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NERVOUS SYSTEM › ANALGESICS › OPIOIDS › Morphinan derivatives
nalbuphine
N02AF02
Forms & Strengths
- Injection: 10 mg/mL, 20 mg/mL in ampules, vials, and prefilled syringes
Adult Dosing
- Moderate to severe pain: 10 mg to 20 mg subcutaneously, intramuscularly, or intravenously every 3 to 6 hours as needed
- Maximum single dose: 20 mg
- Maximum daily dose: 160 mg
- Obstetric analgesia during labor: 10 mg to 20 mg IV/IM/SC
Pediatric Dosing
- Safety and efficacy in pediatric patients below the age of 18 years have not been established
Indications
- Management of moderate to severe pain where the use of an opioid is appropriate
- Supplement to balanced anesthesia
- Preoperative and postoperative analgesia
- Obstetric analgesia during labor and delivery
Mechanism of Action
- Synthetic agonist-antagonist opioid analgesic
- Acts as an agonist at kappa opioid receptors in the central nervous system, producing analgesia
- Acts as an antagonist at mu opioid receptors, potentially reversing mu-opioid-induced effects while maintaining analgesic properties
Contraindications
- Hypersensitivity to nalbuphine or any of its formulation components
- Significant respiratory depression
- Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
- Known or suspected gastrointestinal obstruction, including paralytic ileus
Adverse Reactions
- Sedation
- Dizziness
- Vertigo
- Nausea and vomiting
- Dry mouth
- Sweating
- Respiratory depression
- Headache
Drug Interactions
- Central nervous system (CNS) depressants (e.g., alcohol, benzodiazepines, sedatives, hypnotics): Increased risk of profound sedation, respiratory depression, coma, and death
- Mixed agonist-antagonist/partial agonist opioids: May reduce analgesic effect or precipitate withdrawal symptoms in opioid-dependent patients
- Serotonergic drugs: Increased risk of serotonin syndrome when co-administered with other serotonergic agents
Curated Content: Needs Vetting Before Put to Clinical Use