nalbuphine
Nalbuphine is an opioid pain medication used for people in the hospital. It's unique from other opioids since it's not a controlled medication, but it can still cause abuse and dependence. Because of these risks, this medication is typically used only when other pain medications don't provide enough relief.
What is Nalbuphine?
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Common questions about Nalbuphine
Nalbuphine is used in people in the hospital to relieve pain. It can also be used as an add-on medication to general anesthesia in people getting surgery. This medication is typically only used when non-opioid pain medications aren't the best choice or when they don't provide enough relief. Some studies suggest that nalbuphine may also be helpful in treating certain instances of itching due to other opioid medication use.
Nalbuphine is an opioid agonist-antagonist that works on different opioid receptors in your brain to lower your perception of pain. It binds (attaches) to kappa-opioid receptors in your brain, which helps turn off pain signals. On the other hand, it also blocks mu-opioid receptors, which can help lower your risk of certain side effects commonly seen with other opioid medications, such as itching, nausea, and slowed breathing.
Unlike most other opioid medications, nalbuphine isn't a controlled medication. However, nalbuphine can still cause abuse and dependence. Abuse is when a medication is used for non-medical reasons for its desirable physical or emotional effects. In addition, long-term use of nalbuphine can lead to dependence. Dependence is when you rely on a medication to function normally and experience withdrawal symptoms (e.g., sweating, chills, muscle aches, anxiety, runny nose, trouble sleeping, nausea, vomiting) if you stop taking it suddenly. You can avoid withdrawal symptoms by lowering the dose before completely stopping the medication. To prevent abuse and dependence, your provider will monitor you closely during treatment to make sure you're receiving the medication appropriately and stopping the medication safely when necessary.
The dose will depend on your age, weight, severity of pain, and tolerance to opioid medications. Nalbuphine can be given as an injection into the muscle, in the veins, or under the skin. Your provider will make sure you get the correct dose, and slowly lower your dose when you're ready to stop taking it if needed.
The most common side effect is sleepiness. Other possible side effects include sweating, nausea, vomiting, dizziness, dry mouth, and headache.
There have been reports of severely low heart rate in unborn babies, with some cases being fatal, when the mother received nalbuphine during labor. It's possible that this can happen if the medication is given at an earlier stage in pregnancy. Because of this, nalbuphine should be used in a pregnant female only if the benefits greatly outweigh the risks. Your provider will help you decide if this medication is the best option for you.
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Risks and warnings for Nalbuphine
Nalbuphine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Potentially life-threatening slowed breathing (respiratory depression)
- Risk factors: Taking medications that can cause slow breathing | History of substance abuse | Drinking alcohol | Medical conditions that cause breathing problems (e.g., asthma) | Age 65 years and older | Low body weight | People who are very weak
Nalbuphine can cause irregular or slowed breathing, which can be life-threatening. Your risk is higher if you take other medications that can cause slowed breathing (e.g., benzodiazepines, other opioids, muscle relaxants, sleep medications) or drink alcohol. Make sure to tell your provider about all the medications you're taking before starting nalbuphine treatment.
Respiratory depression can happen at any time, even at recommended doses. This can cause you to stop breathing and can even lead to death, so it's important to recognize signs of breathing problems and treat them right away. Your provider will have naloxone (Narcan), a medication that can reverse the effects of opioids, readily available just in case you experience severely slowed breathing. If you have shortness of breath, slow or shallow breathing, or bluish-colored lips, fingers, or toes, your provider will give you naloxone (Narcan).
Low adrenal hormone levels
- Risk factors: Receiving nalbuphine for longer than 1 month
Opioids like nalbuphine can cause your adrenal hormone levels to drop. This is more likely to happen after taking opioids for longer than 1 month. Symptoms include weakness, tiredness, dizziness, nausea, vomiting, and loss of appetite. Let your provider know right away if you experience these symptoms so they can check your hormone levels.
Severely low blood pressure
- Risk factors: Low blood volume | Receiving nalbuphine with medications can also lower blood pressure
Nalbuphine can cause severely low blood pressure. The risk is higher in people taking other medications that slow the body down (e.g., general anesthetics, sedatives). Your provider will likely check your blood pressure while you're receiving nalbuphine. Let your provider know if you feel lightheaded, dizzy, fatigued, or like you're going to faint.
High pressure in the brain
- Risk factors: History of high pressure in the brain | Brain tumors | Head injuries
As a result of lowering your breathing rate, nalbuphine can also raise the pressure in your brain. This can be problematic for people with certain medical conditions, such as brain tumors, head injuries, or high pressure in the brain. During treatment, your provider will monitor your breathing rate and level of consciousness often.
Risks in people with stomach problems
Nalbuphine can cause problems with your stomach or digestive system, such as raising your risk for inflammation of your pancreas (pancreatitis). People with a blockage in their gut shouldn't take nalbuphine. Let your provider know if you have a history of stomach problems. If you experience constipation while taking nalbuphine, discuss treatment options with your provider.
Seizures
- Risk factors: History of seizures
Nalbuphine can raise the risk for seizures in people with a history of seizures or medical conditions that cause seizures. Let your providers know your full medical history so they can monitor you more closely if you're at risk for seizures.
Serotonin syndrome
- Risk factors: Using nalbuphine with other medications that raise your serotonin levels
Using nalbuphine with other medications that raise serotonin levels in your brain, known as serotonergic medications, can cause a life-threatening condition called serotonin syndrome. Some examples of serotonergic medications include fluoxetine (Prozac), duloxetine (Cymbalta), monoamine oxidase inhibitors (MAOIs), and trazodone (Desyrel). Let your providers know about all the medications you take so they can make sure they're safe with nalbuphine. Call for emergency medical help right away and stop using nalbuphine if you experience diarrhea, high fever, distress, confusion, shakiness, sweating, fast heart rate, or stiff muscles.
Risks of driving and operating machinery due to sleepiness and decreased ability to concentrate
Nalbuphine can lower your alertness and cause you to feel drowsy. Your provider will monitor you to make sure you've recovered from the effects of nalbuphine. They will let you know when it's okay to drive or perform other tasks that require you to be alert.
Nalbuphine dosage
Typical dosage for Nalbuphine
How much does Nalbuphine cost?
$21.69
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