Nalbuphine hydrochloride (Nubain)
Nalbuphine hydrochloride (Nubain) is a synthetic opioid agonist-antagonist analgesic of the phenanthrene series.
ADVERSE REACTIONS Nalbuphine hydrochloride (Nubain)
The most frequent adverse reaction in 1066 patients treated in clinical studies with
NUBAIN was sedation 381 (36%).
Less frequent reactions were: sweaty/clammy 99 (9%), nausea/vomiting 68 (6%),
dizziness/vertigo 58 (5%), dry mouth 44 (4%), and headache 27 (3%).
Other adverse reactions which occurred (reported incidence of 1% or less) were:
Non-opioid-tolerant patients: 10-20 mg/70kg IV/IM/SC q3-6hr PRN; individual dose not to exceed 20 mg
Opioid-dependent patients: Administer ¼ dose, and observe for withdrawal signs
Not to exceed 160 mg/day
0.3-3 mg/kg IV over 10-15 minutes, then 0.25-0.5 mg/kg PRN
Opioid-Induced Pruritus (Off-label)
Prevention and treatment
Renal impairment: Caution; dose reduction may be necessary; monitor
Hepatic impairment: Caution; dose reduction may be necessary; monitor
Accession Number DB00844 (APRD01132)
Type Small Molecule
A narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors. Nalbuphine is the only opioid analgesic that is not a controlled substance in the United States.
What are the possible side effects of nalbuphine?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Tell your caregiver right away if you have:
a light-headed feeling, like you might pass out;
weak or shallow breathing; or
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common side effects may include:
dizziness, spinning sensation;
cold, clammy skin; or
What should I discuss with my healthcare provider before I receive nalbuphine?
You should not be treated with nalbuphine if you are allergic to it, or if you have:
severe asthma or breathing problems; or a stomach or bowel obstruction (including paralytic ileus).
Your dose needs may be different if you are already using a similar opioid medicine and are tolerant to it. Before you receive nalbuphine, tell your doctor about all other pain medicines you have recently used.
To make sure nalbuphine is safe for you, tell your doctor if you have:
any type of breathing problem or lung disease;
problems with your pancreas or adrenal gland;
a history of head injury, brain tumor, or seizures;
a history of drug abuse, alcohol addiction, or mental illness;
liver or kidney disease;
a slow heart rate, or if you have recently had a heart attack;
if you use an MAO inhibitor such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine; or
if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).