Butorphanol
Also known as: Stadol, Torbutrol, Torbugesic, Dolorex, Equanol, Alvegesic, Butomidor, Torphasol
**What is this medication?** Butorphanol is a medication used to relieve coughing, provide mild pain relief, or act as a sedative before veterinary procedures. **What should I expect?** * Your pet will likely become sleepy or slightly uncoordinated (wobbly). This is normal, but you should keep them in a safe, quiet environment (e.g., avoid stairs) until the effects wear off. * If prescribed for a cough, you should notice a significant decrease in coughing spells. **Important Warnings:** * **Do not give more than prescribed.** Giving too much will not increase pain relief but can increase side effects. * If your pet's cough changes from a "dry, hacking" cough to a "wet, productive" cough, contact your veterinarian. Suppressing a wet cough can trap mucus in the lungs. * Report any significant changes in behavior, loss of appetite, or severe constipation/diarrhea to your veterinarian.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- As an analgesic
- As a postoperative CRI
- As an epidural analgesic
- As reversal agent for mu-agonist opiates
- In combination as an immobilizing agent (short procedures)
- In combination as an immobilizing agent (more sedation)
- As a sedative/analgesic
- For injectable anesthesia
- Immobilization combinations
- As an analgesic
- For post-op analgesia (CRI)
- As an analgesic for surgery in adult cattle
- As an analgesic
How it is given
Possible side effects
- Sedation and ataxia
- Anorexia or diarrhea (rare in small animals)
- Respiratory depression (mild compared to pure agonists)
- CNS excitement, head tossing, and increased ambulation (especially in horses at high doses or rapid IV administration)
- Decreased gastrointestinal motility and potential ileus (horses)
- Nystagmus, salivation, seizures, and hyperthermia (at massive overdoses in horses)
Cautions & contraindications
- Known hypersensitivity to butorphanol
- Lower respiratory tract conditions with copious mucous production (suppressing cough prevents clearance)
- Caution in patients with head trauma, increased CSF pressure, or severe CNS dysfunction (e.g., coma)
- Caution in severe liver disease, renal insufficiency, hypothyroidism, or Addison's disease
- Caution in dogs with heartworm disease (safety not established)
- **MDR1 (ABCB1) Mutation Warning**: Dogs with the MDR1 mutation (e.g., Collies, Australian Shepherds) may develop pronounced and prolonged sedation. Reduce the dose by 25% in heterozygous dogs and by 30-50% in homozygous mutant dogs. **Geriatric/Debilitated Patients**: Use with caution and consider dose reductions. **Hepatic/Renal Impairment**: The manufacturer advises against use in dogs with a history of liver disease. Use cautiously in renal insufficiency. **Pregnancy/Nursing**: Category C (human). Safe for use if used cautiously in dogs/cats, but manufacturer does not recommend use in pregnant bitches, foals, weanlings, or breeding horses.
Drug interactions
- Other CNS Depressants (anesthetics, antihistamines, phenothiazines, barbiturates, tranquilizers): May cause increased CNS or respiratory depression; dosage may need to be decreased.
- Erythromycin: Could potentially decrease the metabolism of butorphanol, prolonging its effects.
- Fentanyl (and other pure opiate agonists): Butorphanol may antagonize analgesic effects, but will also reverse sedative and respiratory depressant effects.
- Pancuronium: May cause increased conjunctival changes when used concurrently.
- Theophylline: Could potentially decrease the metabolism of butorphanol.
- Anaesthetic agents: Reduces the doses of other drugs required for induction and maintenance of anaesthesia
- Full mu-opioid agonists (e.g., methadone, fentanyl): Addition of butorphanol will reduce analgesia produced from the full mu agonist; combination is not recommended for analgesia
- Acepromazine: Synergistic sedation
- Alpha-2 agonists: Synergistic sedation and analgesia
- Full mu-agonist opioids (e.g., methadone, fentanyl): Butorphanol's mu-antagonist properties may block or partially reverse the analgesic effects of full mu-agonists. Higher doses of full mu-agonists may be required.
Frequently asked questions
What is Butorphanol used for in pets?
**What is this medication?** Butorphanol is a medication used to relieve coughing, provide mild pain relief, or act as a sedative before veterinary procedures. **What should I expect?** * Your pet will likely become sleepy or slightly uncoordinated (wobbly). This is normal, but you should keep them in a safe, quiet environment (e.g., avoid stairs) until the effects wear off. * If prescribed for a cough, you should notice a significant decrease in coughing spells. **Important Warnings:** * **Do not give more than prescribed.** Giving too much will not increase pain relief but can increase side effects. * If your pet's cough changes from a "dry, hacking" cough to a "wet, productive" cough, contact your veterinarian. Suppressing a wet cough can trap mucus in the lungs. * Report any significant changes in behavior, loss of appetite, or severe constipation/diarrhea to your veterinarian.
Is Butorphanol safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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