Methadone and Stadol

  1. I have had two methadone dependant patients describe acute withdrawal after receiving Stadol while in labor.
    I haven't been able to find anything about it in the drug book.
    Anyone else seen or heard about this?
    Any info would be much apreciated.
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  2. 14 Comments

  3. by   SmilingBluEyes
    never heard this......hmmm. something to ponder and research.
  4. by   sunnygirl272
    stadol a narcotic antagonist....i think that's the right label....it blocks the receptors and will cause withdrawal...there is another med that does this and it is not commonly known,but i cannot remember which off the top of my head....watched a terminal pancreatic ca pt suffer terribly because someone other than the anesthesiologist wrote pain control orders..anesthesia had a morphone gtt...other doc wrote for something for BTP....could hear the poor soul screaming all the way down the hall...
  5. by   sunnygirl272
    Interaction between Naltrexone/Opioid Analgesics


    Return to Drug Interactions
    Severity
    1-Contraindicated Drug Combination: This drug combination is clearly contraindicated in all cases and should not be dispensed or administered to the same patient.

    Action
    Naltrexone is an opioid antagonist and thus inhibits the effects of the opioid analgesics.(1)

    Effect
    Concurrent administration or the administration of naltrexone within 7-10 days of opioids may induce acute abstinence syndrome or exacerbate a pre-existing subclinical abstinence syndrome.(1)

    Predisposing Factors
    None determined.

    Management
    The manufacturer of naltrexone states that the administration of naltrexone concurrently with opioids or to patients dependent on opioids is contraindicated.

    Discussion
    Patients should be opioid-free for a minimum of seven to ten days before beginning naltrexone therapy. The manufacturer of naltrexone states that the naloxone challenge test, described in the naltrexone prescribing information, can be administered to determine if patients are opioid free.(1)
  6. by   SmilingBluEyes
    Sunny, well there ya go. Thankyou, I learned something new. I don't often see methadone-program pts and when I do, they have invariably chosen epidural anesthesia which, of course, does not include stadol use. thanks for the info. I am always willing to learn!
  7. by   BBnurse34
    Thanks for the information!
    I am looking foreward to sharing it at work in the interest of safe patient care.
  8. by   mark_LD_RN
    there are several drugs that can cause this:
    these drugs are classed as Narcotic agonist-antagonists they are:
    1) nubain (NalbuphineHCL)
    2)Stadol (Butorphanol Tartrate)
    3) Buprenex (buprenorephine HCL)

    these are not to be given with patients /c history of narcotic abuse

    hope you find this info helpful
  9. by   sunnygirl272
    yeah!!! nubain....that's the one i was brainfarting on...thanks, mark!!!
  10. by   sbic56
    mark_LD_RN


    That is great information. Thanks!
  11. by   mark_LD_RN
    you're welcome
  12. by   Motivated, SN
    BBnurse 34:

    I had methadone patient deliver yesterday. Doctor said her only options for pain were morphine or epidural because of interactions with other narcotics, Nubain, Stadol.
  13. by   nursing rocks
    just worked with a mom on methadone who's baby is in the special care nursery. she described horrific immediate withdrawal symptoms after being given nubain in labor.
  14. by   kids
    I was told I was defeating the purpose I tried alternating Ultram and ES Vicodin (at home) post op. Apparently it has some antagonist properties.

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