nalbuphine (Nubain)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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GENERIC NAME: nalbuphine hydrochloride

BRAND NAME: Nubain

DRUG CLASS AND MECHANISM: Nalbuphine is a man-made opioid (narcotic) painkiller. Nalbuphine provides pain relief in a similar way as morphine (MS Contin), oxycodone (Oxycontin), and other narcotic analgesics. Narcotic painkillers stimulate the brain to increase the threshold to pain (the amount of stimulation it takes to feel pain) and reduce the perception of pain (the perceived importance of the pain). Nalbuphine is a mixed opioid agonist and antagonist because it stimulates and blocks pain receptors on nerves. The FDA approved nalbuphine in May 1979.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Nalbuphine injections are available in 10 mg/ml and 20 mg/ml strengths in 1 ml ampoule or 10 ml multi-use, flip-top vials.

STORAGE: Store Nalbuphine injections at room temperature between 20 C and 25 C (68 F and 77 F).

PRESCRIBED FOR: Nalbuphine injections are used for treating moderate to severe pain. It is used before and during surgery to control pain as part of anesthesia, and for reducing pain during labor and delivery.

DOSING:

Adults:

  • Pain: For a 70 kg patient, inject 10 to 20 mg via subcutaneous, intravenous, or intramuscular route every 3 to 6 hours as needed. Maximum single dose of 20 mg. Maximum daily dose of 160 mg per day.
  • Opioid-dependent patients: Administer ¼ of normal dose and observe withdrawal signs.
  • Anesthesia supplement: Administer 0.3 to 3 mg/kg intravenously over 10 to 15 minutes, then 0.25 to 0.5 mg/kg as needed.

DRUG INTERACTIONS: Nalbuphine should not be used with alvimopan (Entereg) because alvimopan increases nalbuphine levels in the body and increases side effects. Nalbuphine must be discontinued 7 days prior to using alvimopan.

Medically Reviewed by a Doctor on 8/15/2014

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