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.
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.
- 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.
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