butorphanol vs hydromorphone
Side-by-side comparison of butorphanol and hydromorphone. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
minor Known Drug Interaction
Examples: Butorphanol, nalbuphine, pentazocine, and buprenorphine.
Recommendation: Consult your healthcare provider before using these drugs together. They may need to change your treatment to avoid a decrease in pain relief.
Stadol
Dilaudid
Butorphanol nasal spray is a strong pain medicine. It is used when other pain medicines are not strong enough or cannot be tolerated.
Hydromorphone (Dilaudid) is a strong pain medicine. It is used to treat severe pain when other pain medicines do not work well enough.
This medicine treats severe pain that requires an opioid pain reliever. It is for use when other pain treatments are not strong enough or cannot be tolerated. Do not use this medicine for a long time unless your pain is still severe and other treatments are still not adequate.
This medicine treats severe pain that requires an opioid pain medicine. It is for use when other treatments are not adequate. Do not use it for long periods unless your pain stays severe and other options are still not adequate. This medicine carries risks of addiction, abuse, and misuse.
Butorphanol is an opioid agonist-antagonist. It works by changing how your brain and nervous system respond to pain. It attaches to certain receptors in the brain to reduce pain signals.
Hydromorphone works by binding to receptors in the brain and spinal cord. This blocks pain signals from reaching the brain. This results in a decreased feeling of pain.
- • Sleepiness
- • Dizziness
- • Nausea
- • Vomiting
- • Nasal congestion
- • Lightheadedness
- • Dizziness
- • Sleepiness
- • Nausea
- • Vomiting
- Allergic reaction to the drug 48
- Feeling sick to your stomach 25
- Head pain 16
- Discomfort 16
- Itching 16
- Addiction to the drug 35,077
- Taking too much of the drug 22,994
- Pain 22,132
- Emotional upset 17,685
- Death 14,869
This medicine has serious warnings. It can cause addiction, abuse, and misuse, which can lead to overdose and death. It can also cause life-threatening breathing problems, especially when you first start using it or after a dose increase. Accidental use, even one dose, can cause a fatal overdose, especially in children. Using this medicine with benzodiazepines or other drugs that can make you sleepy, including alcohol, can cause serious problems, including coma and death. If you use this medicine for a long time during pregnancy, it can cause withdrawal symptoms in the newborn that could be life-threatening if not treated.
This medicine has a boxed warning. It can cause serious and life-threatening risks. Taking too much can cause overdose and death. It can cause addiction, abuse, and misuse. It can also cause very slow or stopped breathing. Accidental intake, especially by a child, can cause a fatal overdose. Taking with alcohol or other depressants can cause coma and death. If you are pregnant, long-term use can cause withdrawal symptoms in the newborn.
If you need to use this medicine for a long time during pregnancy, it can cause withdrawal symptoms in your newborn. Make sure a newborn specialist is available when you deliver your baby.
Using this medicine for a long time during pregnancy can cause withdrawal symptoms in the baby after birth. Talk to your doctor if you are pregnant or plan to become pregnant. This medicine may not be recommended during labor.
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How to Read This butorphanol vs hydromorphone Comparison
butorphanol is classified in the Opioid Agonist-Antagonist drug class, while hydromorphone sits within the Opioid Analgesic class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, butorphanol has 121 submissions while hydromorphone has 112,757. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to butorphanol can interfere with hydromorphone by blocking the same receptors that help relieve pain. this can make your pain medicine work less effectively or cause withdrawal symptoms.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between butorphanol and hydromorphone - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.