| Drug Index |
| GENERIC NAME : |
| nalbuphine |
| BRAND NAMES : |
| Nubain |
| STREET NAMES : |
| none known |
| BRIEF DESCRIPTION : |
| Nalbuphine hydrochloride (Nubain) is a synthetic opioid agonist-antagonist analgesic (pain killer) of the phenanthrene series. It is supplied in liquid form for intravenous, intramuscular, or subcutaneous use. It is chemically related to the widely used opioid antagonist, naloxone (Narcan), and the potent opioid analgesic oxymorphone (Numorphan and Opana). Nalbuphine is not a pure opioid antagonist like naloxone.It is a partial antagonist that is capable of producing partial opioid agonist effects (by attachment to the mu (µ) opiate receptors), and can therefore produce analgesia when administered at recommended dosages to opioid-naïve individuals (individuals who have no history of recent opiate use or past heavy or prolonged opiate use). In individuals who have recently been using complete opiate agonists (examples would include: oxymorphone, hydrocodone, oxycodone, morphine, and methadone), use of nalbuphine can precipitate an immediate opiate withdrawal syndrome. The half-life is 5 hours and the analgesic effect can last from 3 to 6 hours. Nalbuphine is in the class of Drugs called Narcotic Analgesics. |
| INDICATIONS FOR USE : |
| Nalbuphine is indicated for the relief of moderate to severe pain. It can also be used as a supplement to balanced anesthesia (during surgery), for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery. |
| ABUSE AND ADDICTIVE POTENTIAL : |
Nalbuphine poses a risk for addiction. Usually it is used short term in emergency rooms, hospitals, surgery and labor and delivery. Medical professionals are a special population at risk for addiction to nalbuphine because they have access to it in medical offices or institutions. When nalbuphine is used in any individual for weeks consecutively, dependence is likely. A symptom that is easily detected with opiate use is pinpoint pupils (miosis). Psychological dependence may occur early in use of this medication, but physical dependence and tolerance may develop upon repeated administration over several weeks or months (requiring larger or more frequent dosages of nalbuphine to produce relief of pain or achieve a state of euphoria). When nalbuphnie is abused, the individual is seeking the euphoric effect ("high"). As with all opiates, individuals with a history of drug addiction or alcoholism are at much higher risk for addiction to nalbuphine when used beyond the short term management of pain. Abrupt discontinuation of nalbuphine after prolonged use can cause a classic opiate withdrawal syndrome which may include:
Withdrawal of nalbuphine is best handled by a physician that is skilled at assisting patients with opiate detoxification. Medications are often necessary to help control symptoms of withdrawal. |
| OVERDOSAGE : |
| Acute overdose of nalbuphine can cause respiratory depression (although usually not as severe as with pure opiate agonists), extreme drowsiness or prolonged sleeping, stupor or coma, muscle flaccidity, cold/clammy skin, constricted pupils, slow heart rate (bradycardia), low blood pressure (hypotension), and death. Because of the dangers associated with overdose, immediate medical attention should be sought. |
| CAUTIONS : |
| Physical dependence and tolerance are not unusual with chronic nalbuphine therapy. Caution is advised when prescribing this medication to anyone with a history of drug addiction, alcoholism or suicide attempts. Because the drug is metabolized in the liver and eliminated via the kidneys, caution is advised when prescribing this medication to individuals with impaired liver or kidney function.When nalbuphine is used in combination with alcohol or other central nervous system depressants, the two drugs potentiate one another and can greatly enhance the risk for overdose. |
| SIDE EFFECTS : |
| The most common side effect is sedation. Others observed include sweaty/clammy, nausea/vomiting, dizziness, dry mouth, headache, mood changes, anxiety, tingling, numbness, confusion, hallucinations, abnormal changes in blood pressure or heart rate, asthma, itching, rash, blurred vision, and urinary retention. This is not s complete list if side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. |
| FOR MORE INFORMATION : |
*This is a condensed description of nalbuphine. For more details check with your physician, pharmacist,or resources such as The Physicians' Desk Reference (PDR) http://www.rxlist.com/script/main/hp |
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