Category:

• Analgesic

Description:

• Partial opiate agonist analgesic

Indications:

• Moderate to severe pain (surgical, cancer, burns)

• Migraine headache (nasal inhaler)

Contraindications:

• Patients with impaired respiratory function.

Precautions:

• Pregnancy Category C 

• Patients will experience CNS effects of drowsiness and dizziness, therefore use caution with motor vehicle operation or other hazardous tasks.

• Low physical dependence, however use in caution with unstable or history of abuse patients.

• Avoid prolonged, sustained usage to decrease addiction potential.

• Geriatric patients may have decreased medication clearance and elimination, therefore dosage must be modified.

• Use with caution with other CNS depressive medications.

Adverse Reactions (Side Effects):

• Sedation (43%)

• Dizziness (19%)

• Nausea and vomiting (13%)

Dosage:

Administered by injection (IM or IV) or nasal inhalation, adjusted to severity of pain

Adult:

• Initial dose: 2mg IM or 1mg IV, repeated q3-4h as needed

• Maintenance: 1-4mg IM or 0.5-2mg IV q3-4h

• Inhalation: 1 spray (1mg per spray) in each nostril, if pain control not achieved then repeat with one spray in one nostril in 60-90 minutes, then q3-4h if needed

Geriatric or Impaired Hepatic or Renal Function:

• One-half ( ½ ) normal dose IM or IV

• Inhalation: 1 spray (1mg per spray) in each nostril, if pain control not achieved then repeat with one spray in one nostril in 90-120 minutes, then q6h if needed

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001