What is the most important information I should know about butorphanol nasal?

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Avoid alcohol while using butorphanol nasal. Alcohol will greatly increase the drowsiness and dizziness caused by butorphanol and could be dangerous.

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Also avoid sleeping pills, tranquilizers, sedatives, and antihistamines except under the supervision of your doctor. These medications also may cause dangerous sedation when taken with butorphanol nasal.

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Use caution when driving, operating machinery, or performing other hazardous activities. Butorphanol may cause drowsiness. If you experience drowsiness, avoid these activities.

What is butorphanol nasal?

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Butorphanol is in a class of drugs called narcotic analgesics. It relieves pain.

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Butorphanol nasal is used to treat moderate-to-severe pain.

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Butorphanol nasal may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before using butorphanol nasal?

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Butorphanol can reverse the effects of other narcotic pain relievers. This medication should be used cautiously if you have been regularly taking other pain relievers.

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Before taking this medication, tell your doctor if you have

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kidney disease;

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liver disease;

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asthma or another lung condition;

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heart disease; or

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a history of drug dependence.

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You may not be able to use butorphanol nasal or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

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Butorphanol is in the FDA pregnancy category C. This means that it is not known whether butorphanol will harm an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant.

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Butorphanol passes into breast milk and may harm a nursing baby. Do not use butorphanol nasal without first talking to your doctor if you are breast-feeding a baby.

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Butorphanol nasal is not recommended for use by children younger than 18 years of age.

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Butorphanol nasal is more likely to cause side effects in people over 60 years of age. Your doctor may prescribe a lower dose of this medication for you.

How should I use butorphanol nasal?

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Use butorphanol nasal exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

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Never use more of this medication than is prescribed for you. Too much butorphanol could be very harmful.

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Blow your nose before using the nasal spray.

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Remove the cover from the unit. Prime the pump by pumping the sprayer quickly several (seven to eight) times until a fine spray appears.

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Insert the spray tip about 1 centimeter (one-third inch) into your nostril and point it towards the back of your nose. Block your other nostril with your finger and tilt your head slightly forward. Breathe in through your nose and spray once. Remove the unit from your nose, tilt your head slightly back, and sniff a few times.

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Use a second spray in your other nostril if your doctor has prescribed two sprays.

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Replace the protective clip and clear cover after each use.

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Store butorphanol nasal at room temperature away from moisture and heat.

What happens if I miss a dose?

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Since butorphanol nasal is used as needed to relieve pain, missing a dose is not usually a problem. Use the missed dose as soon as you remember, then wait the prescribed amount of time before using another dose. Do not use a double dose of this medication, unless otherwise directed by your doctor.

What happens if I overdose?

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Seek emergency medical attention.

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Symptoms of a butorphanol overdose include slow breathing, seizures, dizziness, weakness, loss of consciousness, coma, confusion, tiredness, cold and clammy skin, and small pupils.

What should I avoid while using butorphanol nasal?

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Avoid alcohol while using butorphanol nasal. Alcohol will greatly increase the drowsiness and dizziness caused by butorphanol and could be dangerous.

•

Also avoid sleeping pills, tranquilizers, sedatives, and antihistamines except under the supervision of your doctor. These medications also may cause dangerous sedation when taken with butorphanol nasal.

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Use caution when driving, operating machinery, or performing other hazardous activities. Butorphanol may cause drowsiness. If you experience drowsiness, avoid these activities.

What are the possible side effects of butorphanol nasal?

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If you experience any of the following serious side effects, stop using butorphanol nasal and seek emergency medical attention:

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an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

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slow, weak breathing;

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seizures;

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cold, clammy skin;

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severe weakness or dizziness; or

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unconsciousness.

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Other, less serious side effects may be more likely to occur. Continue to use butorphanol nasal and talk to your doctor if you experience

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constipation;

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dry mouth, nausea, vomiting, or decreased appetite;

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dizziness, tiredness, or lightheadedness;

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ringing in your ears;

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an unpleasant taste;

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nasal congestion or irritation;

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insomnia; or

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headache.

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Butorphanol may be habit forming.

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Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect butorphanol nasal?

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Butorphanol nasal may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), other pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.

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Drugs other than those listed here may also interact with butorphanol nasal. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

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Your pharmacist has additional information about butorphanol nasal written for health professionals that you may read.

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed