nalbuphine

• 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).

• 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.

• 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.

• 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.

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.

• 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.

• 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.

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.