N02AF02

A strong opioid analgesic equivalent to morphine with a partially antagonistic action. It is used during childbirth and cesarean section. Administered subcutaneously, intramuscularly or intravenously every 3 to 6 hours.

It is excreted in breastmilk in clinically insignificant amounts. ^{(Reece 2017, Mustafa 2016, FDA 2016, Jacqz-Aigrain 2007, Wischnik 1988)}

Its low oral bioavailability ^{(Aitkenhead 1988)} hinders transfer to the infant’s plasma from ingested breastmilk.

The time of onset of breastfeeding was delayed in newborns whose mothers received analgesia at delivery with butorphanol or nalbuphine compared to those who did not receive analgesia, although in both groups it occurred on average within the first hour after birth. ^{(Crowell 1994)}

There is a dosage and it is considered safe in the pediatric age group without causing respiratory depression. ^{(Kubica 2015)}

Unlike other opioids, its metabolites are inactive. ^{(Martin 2018)}

It can increase the secretion of prolactin. ^{(Saarialho 1988)}

Not available in several countries including Spain.