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Nalbuphine

Pronunciation

Generic Name: nalbuphine (NAL-byoo-feen)
Brand Name: Nubain

Nalbuphine is used for:

Treating and preventing moderate to severe pain. It can also be used for pain relief before and after surgery and during childbirth. It may also be used for other conditions as determined by your doctor.

Nalbuphine is an analgesic. It works by blocking certain receptor sites in the central nervous system, which helps to decrease pain.

Do NOT use nalbuphine if:

  • you are allergic to any ingredient in nalbuphine or to another opioid analgesic (eg, morphine or hydromorphone)
  • you have diarrhea due to poisoning, a certain type of bowel problem (pseudomembranous colitis), or are dependent on any medicine or substance
  • you are taking sodium oxybate (GHB)

Contact your doctor or health care provider right away if any of these apply to you.

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Before using nalbuphine:

Some medical conditions may interact with nalbuphine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines or other substances
  • if you have a history of alcoholism or substance abuse, depression or other mental or mood problems, suicidal thoughts, head injury, brain growths, increased pressure in the head, or seizures
  • if you have asthma or other breathing problems, high blood pressure, an underactive thyroid, or liver or kidney problems, or you are having a heart attack with nausea and vomiting or other heart problems
  • if you have problems urinating, prostate problems, or severe inflammatory bowel disease, or you are having gastrointestinal tract surgery

Some MEDICINES MAY INTERACT with nalbuphine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Naltrexone because it could decrease the effectiveness of nalbuphine
  • Alcohol, barbiturate anesthetics (eg, thiopental), cimetidine, narcotic analgesics (eg, fentanyl), phenothiazines (eg, promethazine), or sodium oxybate (GHB) because side effects, such as increased risk of slow or difficult breathing or drowsiness leading to unresponsiveness or coma, may occur
  • Methadone because its effectiveness may be decreased by nalbuphine

This may not be a complete list of all interactions that may occur. Ask your health care provider if nalbuphine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use nalbuphine:

Use nalbuphine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Nalbuphine is sometimes used at home as an injection. Before using nalbuphine, a health care professional will provide detailed instructions for appropriate use of nalbuphine. Ask any questions that you may have about nalbuphine or giving injections.
  • Do not use more of nalbuphine or take it more often than recommended by your doctor. Exceeding the recommended dose or taking nalbuphine for longer than prescribed may be habit-forming.
  • If nalbuphine contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
  • Keep this product, as well as syringes and needles, out of the reach of children. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for proper disposal.
  • If you miss a dose of nalbuphine and you are using it regularly, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use nalbuphine.

Important safety information:

  • Nalbuphine may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to nalbuphine. Using nalbuphine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
  • Avoid drinking alcohol or taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while taking nalbuphine. Nalbuphine will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
  • Before you have any medical or dental surgery or emergency treatment, tell the doctor or dentist that you are taking nalbuphine.
  • Use nalbuphine with extreme caution in CHILDREN younger than 18 years of age. Safety and effectiveness in this age group have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using nalbuphine during pregnancy. Use nalbuphine with extreme caution during labor and delivery because it may cause breathing problems or irregular heartbeat in the baby. It is unknown if nalbuphine is excreted in breast milk. If you are or will be breast-feeding while you are using nalbuphine, check with your doctor or pharmacist to discuss the risks to your baby.

When used for long periods of time or at high doses, nalbuphine may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if nalbuphine stops working well. Do not take more than prescribed.

When used for long periods of time or at high doses, some people develop a need to continue taking nalbuphine. This is known as DEPENDENCE or "addiction."

If you suddenly stop taking nalbuphine, you may experience WITHDRAWAL symptoms including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing, or feeling things that are not there; shivering or tremors; sweating; watery eyes; stomach cramps; restlessness; and trouble sleeping.

Possible side effects of nalbuphine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness; drowsiness; dry mouth; feeling of a whirling motion; headache; nausea; sweating/clammy skin; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; difficulty urinating; fainting; numbness of an arm or leg; seizures; severe headache, dizziness, or vomiting; slow heartbeat; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include general discomfort; restlessness; sleepiness.

Proper storage of nalbuphine:

Nalbuphine is usually handled and stored by a health care provider. If you are using nalbuphine at home, store nalbuphine as directed by your pharmacist or health care provider. Keep nalbuphine out of the reach of children and away from pets.

General information:

  • If you have any questions about nalbuphine, please talk with your doctor, pharmacist, or other health care provider.
  • Nalbuphine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take nalbuphine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about nalbuphine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to nalbuphine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using nalbuphine.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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