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Contraindications
Significant resp depression, unmonitored acute or severe brochial asthma.
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Special Precautions
Patient w/ head injury, increased intracranial pressure, acute MI, ventricular dysfunction, coronary insufficiency, adrenal insufficiency, biliary tract dysfunction, CNS depression, prostatic hyperplasia, hypercapnia/hypoxia, COPD, thyroid dysfunction; obese patients and those at risk for drug abuse. Renal and hepatic impairment. Elderly. Pregnancy (may cause neonatal opioid withdrawal syndrome in prolonged use during pregnancy) and lactation. Patient Counselling This drug may cause drowsiness and dizziness, if affected, do not drive or operate machinery. Monitoring Parameters Monitor pain relief, resp and mental status, BP, signs and symptoms of hypogonadism or hypoadrenalism.
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Adverse Reactions
Asthenia/lethargy, headache, heat sensation, vasodilation, palpitations, anorexia, constipation, dry mouth, nausea and vomiting, stomach pain, anxiety, confusion, dizziness, euphoria, floating feeling, insomnia, nervousness, paraesthesia, somnolence, tremor, bronchitis, cough, dyspnoea, epistaxis, nasal congestion, nasal irritation, pharyngitis, rhinitis, sweating, pruritus, blurred vision, ear pain, tinnitus, unpleasant taste, hypotension, syncope, abnormal dreams, agitation, dysphoria, hallucinations, hostility, rash, impaired urination, oedema, chest pain, HTN, tachycardia, depression, shallow breathing.
Potentially Fatal: Resp depression. |
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ROUTE(S) : IM / IV: C
ROUTE(S) : Nasal / Parenteral: C
D if prolonged use/high doses at term.
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Drug Interactions
Additive effect w/ other CNS depressants (e.g. general anaesth, phenothiazines or other tranquilizers, sedatives, hypnotics, antihistamines). May increase risk of transient high BP when used w/ sumatriptan nasal spray. Increased conjunctival changes when used w/ pancuronium. Decreased rate of absorption when used w/ oxymetazoline (nasal).
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CIMS Class
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ATC Classification
N02AF01 - butorphanol ; Belongs to the class of morphinan derivative opioids. Used to relieve pain.
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