Butorphanol

Administration

• Type: synthetic mixed agonist-antagonist opioid
• Dosage Forms:
• Routes of Administration: IV, IN
• Common Trade Names:

Adult Dosing

• 0.5-2mg IV, IM, or IN q3h prn

Special Populations

Pregnancy Rating

• Category C

Lactation risk

• Infant risk cannot be ruled out

Renal Dosing

• Reduce dose (0.5-1mg)

Hepatic Dosing

• Reduce dose (0.5-1mg)

Contraindications

• Allergy to class/drug
• Significant respiratory depression
• Acute or severe asthma if unmonitored setting
• Known or suspected SBO or ileus

Adverse Reactions

Serious

• Respiratory depression

Common

• Nausea/vomiting
• Sedation/somnolence, Dizziness, insomnia
• Nasal congestion (long term use of IN)

Pharmacology

• Half-life: 4-6h in healthy patients, 10-17h inhepatic or renal impairment
• Metabolism: Hepatic
• Excretion: Mostly renal

Mechanism of Action

• Mixed agonist-antagonist analgesic, kappa-opioid receptor agonist, low intrinsic activity at mu-opioid receptor

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

	Indication	Dose	Context	Route	Population
Acute pain management#Butorphanol Step 3 - Severe pain (mixed agonist-antagonist) Adult	Acute pain management	0.5-2.0 mg IV; average 2 mg q3-4h	Step 3 - Severe pain (mixed agonist-antagonist)	IV	Adult

See Also

• Opioids
• Opioid toxicity