pms-Butorphanol

pms-Butorphanol Uses, Dosage, Side Effects, Food Interaction and all others data.

A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain.

pms-Butorphanol is a synthetic opioid agonist-antagonist analgesic with a pharmacological and therapeutic profile that has been well established since its launch as a parenteral formulation in 1978. The introduction of a transnasal formulation of butorphanol represents a new and noninvasive presentation of an analgesic for moderate to severe pain. This route of administration bypasses the gastrointestinal tract, and this is an advantage for a drug such as butorphanol that undergoes significant first-pass metabolism after oral administration. The onset of action and systemic bioavailability of butorphanol following transnasal delivery are similar to those after parenteral administration. pms-Butorphanol blocks pain impulses at specific sites in the brain and spinal cord.

Trade Name pms-Butorphanol
Availability Prescription only
Generic Butorphanol
Butorphanol Other Names Butorfanol, Butorphanol, Butorphanolum
Related Drugs Buprenex, aspirin, acetaminophen, tramadol, naproxen, Tylenol, oxycodone, fentanyl, lidocaine, ketamine
Type
Formula C21H29NO2
Weight Average: 327.4605
Monoisotopic: 327.219829177
Protein binding

Serum protein binding is approximately 80%.

Groups Approved, Illicit, Vet approved
Therapeutic Class
Manufacturer
Available Country Canada, United States
Last Updated: September 19, 2023 at 7:00 am
pms-Butorphanol
pms-Butorphanol

Uses

pms-Butorphanol is an opioid agonist-antagonist used to treat moderate to severe pain.

For the relief of moderate to severe pain.

pms-Butorphanol is also used to associated treatment for these conditions: Pain, Perioperative Pain, Severe Pain

How pms-Butorphanol works

The exact mechanism of action is unknown, but is believed to interact with an opiate receptor site in the CNS (probably in or associated with the limbic system). The opiate antagonistic effect may result from competitive inhibition at the opiate receptor, but may also be a result of other mechanisms. pms-Butorphanol is a mixed agonist-antagonist that exerts antagonistic or partially antagonistic effects at mu opiate receptor sites, but is thought to exert its agonistic effects principally at the kappa and sigma opiate receptors.

Toxicity

The clinical manifestations of butorphanol overdose are those of opioid drugs in general. The most serious symptoms are hypoventilation, cardiovascular insufficiency, coma, and death.

Food Interaction

  • Avoid alcohol.

pms-Butorphanol Alcohol interaction

[Moderate] GENERALLY AVOID:

Ethanol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics.

Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills.

In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

Concomitant use of opioid analgesics with ethanol should be avoided.

pms-Butorphanol Hypertension interaction

[Moderate] pms-Butorphanol may increase blood pressure and rarely causes severe hypertension.

Therapy with butorphanol should be administered cautiously in hypertensive patients, particularly when given before surgery or anesthesia.

Volume of Distribution

  • 305 to 901 L

Elimination Route

Rapidly absorbed after intramuscular injection and peak plasma levels are reached in 20-40 minutes. The absolute bioavailability is 60-70% and is unchanged in patients with allergic rhinitis. In patients using a nasal vasoconstrictor (oxymetazoline) the fraction of the dose absorbed was unchanged, but the rate of absorption was slowed. Oral bioavailability is only 5-17% because of extensive first-pass metabolism.

Half Life

The elimination half-life of butorphanol is about 18 hours. In renally impaired patients with creatinine clearances <30 mL/min the elimination half-life is approximately doubled. After intravenous administration to patients with hepatic impairment, the elimination half-life of butorphanol was approximately tripled.

Clearance

  • 99 +/- 23 L/h [Young with IV 2 mg]
  • 82 +/- 21 [Eldery with IV 2 mg]

Elimination Route

pms-Butorphanol is extensively metabolized in the liver. Elimination occurs by urine and fecal excretion.

Innovators Monograph

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*** Taking medicines without doctor's advice can cause long-term problems.
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