Butorphanol, an injectable narcotic with mixed activity at different opioid receptors, has multiple drug interactions and crucial FDA warnings dentists should be aware of. Read on to learn more:
Generic Name: Butorphanol
Brand Name(s): Stadol (Now discontinued)
Pronunciation: bue TOR fa nol
About this drug:
Butorphanol is an opioid narcotic used only to treat moderate to severe pain that is not controlled by alternate treatments.
Dentistry-related tidbits:
This medication may cause an unpleasant taste in the mouth and xerostomia. Consider prescribing a fluoride supplement to use at bedtime if the patient has a high rate of caries and scheduling frequent dental examinations.
Monitor blood pressure when administering Articaine, Bupivacaine, Lidocaine, Mepivacaine, or Ropivacaine with Epinephrine to a patient taking Butorphanol, as this combination may increase the risk of hypotension and syncope.
For post-procedural pain, first attempt pain control by prescribing 400-600 mg of Ibuprofen and 500-1000 mg of Acetaminophen at the same time. Take every 6 hours as needed for pain. Never exceed 4000 mg per day to avoid liver complications. Consider using Bupivacaine (Marcaine) local anesthetic to minimize post-op pain.
This medication may cause severe drowsiness, lightheadedness, dizziness, and respiratory depression, especially in elderly patients. Follow patients for signs and symptoms of respiratory depression and sedation.
Butorphanol in combination with Alcohol, over-the-counter antihistamines, sleep aids, benzodiazepines, narcotics, anticonvulsant Carbamazepine, muscle relaxants, quinolone antibiotic Ciprofloxacin, macrolide antibiotics, and antifungals may increase the risk of CNS and respiratory depression and diminished psychomotor function.
If the patient is at risk for overdose, consider prescribing Naloxone especially if the patient is taking other CNS depressants.
The oxazolidinone antibiotic Linezolid in combination with Butorphanol may increase the risk of respiratory depression and serotonin syndrome. Before prescribing any medication, use the Rx Check tool to prevent potential drug interactions or adverse effects.
Fun facts:
Butorphanol is a partial opioid agonist at the mu opioid receptor and a full agonist at the kappa opioid receptor, resulting in analgesia.
Butorphanol is not administered by mouth due to the liver’s extensive metabolism (only 5-17% of the drug is delivered to the body).
This medication has multiple FDA Warnings. Examples include risks for medication errors, addiction and abuse, respiratory depression, and concomitant use with benzodiazepines or other CNS depressants.
Butorphanol should not be used if the patient is pregnant as it might result in neonatal opioid withdrawal syndrome.
Join us in ending smile denial™️ by signing up for the Digital Drug Handbook™️ today!
Comentarios