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butorphanol

Partial kappa/mu-opioid receptor agonist · Analgesic

Partial kappa/mu-opioid receptor agonistAnalgesic
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 12 →
  • AlprazolamSevereDatabaseDDInter
  • AlvimopanSevereDatabaseDDInter
  • AminoglutethimideSevereDatabaseDDInter
  • AmobarbitalSevereDatabaseDDInter

Mechanism

Butorphanol is a partial agonist at kappa- and mu-opioid receptors, producing analgesia and respiratory depression with a ceiling effect.

Indications

acute pain (e.g., postoperative pain)migraine pain (nasal formulation)postoperative painful conditionsshort-lasting painful conditions (e.g. renal colic)

Dosing

Adult
Parenteral: 2 mg/3–4 h

Pharmacokinetics

Duration
Duration of action is similar to morphine.
Half-life
3 h

Contraindications

  • patients with cardiac ischaemia

Side effects

Common
drowsinessweaknesssweatingfeelings of floatingnauseadizzinesssedationcardiac stimulationsubjective effects (less dysphoric than pentazocine)respiratory depression (lower ceiling than morphine)
Serious
  • increase in pulmonary arterial pressure
  • increase in the work of the heart
  • psychotomimetic effects
  • physical dependence
  • produces physical dependence (withdrawal can be precipitated by high dose of naloxone, but syndrome is mild)
  • abuse potential is low
  • cannot substitute for, nor antagonize morphine

Drug interactions

Alprazolam
Severe
Database

Drug interaction classified as: synergy.

Source: DDInter

Alvimopan
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Aminoglutethimide
Severe
Database

Drug interaction classified as: metabolism

Source: DDInter

Amobarbital
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Amprenavir
Severe
Database

Drug interaction classified as: metabolism

Source: DDInter

Apalutamide
Severe
Database

Drug interaction classified as: metabolism

Source: DDInter

Aprepitant
Severe
Database

Drug interaction classified as: metabolism

Source: DDInter

Aripiprazole
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Armodafinil
Severe
Database

Drug interaction classified as: metabolism

Source: DDInter

Asenapine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Atazanavir
Severe
Database

Drug interaction classified as: metabolism

Source: DDInter

Baclofen
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Related guidelines

Painful diabetic peripheral neuropathy
AAN · Neurology · 2022
Migraine — preventive therapy
AAN · Neurology · 2015
Coronary angiography with renal dysfunction
CSI · Cardiology · 2020
Gastric premalignant conditions
ACG · Gastroenterology · 2025
Substance use disorders
NIMHANS · Psychiatry · 2022

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Textbook-sourced·Sources: KD Tripathi 7e, Goodman & Gilman 14e·Updated: 2026-05-10