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Important Note

The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.





This medication is a strong narcotic analgesic (pain reliever) used to control pain. It has also been used to treat migraine headaches.

How To Use

The medication is a nasal spray. Have your doctor or pharmacist demonstrate the proper way to use the nasal spray. For best results, clear nasal passages before using. Before using, the spray unit may require 7 or 8 pumps until a fine spray appears. At this point the unit is "primed" and ready to use. If the spray has not been used in 48 hours, an additional 1 or 2 pumps may be needed to "re-prime" the unit. Place the tip of the spray pump just at the entrance of the nostril. Squeeze the pump as you inhale deeply through your nostril. Use this medication exactly as prescribed. Do not increase your dose, take it more frequently or use it for a longer period of time than prescribed because this drug can be habit-forming. Also, if used for a longer period of time, do not suddenly stop using this drug without your doctor's approval. When used for extended periods, this medication may not work as well and may require different dosing. Consult your doctor if the medication is not working well.

Side Effects

This medication may cause lightheadedness, insomnia, dizziness, drowsiness, dry mouth, stomach upset, loss of appetite, nausea, headache, nasal congestion, nasal irritation, strange taste in the mouth or increased sweating the first few days as your body adjusts to the medication. If these symptoms continue or become bothersome, inform your doctor. Notify your doctor if you develop: breathing difficulties, irregular heartbeat, flushing, confusion, restlessness, anxiety, tremors, cough, blurred vision, ear pain, rash or hives, ringing in the ears, seizures. Avoid activities requiring alertness while taking this medication, since it can cause dizziness and drowsiness. To prevent excess sedation, avoid using alcohol and other sedative type medications while taking this. If you notice other effects not listed above, contact your doctor or pharmacist.


Tell your doctor if you have: kidney disease, liver disease, lung disease, asthma, heart disease, recent head injury, a history of drug dependence, allergies (especially to pain relievers). Using alcohol may add to the drowsiness side effect. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. This medication should be used only if clearly needed during pregnancy. Discuss the risks and benefits with your doctor. Since small amounts of butorphanol are found in breast milk, consult your doctor before breast-feeding.

Drug Interactions

Tell your doctor of any over-the-counter or prescription medication you may take including: sleeping pills, sedatives, tranquilizers, muscle relaxants, medication for depression, anti-seizure drugs, other narcotic pain medication. Do not start or stop any medicine without doctor or pharmacist approval.


If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include cold and clammy skin, slowed breathing, slowed heartbeat, drowsiness, dizziness, lightheadedness, deep sleep, and loss of consciousness.


This medication should only be used for short-term or intermittent pain control. Do not use this longer or more often than prescribed. Follow your doctor's instructions carefully. To prevent constipation, increase your intake of fiber, drink plenty of water and exercise.

Missed Dose

If you miss a dose, use it as soon as remembered; do not use it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.


Store at room temperature between 59 and 86 degrees F (15 to 30 degrees C) away from heat and light. Do not store in the bathroom.