Management of moderate to severe pain.
2 mg q 3-4 hr as needed (range 1-4 mg).
1 mg q 3-4 hr as needed (range 0.5-2 mg).
1 mg (1 spray in 1 nostril) initially. An additional dose may be given 60-90 min
later. This sequence may be repeated in 3-4 hr. If pain is severe, an initial dose of 2 mg (1 spray in
each nostril) may be given. May be repeated in 3-4 hr.
A- Decreased severity of pain.
Major side effects:
, euphoria, floating feeling, headache, unusual
blurred vision, diplopia, miosis (high doses).
hypertension, hypotension, palpitations.
, constipation, dry mouth, ileus, vomiting.
, clammy feeling.
physical dependence, psychological dependence, tolerance.
Assess type, location, and intensity of pain before and 30-60 min after IM, 5 min after IV, and
60-90 min after intranasal administration. When titrating opioid doses, increases of 25-50% should be
administered until there is either a 50% reduction in the patient's pain rating on a numerical or visual
analogue scale or the patient reports satisfactory pain relief. A repeat dose can be safely administered