Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using butorphanol and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

This medication is a nasal spray. Have your doctor or pharmacist show the proper way to use the nasal spray. For best results, blow your nose gently before using. Follow the patient instruction leaflet for priming the pump before first use. If the spray has not been used in 48 hours, you may need to prime the pump again before use.

Use this product as directed by your doctor, usually every 3 to 4 hours as needed. This drug can cause a drop in blood pressure, especially within the first hour after use. This can cause dizziness, lightheadedness, and fainting. To lower this risk, remain sitting or lying down after using this medication. Follow your doctor's directions carefully.

The dosage is based on your medical condition and response to treatment. Do not increase the dose or use it more often than directed by your doctor. Pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.

If you use a nasal decongestant spray (such as oxymetazoline), the decongestant may make this pain medication work more slowly. Ask your doctor or pharmacist about using these 2 medications.

If you have nausea, ask your doctor or pharmacist about ways to decrease it (such as lying down for 1 to 2 hours with as little head movement as possible).

Suddenly stopping this medication may cause withdrawal, especially if you have used it for a long time or in high doses. To prevent withdrawal, your doctor may lower your dose slowly. Tell your doctor or pharmacist right away if you have any withdrawal symptoms such as restlessness, mental/mood changes (including anxiety, trouble sleeping, thoughts of suicide), watering eyes, runny nose, nausea, diarrhea, sweating, muscle aches, or sudden changes in behavior.

Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Use this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.

When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.

Tell your doctor if your pain does not get better or if it gets worse, or if you have any new pain.