nalbuphine (Nubain) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:


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.

Combining nalbuphine with fentanyl (Duragesic), alfentanil (Alfenta), buprenorphine (Subutex), and other opioid medications increases sedation and may cause withdrawal symptoms in narcotic addicts.

Nalbuphine should not be used with MAO inhibitors like phenelzine (Nardil), selegiline (Zelapar, Emsam, Eldepryl), and isocarboxazid (Marplan) as well as linezolid (Zyvox) antibiotic because they can increase nalbuphine toxicity, causing decreased blood pressure, fever, sleepiness, and in severe cases, death. Nalbuphine administration must be separated by 14 days from MAOI inhibitors and linezolid (Zyvox).

Medically Reviewed by a Doctor on 8/15/2014

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Pill Finder Tool

Need help identifying pills and medications?
Use the pill identifier tool on RxList.

Back to Medications Index

Health Solutions From Our Sponsors