
- sensation of spinning
For Healthcare Professionals
Applies to butorphanol: injectable solution, nasal spray.
General
The most commonly reported adverse events have included somnolence, dizziness, nausea, and vomiting. Nasal congestion has been reported with use of the nasal spray.[Ref]
Respiratory
Very common (10% or more): Nasal congestion (13%)
Common (1% to 10%): Epistaxis, nasal congestion, nasal irritation, rhinitis, sinus congestion, sinusitis, nose pain, cough, dyspnea
Frequency not reported: Shallow breathing[Ref]
Hypersensitivity
Postmarketing reports: Anaphylaxis
Anaphylaxis has been reported with ingredients contained in butorphanol nasal spray.
Gastrointestinal
Common (1% to 10%): Nausea, anorexia, constipation, dry mouth, nausea and/or vomiting, diarrhea, stomach pain[Ref]
Nervous system
Very common (10% or more): Somnolence (49%), dizziness (23%)
Common (1% to 10%): Headache, lethargy, confusion, dizziness, paresthesia, somnolence, tremor, unpleasant taste
Postmarketing reports: Serotonin syndrome[Ref]
Concomitant use of opioids and serotonergic drugs have been associated with reports of serotonin syndrome.[Ref]
Psychiatric
Abnormal dreams, agitation, dysphoria, hallucinations, hostility, withdrawal symptoms, and depression have been reported in less than 1% of patients.
Very common (10% or more): Insomnia (11%)
Common (1% to 10%): Anxiety, euphoria, nervousness
Frequency not reported: Abnormal dreams, agitation, dysphoria, hallucinations, hostility, withdrawal symptoms, depression
Cardiovascular
Syncope, chest pain, tachycardia, and edema have been reported in less than 1% of patients.[Ref]
Common (1% to 10%): Hypertension, hypotension, vasodilation, palpitations
Frequency not reported: Syncope, edema, chest pain, tachycardia[Ref]
Dermatologic
Rash/hives have been reported in less than 1% of patients.[Ref]
Common (1% to 10%): Sweating, pruritus
Frequency not reported: Rash/hives[Ref]
Ocular
Common (1% to 10%): Blurred vision[Ref]
Other
Common (1% to 10%): Asthenia, sensation of heat, pain, ear pain, tinnitus[Ref]
Genitourinary
Frequency not reported: Impaired urination
Endocrine
Postmarketing reports: Adrenal insufficiency, androgen deficiency
Cases of adrenal insufficiency have been reported with opioid use, more often following greater than one month of use; Cases of androgen deficiency have occurred with chronic use of opioids.
