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The clinical manifestations of butorphanol overdose are those of opioid drugs in general. Consequences of overdose vary with the amount of butorphanol ingested and individual response to the effects of opiates. The most serious symptoms are hypoventilation, cardiovascular insufficiency, coma, and death. Butorphanol overdose may be associated with ingestion of multiple drugs (see ADVERSE REACTIONS: Postmarketing Experience).
Overdose can occur due to accidental or intentional misuse of butorphanol, especially in young children who may gain access to the drug in the home.
The management of suspected butorphanol overdosage includes maintenance of adequate ventilation, peripheral perfusion, normal body temperature, and protection of the airway. Patients should be under continuous observation with adequate serial measures of mental state, responsiveness, and vital signs. Oxygen and ventilatory assistance should be available with continual monitoring by pulse oximetry if indicated. In the presence of coma, placement of an artificial airway may be required. An adequate intravenous portal should be maintained to facilitate treatment of hypotension associated with vasodilation.
The use of a specific opioid antagonist such as naloxone should be considered. As the duration of butorphanol action usually exceeds the duration of action of naloxone, repeated dosing with naloxone may be required.
In managing cases of suspected butorphanol overdosage, the possibility of multiple drug ingestion should always be considered.
STADOL (butorphanol tartrate) Injection and STADOL (butorphanol tartrate) NS are contraindicated in patients hypersensitive to butorphanol tartrate or the preservative benzethonium chloride in STADOL (butorphanol tartrate) NS or STADOL (butorphanol tartrate) Injection in the multi-dose vial.
Last reviewed on RxList: 6/2/2008
This monograph has been modified to include the generic and brand name in many instances.
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