Butrum Solution
Butorphanol
2mg
Aristo Pharmaceuticals Ltd.
| Pack size | 1 |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 564.00 NPR |
Available as:
Indications
Butrum Solution is used for:
Moderate to severe pain, Anaesthesia
Adult Dose
Pain
Parenteral
Indicated for pain when use of opioid analgesic is appropriate
IV: 1 mg IV q3-4hr PRN; dosage range 0.5-2 mg q3-4hr
IM: 2 mg IM q3-4 hr; dosage range 1-4 mg q3-4hr
Intranasal
Initial: 1 mg (1 spray in 1 nostril); may repeat once after 60-90 min if inadequate pain relief
Depending on pain severity, by give initial dose of 2 mg (1 spray in each nostril); patient must remain recumbant; do not repeat this dose
Maintenance: 1 mg (1 spray in 1 nostril) q3-4hr prn
Balanced Anesthesia
Parenteral
2 mg IV before induction and/or 0.5-1 mg increments during anesthesia (higher dose may be required, up to 0.06 mg/kg, or 4 mg/70 kg)
Total cumulative dose varies; typically ranges between 4-12.5 mg (0.06-0.18 mg/kg)
Labor Pain
Indicated for labor pain in full-term (37 weeks gestation or more) women without fetal distress in early labor
1-2 mg/dose IV/IM; may repeat PRN q4hr
Decrease dose if concomitantly used with other analgesics or CNS depressants
Do not administer within 4 hr of anticipated delivery
Preoperative & Preanesthesia
2 mg IM 60-90 minutes preop
This dose is approximately equipotent to morphine 10 mg or meperidine 80 mg
Elderly
Parenteral
Decrease initial dose by 50% (0.5 mg IV and 1 mg IM)
Increase dose interval from q4hr to q6hr
Intranasal
1 mg (1 spray in 1 nostril) initially, may repeat once after 90-120 minutes if inadequate pain control
Maintenance: 1 mg (1 spray in 1 nostril) q4-6hr prn
Hepatic Impairment
Parenteral
Decrease initial dose by 50% (0.5 mg IV and 1 mg IM)
Increase dose interval from q4hr to q6hr
Intranasal
1 mg (1 spray in 1 nostril) initially, may repeat once after 90-120 minutes if inadequate pain control
Maintenance: 1 mg (1 spray in 1 nostril) q4-6hr prn
Child Dose
<18 years old: Not recommended
Renal Dose
Renal Impairment
Parenteral
Decrease initial dose by 50% (0.5 mg IV and 1 mg IM)
Increase dose interval from q4hr to q6hr
Intranasal
1 mg (1 spray in 1 nostril) initially, may repeat once after 90-120 minutes if inadequate pain control
Maintenance: 1 mg (1 spray in 1 nostril) q4-6hr prn
Administration
Contra Indications
Opiate-dependent patients who have not been detoxified; acute resp depression; pregnancy.
Precautions
Elderly; renal and hepatic impairment; hypertensive patients (when used preoperatively); patients with acute MI; head injury; lactation; patients on MAOI or within 2 wk of treatment withdrawal.
Lactation: excreted in breast milk, but infant likely exposed to insignificant amounts (AAP Committee states compatible w/ nursing)
Pregnancy-Lactation
Pregnancy Category: C; D if used for prolonged periods or near term
Interactions
Additive depressant effects with other CNS depressants e.g. general anaesthetics, phenothiazines or other tranquilizers, sedatives, hypnotics, antihistamines or alcohols.
Adverse Effects
Side effects of Butorphanol :
>10%
Sedation (43%),Dizziness (19%),Nasal congestion (13%),Nausea and/or vomiting (13%),Insomnia (11%)
1-10%
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
<1%
Apnea,Increased/decreased BP,Bradycardia,Chest pain,Respiratory depression,Tachycardia
Mechanism of Action
Butorphanol is a phenanthrene derivative with opioid agonist and antagonist properties. It has central analgesic actions and produces generalised CNS depression. It also alters perception of and response to pain by binding to opiate receptors in the CNS.
Note
Butrum 2mg Solution manufactured by Aristo Pharmaceuticals Ltd.. Its generic name is Butorphanol. Butrum is availble in Nepal.
Farmaco Nepal drug index information on Butrum Solution is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.