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    DEA Class; Rx

    Common Brand Names; Stadol

    • Opioid Analgesics; 
    • Analgesics, Opioid Partial Agonist

    Semisynthetic mixed opiate agonist-antagonist; partial mu-receptor agonist with a ceiling to its pharmacological effects
    Immediate-release parenteral form used for moderate to severe pain; transdermal and buccal forms used for continuous therapy for chronic severe pain
    Sublingual tablets, dermal implant, and extended-release subcutaneous injection are used for opioid dependence in conjunction with the Drug Addiction Treatment Act (DATA)

    Indicated for pain when use of opioid analgesic is appropriate

    Indicated for labor pain in full-term (37 weeks gestation or more) women without fetal distress in early labor

    Absolute: opioid dependence, respiratory depression, respiratory failure

    Relative: cardiac arrhythmias, cardiovascular disease, coronary insufficiency, myocardial infarction, toxin-mediated diarrhea

    • Sedation (43%)
    • Dizziness (19%)
    • Nasal congestion (13%)
    • Nausea and/or vomiting (13%)
    • Insomnia (11%)
    • Anorexia
    • Anxiety
    • Blurred vision
    • Bronchitis
    • Confusion
    • Constipation
    • Cough
    • Dizziness
    • Dry mouth
    • Dyspnea
    • Ear pain
    • Epistaxis
    • Euphoria
    • Floating feeling
    • Headache
    • Lethargy
    • Nasal irritation
    • Nervousness
    • Paresthesia
    • Palpitations
    • Pharyngitis
    • Pruritis
    • Rhinitis
    • Sensation of heat
    • Sinus congestion
    • Sinusitis
    • Stomach pain
    • Sweating/clammy
    • Taste abnormalities
    • Tinnitus
    • Tremor
    • URI
    • Vasodilation
    • Apnea
    • Increased/decreased BP
    • Bradycardia
    • Chest pain
    • Respiratory depression
    • Tachycardia

    Drug abuse, emotional lability, head injury, hepatic/renal impairment, incr ICP, GI/urinary obstruction, BPH, hypothyroidism

    Less risk of respiratory sedation than with pure opioid agonist

    May produce withdrawal in opioid dependent pts

    Avoid alcohol

    Pregnancy Category: C; D if used for prolonged periods or near term

    Lactation: excreted in breast milk, but infant likely exposed to insignificant amounts (AAP Committee states compatible w/ nursing)


    The maximum dosage is dependent on route of administration and indication for therapy.


    The maximum dosage is dependent on route of administration and indication for therapy.


    Safety and efficacy have not been established.


    Safety and efficacy have not been established.

    Butorphanol tartrate

    injectable solution: Schedule IV

    • 1mg/mL
    • 2mg/mL

    nasal spray: Schedule IV

    • 10 mg/mL (1mg/spray)