Stadol, Stadol NS
Classifications: analgesic; narcotic (opiate) agonist-antagonist; Therapeutic: narcotic analgesic
Pregnancy Category: C
Controlled Substance: Schedule IV
1 mg/mL, 2 mg/mL injection; 10 mg/mL spray
Synthetic, centrally acting analgesic with mixed narcotic agonist and antagonist actions. Acts as agonist on one type of
opioid receptor and as a competitive antagonist at others. Site of analgesic action believed to be subcortical, possibly
in the limbic system. Respiratory depression does not increase appreciably with higher doses, as it does with morphine,
but duration of action increases.
Narcotic analgesic that relieves moderate to severe pain with apparently low potential for physical dependence.
Relief of moderate to severe pain, preoperative or preanesthetic sedation and analgesia, obstetrical analgesia during labor,
cancer pain, renal colic, burns.
Musculoskeletal and post-episiotomy pain.
Narcotic-dependent patients; opiate agonist hypersensitivity; pregnancy and prior to labor (category C). Safety in children
<18 y is not established.
History of drug abuse or dependence; emotionally unstable individuals; head injury, increased intracranial pressure; acute
MI, ventricular dysfunction, coronary insufficiency, hypertension; patients undergoing biliary tract surgery; respiratory
depression, bronchial asthma, obstructive respiratory disease; and renal or hepatic dysfunction.
Route & Dosage
Adult: IM 14 mg q34h as needed (max: 4 mg/dose) IV 0.52 mg q34h as needed
Geriatric: IM/IV 0.251 mg q68h Intranasal 1 mg (1 spray) in one nostril, may repeat in 90 s, then may repeat these 2 doses q34h prn
Adjunct to Balanced Anesthesia
Adult: IV 2 mg before induction or 0.51 mg in increments during anesthesia
Adult: IV/IM 12 mg may repeat in 4 h
For GFR <10 mL/min, use 50% of dose.
Use half normal dose and at least 6 h interval.
- Give 1 spray into one nostril only. One spray provides a 1 mg dose.
- Do not give more than 4 mg in a single IM dose.
- Give preoperative IM injection 6090 min before surgery.
PREPARE: Direct: Give undiluted.
ADMINISTER: Direct: Give at a rate of 2 mg over 35 min.
INCOMPATIBILITIES Y-site: Amphotericin B cholesteryl, lansoprazole, midazolam.
- Store at 15°30° C (59°86° F) unless otherwise directed. Protect from light.
Adverse Effects (≥1%)CNS:
headache, vertigo, dizziness, floating feeling, weakness, lethargy, confusion, light-headedness, insomnia
respiratory depression. CV:
Palpitation, bradycardia. GI:
Clammy skin, tingling sensation, flushing and warmth, cyanosis of extremities, diaphoresis, sensitivity to cold, urticaria,
Difficulty in urinating, biliary spasm.
and other cns depressants
augment CNS and respiratory depression
1030 min IM; 1 min IV. Peak:
0.51 h IM; 45 min IV. Duration:
34 h IM; 24 h IV. Distribution:
Crosses placenta; distributed into breast milk. Metabolism:
In liver in inactive metabolites. Elimination:
Primarily in urine. Half-Life:
Assessment & Drug Effects
- Monitor for respiratory depression. Do not administer drug if respiratory rate is <12 breaths/min.
- Monitor vital signs. Report marked changes in BP or bradycardia.
- Note: If used during labor or delivery, observe neonate for signs of respiratory depression.
- Note: Drug can induce acute withdrawal symptoms in opiate-dependent patients.
- Schedule gradual withdrawal following chronic administration. Abrupt withdrawal may produce vomiting, loss of appetite, restlessness,
abdominal cramps, increase in BP and temperature, mydriasis, faintness. Withdrawal symptoms peak 48 h after discontinuation
Patient & Family Education
- Lie down to control drug-induced nausea.
- Do not take alcohol or other CNS depressants with this drug without consulting physician because of possible additive effects.
- Do not drive or engage in other potentially hazardous activities until response to drug is known.