| NALBUPHINE HYDROCHLORIDE
Classifications: analgesic; narcotic (opiate) agonist-antagonist; Therapeutic: narcotic analgesic
Pregnancy Category: C
10 mg/mL, 20 mg/mL injection
Synthetic narcotic analgesic with agonist and weak antagonist properties. Analgesic potency is approximately equal to that
produced by equivalent doses of morphine. On a weight basis, produces respiratory depression about equal to that of morphine;
however, in contrast to morphine, doses greater than 30 mg produce no further respiratory depression. Antagonistic potency
is approximately one-fourth that of naloxone.
Analgesic action that relieves moderate to severe pain with apparently low potential for dependence.
Symptomatic relief of moderate to severe pain. Also preoperative sedation analgesia and as a supplement to surgical anesthesia.
History of hypersensitivity to nalbuphine, opiate agonists; pregnancy (category C). Prolonged use during pregnancy could
result in neonatal withdrawal.
History of emotional instability or drug abuse; head injury, increased intracranial pressure; cardiac disease; impaired
respirations, COPD; GI disorders; impaired kidney or liver function; MI; biliary tract surgery; lactation.
Route & Dosage
|Moderate to Severe Pain
Adult: IV/IM/SC 10 mg/70 kg q36h prn (max: 160 mg/d)
Surgery Anesthesia Supplement
Adult: IV Induction: 0.33 mg/kg, then 0.250.5 mg/kg as required
PREPARE: Direct: Give undiluted.
ADMINISTER: Direct: Give at a rate of 10 mg or fraction thereof over 35 min.
INCOMPATIBILITIES Solution/additive: Diazepam, dimenhydrinate, ketorolac, pentobarbital, promethazine, thiethylperazine. Y-site: Allopurinol, amphotericin B cholesteryl, cefepime, docetaxel, methotrexate, nafcillin, piperacillin/tazobactam, sargramostim,
- Store at 15°30°C (59°86°F), avoid freezing.
Adverse Effects (≥1%)CV:
Hypertension, hypotension, bradycardia, tachycardia, flushing. GI:
Abdominal cramps, bitter taste, nausea, vomiting,
dry mouth. CNS: Sedation, dizziness,
, restlessness, crying, euphoria, dysphoria, distortion of body image, unusual dreams, confusion,
hallucinations; numbness and tingling sensations, headache, vertigo. Respiratory: Dyspnea
, respiratory depression. Skin:
Pruritus, urticaria, burning sensation, sweaty, clammy skin. Special Senses:
Miosis, blurred vision, speech difficulty. Urogenital:
and other cns depressants
add to CNS depression
23 min IV
; 15 min IM. Peak:
30 min IV
36 h. Distribution:
Crosses placenta. Metabolism:
In liver. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Assess respiratory rate before drug administration. Withhold drug and notify physician if respiratory rate falls below 12.
- Watch for allergic response in persons with sulfite sensitivity.
- Administer with caution to patients with hepatic or renal impairment.
- Monitor ambulatory patients; nalbuphine may produce drowsiness.
- Watch for respiratory depression of newborn if drug is used during labor and delivery.
- Avoid abrupt termination of nalbuphine following prolonged use, which may result in symptoms similar to narcotic withdrawal:
nausea, vomiting, abdominal cramps, lacrimation, nasal congestion, piloerection, fever, restlessness, anxiety.
Patient & Family Education
- Do not drive or engage in potentially hazardous activities until response to drug is known.
- Avoid alcohol and other CNS depressants.