Butorphanol 73reported in scientific literature. Two investigators say, however, that depen-
dency and addiction were the most frequent adverse reaction reports about
the drug received by the U.S. Food and Drug Administration in the early
1990s.Heroinusers who received butorphanol in an experiment described
butorphanol as unpleasant. Former opioid addicts have said it reminded them
of pentazocine. At one time in the United States butorphanol was not a con-
trolled substance, but instances of addiction prompted government authorities
to change the drug’s status to Schedule IV in 1997.
Drug interactions.Some recreational users combine butorphanol with the
common cold and allergy remedy diphenhydramine to produce a typical
opiate-type stupor. Users of that combination sometimes report loss of interest
in other drugs. Unwanted results can include emotional flip-flops, dizziness,
nausea, vomiting, breathing difficulty, and general reduction of mental and
physical abilities. Withdrawal symptoms from the combination may involve
impaired concentration, mental restlessness and unease, and emotional insta-
bility and peevishness.
In a mice experiment butorphanol and acetaminophen (Tylenol and similar
products) boosted each other’s pain relieving effects.
Cancer.Laboratory tests and two-year animal experiments have not indi-
cated that butorphanol causes cancer.
Pregnancy.Research using rats, mice, and rabbits has not yielded evidence
of birth defects caused by butorphanol, but some of the experiments produced
fetal death. The drug passes from a pregnant woman into the fetus and can
cause abnormal fetal heartbeat. When used in childbirth, impact on newborns
is similar to that of meperidine; respiratory distress can occur in the infant.
One study found the average drug level in newborns to match the maternal
level at time of birth. The amount of drug that passes into milk is believed
unharmful to nursing infants.
Additional scientific information may be found in:
Fisher, M.A., and S. Glass. “Butorphanol (Stadol): A Study in Problems of Current
Drug Information and Control.”Neurology48 (1997): 1156–60.
Gillis, J.C., P. Benfield, and K.L. Goa. “Transnasal Butorphanol: Review of Its Phar-
macodynamic and Pharmacokinetic Properties, and Therapeutic Potential in
Acute Pain Management.”Drugs50 (1995): 157–75.
Rosow, C.E. “Butorphanol in Perspective.”Acute Care12 (1988, Suppl. 1): 2–7.
Smith, S.G., and W.M. Davis. “Nonmedical Use of Butorphanol and Diphenhydra-
mine.”Journal of the American Medical Association252 (1984): 1010.
Vogelsang, J., and S.R. Hayes. “Butorphanol Tartrate (Stadol): A Review.”Journal of
Post Anesthesia Nursing6 (1991): 129–35.
Zacny, J.P., et al. “Comparing the Subjective, Psychomotor and Physiological Effects of
Intravenous Butorphanol and Morphine in Healthy Volunteers.”Journal of Phar-
macology and Experimental Therapeutics270 (1994): 579–88.
Zacny, J.P., et al. “The Effects of Transnasal Butorphanol on Mood and Psychomotor
Functioning in Healthy Volunteers.”Anesthesia and Analgesia82 (1996): 931–35.