Butorphanol Nasal Spray (patient information)

# Why this medication is prescribed
Butorphanol nasal spray is used to relieve moderate to severe pain. It also is used to manage migraine headaches.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

# How this medication should be used
Butorphanol nasal spray comes in a pump. It usually is used as one spray in one nostril. If pain relief does not occur within 60-90 minutes, another single spray may be used. This two-dose sequence usually is repeated every 3-4 hours as needed. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
Before you use butorphanol for the first time, read the written directions provided by the manufacturer. The pump must be primed (made ready to work) if it is not used for 48 hours or longer. One bottle provides approximately 8-10 doses (if priming is needed) or 14 or 15 doses (if no priming is needed between any doses).
To use the pump, follow these directions:
- Wash your hands.
- Gently blow your nose to clear your nasal passages.
- Remove the clear cover and protective clip from the bottle.
- With the nasal sprayer aimed away from all people and animals, prime the pump if needed. To prime the pump, pump the spray bottle firmly and quickly (up to eight strokes) until a fine spray appears.
- Insert the tip of the sprayer approximately 1/4 inch into one nostril, pointing the tip toward the back of your nose.
- Close your other nostril with your finger and tilt your head slightly forward.
- Pump the spray firmly and quickly one time and sniff gently with your mouth closed.
- Remove the sprayer from your nose.
- Replace the protective clip and cover on the spray bottle.
Use butorphanol nasal spray exactly as directed. There is a small chance that the drug can be habit-forming. Do not use a larger dose, use it more often, or for a longer period than your doctor tells you to.

# Special precautions
Before using butorphanol nasal spray:
- tell your doctor and pharmacist if you are allergic to butorphanol or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other pain relievers; antidepressants; medications for cough, cold, or allergies; nasal sprays; sedatives; sleeping pills; tranquilizers; and vitamins.
- tell your doctor if you have or have ever had liver, kidney, lung, or heart disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking butorphanol nasal spray, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking butorphanol nasal spray.
- you should know that this drug may make you drowsy or dizzy. Do not drive a car or operate machinery for at least one hour after using butorphanol and until you no longer feel drowsy or dizzy.
- remember that alcohol can add to the drowsiness caused by this drug. You should not drink alcohol while using butorphanol.

# What to do if you forget a dose
Butorphanol nasal spray usually is used as needed. If your doctor has told you to use butorphanol nasal spray regularly, use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

# Side effects

## Minor side effects
Butorphanol nasal spray may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- drowsiness
- lightheadedness
- dizziness
- upset stomach
- vomiting
- headache
- congestion
- runny nose
- sore throat
- ringing in the ears

## Severe side effects
If you experience any of the following symptoms, call your doctor immediately:
- difficulty breathing
- fainting
- irregular heartbeat
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions needed for this medication
After each use, replace the protective clip and clear cover on the spray bottle and return it to its child-resistant container. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Other information
Keep all appointments with your doctor.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Stadol
- Stadol NS