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Generic Name: nalbuphine (NAL bue feen)
Brand Name: Nubain

Medically reviewed by on Apr 16, 2019 – Written by Cerner Multum

What is nalbuphine?

Nalbuphine is an opioid pain medication. An opioid is sometimes called a narcotic.

Nalbuphine is used to treat moderate to severe pain. It is also used for treating pain just after surgery or childbirth.

Nalbuphine may also be used for purposes not listed in this medication guide.

Important Information


Nalbuphine can slow or stop your breathing, especially when you also use other medicines that can make you sleepy or slow your breathing.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Before you receive nalbuphine, tell your doctor about all other medicines you have recently used, especially a sedative or tranquilizer, sleep medicine, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for depression or seizures.

Before taking this medicine

You should not be treated with nalbuphine if you are allergic to it, or if you have:

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:

Some medicines can interact with nalbuphine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

Nalbuphine is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

Although nalbuphine is sometimes used during labor and delivery, this medicine can cause breathing problems or life-threatening withdrawal symptoms in the newborn. If you receive nalbuphine during labor and delivery, your caregivers will watch your baby closely for any serious side effects of nalbuphine. These effects can usually be treated quickly in a hospital setting.

Unless you are given nalbuphine during labor or delivery, tell your doctor if you are pregnant before you are treated with this medicine.

Nalbuphine can pass into breast milk and may cause side effects in the nursing baby. Tell your doctor if you are breast-feeding.

How is nalbuphine given?

Nalbuphine is injected under the skin, into a muscle, or into a vein through an IV. A healthcare provider will give you this injection.

Nalbuphine is usually given every 3 to 6 hours as needed. Your doctor may occasionally change your dose to make sure you get the best results.

Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Nalbuphine can slow or stop your breathing, and may be habit-forming. MISUSE OF nalbuphine CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away this medicine is against the law.

You may have unpleasant withdrawal symptoms after your treatment ends. Ask your doctor how to avoid withdrawal symptoms when you stop using nalbuphine.

What happens if I miss a dose?

Since nalbuphine is given by a healthcare professional, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or other person using nalbuphine without a prescription. Overdose symptoms may include slow breathing, noisy breathing, severe drowsiness, muscle weakness, pinpoint pupils, and loss of consciousness.

What should I avoid while receiving nalbuphine?

Do not drink alcohol. Dangerous side effects or death could occur.

Nalbuphine may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Nalbuphine side effects

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:

  • slow heartbeats;

  • a light-headed feeling, like you might pass out;

  • weak or shallow breathing; or

  • severe constipation.

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:

  • drowsiness;

  • dizziness, spinning sensation;

  • dry mouth;

  • headache;

  • sweating;

  • cold, clammy skin; or

  • nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Nalbuphine dosing information

Usual Adult Dose for Pain:

Initial dose: 10 mg IV, IM, or subcutaneous every 3 to 6 hours as needed

Maximum single dose: 20 mg
Maximum daily dose: 160 mg

-Usual adult dose is based on a 70 kg individual; dosage should be adjusted according to the severity of pain, physical status, and concomitant medications.
-Monitor patients closely for respiratory depression, especially within the first 24 to 72 hours of initiating therapy and with each dose increase.
-Because of the risks of addiction, abuse, and misuse, reserve use to patients for whom alternative treatment options have not been tolerated, or are not expected to be tolerated; or have not provided adequate analgesia or are not expected to provide adequate analgesia.

Use: For the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

Usual Adult Dose for Anesthesia:

Supplement to balanced anesthesia:
Induction dose: 0.3 to 3 mg/kg IV over 10 to 15 minutes
Maintenance dose: 0.25 to 0.5 mg/kg in single IV administrations as required

-This drug should be administered as a supplement to general anesthesia by persons specifically trained in the use of IV anesthetics and management of the respiratory effects of potent opioids; naloxone, resuscitative and intubation equipment and oxygen should be readily available.

Use: As a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery.

What other drugs will affect nalbuphine?

Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • other narcotic medications--opioid pain medicine or prescription cough medicine;

  • drugs that make you sleepy or slow your breathing--a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine; or

  • drugs that affect serotonin levels in your body--medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with nalbuphine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.