Generic Name: nalbuphine (NAL bue feen)
Brand Name: Nubain
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.
What is the most important information I should know about nalbuphine?
MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH.
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.
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).
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 THIS MEDICINE 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 this medicine 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:
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
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.
See also: Side effects (in more detail)
Nalbuphine dosing information
Usual Adult Dose for Pain:
10 mg/70 kg administered IV, IM, or subcutaneous every 3 to 6 hours as needed.
Maximum single dose: 20 mg
Maximum daily dose: 160 mg
Usual Adult Dose for Anesthesia:
Supplement to balanced anesthesia:
Induction dose: 0.3 to 3 mg/kg IV over 10 to 15 min.
Maintenance dose: 0.25 to 0.5 mg/kg IV once. May repeat as necessary.
Usual Pediatric Dose for Pain:
The safety and efficacy of nalbuphine in patients <18 years has not been established. However, the use of nalbuphine may be appropriate in some situations.
>= 1 year to 18 years:
0.1 to 0.2 mg/kg IM, IV, subcutaneous every 3 to 4 hours.
Maximum single dose: 20 mg
Maximum daily dose: 160 mg
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.
More about nalbuphine
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- Support Group
- Pricing & Coupons
- En Español
- 25 Reviews – Add your own review/rating
- Drug class: narcotic analgesics
Other brands: Nubain
Related treatment guides
Where can I get more information?
- Your doctor or pharmacist can provide more information about nalbuphine.
- 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.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 4.01.
Date modified: May 03, 2017
Last reviewed: April 16, 2017