Butorphanol nasal - Uses, Side Effects, and More

What are the most common side effects of butorphanol?

The most common side effects of butorphanol are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Drowsiness
• Dizziness
• Nausea and vomiting
• Stuffy nose
• Trouble sleeping

There may be other side effects of butorphanol that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of butorphanol?

While less common, the most serious side effects of butorphanol are described below, along with what to do if they happen.

Severe Allergic Reactions. Butorphanol can cause allergic reactions, which can be serious. Stop using butorphanol and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Butorphanol can cause serotonin syndrome when it is used alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

• Sweating, fever, or flushing
• Confusion
• Feeling agitated or restless
• Seeing or hearing unusual things
• Dizziness
• Fast or racing heartbeat
• Nausea, vomiting, or diarrhea
• Muscle twitching, stiffness, or tremor
• Seizures

Risk of Misuse and Addiction. Misusing butorphanol can lead to serious side effects like coma or death. Misuse means using medicine in a way other than how it was prescribed. Use butorphanol exactly as prescribed. Tell your healthcare provider if you feel that butorphanol is not working. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.

• Sudden confusion or feeling disoriented
• Feeling paranoid
• Suicidal thoughts or actions
• Seizures
• Trouble breathing

Breathing Problems. Butorphanol may cause slow or shallow breathing, especially if you have breathing problems from another condition or take other medicines that can slow your breathing. Tell your healthcare provider if you develop severe sleepiness or trouble breathing, especially when you start butorphanol or when your dose is increased. Get emergency help if you have any of the following symptoms.

• Changes in the color of your skin, including bluish color to your lips and fingernails
• Confusion
• Shortness of breath
• Feeling dizzy, lightheaded, or fainting
• Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
• Slow or shallow breathing
• Excessive sleepiness or trouble staying awake

Increased Pain Sensitivity (Hyperalgesia). Butorphanol can cause an increased sensitivity to pain. It can cause things that normally cause pain to feel more painful than usual. Butorphanol can also cause allodynia. This happens when things that normally do not cause pain, such as wearing glasses or brushing your hair, become painful. If your pain increases, do not take extra doses of butorphanol. This could cause you to overdose or develop other serious side effects. Call your healthcare provider right away if your pain increases, you feel more sensitive to pain, or if you develop pain in other areas of the body.

Dependence and Withdrawal Reactions. Butorphanol can cause physical dependence, which means your body relies on the medicine to function properly. If you stop butorphanol suddenly, it could lead to withdrawal symptoms, which may be life-threatening. Do not stop using butorphanol without talking to your healthcare provider. Your healthcare provider will tell you how to stop butorphanol to reduce the risk for withdrawal reactions. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.

• Unusual movements, responses, or expressions
• Seizures
• Sudden and severe mental or nervous system changes
• Seeing or hearing things that others do not see or hear (hallucinations)
• An extreme increase in activity or talking
• Losing touch with reality

Increased Blood Pressure (Hypertension). Rarely, butorphanol may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while using this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your healthcare provider right away if you have any of the following symptoms of severely high blood pressure.

• Sudden severe headache
• Chest pain
• Dizziness or confusion
• Trouble breathing
• Nausea or vomiting
• Blurry or other changes to vision
• Anxiety
• Buzzing in the ears
• Nosebleed
• Feeling of skipped heartbeats

Adrenal Insufficiency. Long-term use of butorphanol can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your healthcare provider if you have any of the following symptoms of adrenal insufficiency.

• Nausea and vomiting
• Weakness, tiredness, or lack of energy
• Low blood pressure
• Dizziness
• Tiredness
• Loss of appetite

Low Blood Pressure (Hypotension). Butorphanol may cause low blood pressure, especially within an hour of using it. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

• Dizziness, feeling lightheaded, or fainting
• Confusion
• Feeling weak or tired

Decreased Alertness or Coordination. Butorphanol can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how butorphanol affects you.

Sphincter of Oddi Spasm. The sphincter of Oddi is a muscular valve in your body that controls the flow of bile and digestive juices from the pancreas into the small intestine. When this valve spasms, it may feel like getting a tight muscle cramp, causing pain and blocking the flow of these juices, which can lead to discomfort and digestive problems. This is more likely to happen if you do not have a gallbladder. Get emergency medical help if you have new or worse stomach pain or pain in the upper right side of your stomach-area that travels to your back or shoulder, with or without nausea and vomiting.

Severe Constipation. Some people using butorphanol have had severe constipation. Some needed to go to the hospital. Talk with your healthcare provider about ways to decrease your risk of having constipation while using butorphanol. Stop using butorphanol and get help right away if you have severe constipation.