ZIPHANOL
Therapeutic Indication
Moderate to severe pain of any form, particularly visceral pain; perioperative analgesia.
Dosage Forms
Soln for inj (amp) 2 mg/mL x 1 mL x 10’s.
Bioavailability and Pharmacokinetics
Opioids are readily absorbed after subcutaneous or intramuscular injection from the GI tract. A nasal formulation is available and has proven to be effective. The major pathway for the metabolism is conjugation with glucuronic acid. Very little of butorphanol is excreted unchanged. It is eliminated by glomerular filtration, 90% of the total excretion takes place during the first day.
The plasma half-life of butorphanol is about 3hrs. The usual dose is between 1 and 4mg of the tartrate given intramuscularly, or 0.5-2mg given intravenously every 3-4hrs.
Dose Range
IV 1 mg as single dose. May be repeated 3-4 hrly. Effective dose range: 0.5-2 mg repeated 3-4 hrly. IM 2 mg as single dose. May be repeated 3-4 hrly. Effective dose range: 1-4 mg repeated 3-4 hrly. Pre-op/pre-anesth/post-op medication 2 mg IM given 60-90 min prior to surgery. Balanced anesth 2 mg IV shortly before induction &/or 0.5-1 mg IV in increments during anesth. Labor 1-2 mg IV/IM & may be repeated after 4 hr.
Drug Interactions
Somnolence, dizziness, nausea, vomiting.
Special Precautions
Hepatic or renal disease; history of drug abuse; presence of abnormal fetal heart rate pattern during labor. Concomitant use w/ alcohol. May impair ability to drive or operate machinery. Pregnancy & lactation. Childn <18 yr. Elderly >65 yr.
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