ATC Group: N02AF Morphinan derivatives

The World Health Organization's ATC classification organizes medical drugs based on therapeutic properties, chemical composition, and anatomy. It helps make essential medicines readily available globally and is widely used in the pharmaceutical industry.

Position of N02AF in the ATC hierarchy

Level Code Title
1 N Nervous system
2 N02 Analgesics
3 N02A Opioids
4 N02AF Morphinan derivatives

Group N02AF contents

Code Title
N02AF01 Butorphanol
N02AF02 Nalbuphine

Active ingredients in N02AF

Active Ingredient Description
Butorphanol

Butorphanol is a morphinan-type synthetic agonist–antagonist opioid analgesic. Butorphanol is most closely structurally related to levorphanol. Butorphanol exhibits partial agonist and antagonist activity at the ÎŒ-opioid receptor, as well as partial agonist activity at the Îș-opioid receptor (Ki = 2.5 nM; EC50 = 57 nM; Emax = 57%). Stimulation of these receptors on central nervous system neurons causes an intracellular inhibition of adenylate cyclase, closing of influx membrane calcium channels, and opening of membrane potassium channels. This leads to hyperpolarization of the cell membrane potential and suppression of action potential transmission of ascending pain pathways. Because of its Îș-agonist activity, at analgesic doses butorphanol increases pulmonary arterial pressure and cardiac work. Additionally, Îș-agonism can cause dysphoria at therapeutic or supertherapeutic doses; this gives butorphanol a lower potential for abuse than other opioid drugs.

Levallorphan
Nalbuphine

Nalbuphine is an opioid with kappa-agonistic and mu-antagonistic properties. Beside the essential agonistic (analgesic) effect nalbuphine has antagonistic effects of about a fourth of nalorfine and ten times of pentazocine.

Related product monographs

Title Information Source Document Type  
NALPAIN Solution for injection Medicines & Healthcare Products Regulatory Agency (GB) MPI, EU: SmPC
NUBAIN Solution for injection Health Products and Food Branch (CA) MPI, CA: SPM