Ziphanol Dosage/Direction for Use

Pain: Intravenous: The usual recommended single dose for IV administration is 1 mg repeated every 3 to 4 hours as necessary. The effective dosage range, depending on the severity of pain, is 0.5 to 2mg repeated every 3 to 4 hours.
Intramuscular: The usual recommended single dose for IM administration is 2mg in patients who will be able to remain recumbent, in the event drowsiness or dizziness occurs. This may be repeated every 3 to 4 hours, as necessary. The effective dosage range depending on the severity of pain is 1 to 4mg repeated every 3 to 4 hours. There are insufficient clinical data to recommend single doses above 4 mg.
Both expected efficacy and adverse reaction should be considered in dosage adjustment. The dose of this drug recommended for elderly patients, patients with hepatic or renal impairment should generally be half the recommended adult dose (0.5 mg IV and 1.0 mg IM). Repeat doses should be determined by the patient's response rather than at fixed intervals, but will generally be no less than 6 hours apart.
Use as Preoperative/Pre-anesthetic/Post-operative Medication: The preoperative medication dosage should be individualized. The usual adult dose is 2 mg IM, administered 60-90 minutes before surgery. This is approximately equivalent in sedative effect to 10 mg morphine or 80 mg meperidine.
Use in Balanced Anesthesia: The usual dose is 2 mg IV shortly before induction and/or 0.5 to 1.0 mg IV in increments during anesthesia. The increments may be higher, up to 0.6 mg/kg (4 mg/70 kg), depending on previous sedative, analgesic, and hypnotic drugs administered. The total dose of this drug will vary; however, patients seldom require less than 4 mg or more than 12.5 mg (approximately 0.06 to 0.18 mg/kg). Opioid, including this drug, may not produce appropriate analgesic effect for every patient or every state during surgery. Analgesic fail during induction anesthesia can be judged to be general sympathetic nerve negative, intensive inhalation anesthesia or another IV should be considered.
Labor: In patients at full term or without fetal distress in early labor a 1-2 mg dose IV or IM may be administered and repeated after 4 hours. Alternative analgesia should be used for pain associated with delivery or if delivery is expected to occur within 4 hours. Other analgesics should be used when delivery is expected within 4 hours. Dosage titration should be based on concurrent analgesics, sedatives, expected time of delivery and response of the first administration. If concomitant use of this drug with drugs that may potentiate its effects is deemed necessary, the lowest effective dose should be employed.