Nalbuphine (Injection)

Nalbuphine is a narcotic medication, administered by injection, that is used to treat moderate to severe pain.

Overview

Nalbuphine is a narcotic, or opioid, pain reliever administered by injection. It is used to treat moderate to severe chronic pain or to treat the pain during a surgery or childbirth. Nalbuphine is a synthetic opioid that works by altering the central nervous system.

All narcotics come with the risk of physical or mental dependence. Mental dependence is also known as addiction. Physical dependence is a result of your body's reliance on the medication and means that if you suddenly stop taking it, you may experience withdrawal symptoms. Withdrawal symptoms can usually be avoided by slowly reducing the amount of narcotic that you are taking until you don't take it anymore. If you are concerned about your risk of addiction from taking nalbuphine, talk to your doctor about it.

Nalbuphine is administered by injection, which is usually performed by a doctor or medical professional.

Using nalbuphine in any way other than how your doctor has instructed you to can result in serious addiction or overdose. Overdose can be fatal.

Never combine nalbuphine with alcohol. Doing so can cause fatal side effects.

Nalbuphine can stop your breathing or slow it to a dangerous level. This is a particular risk when combined with alcohol or other medications. Make sure your doctor knows about any other medications that you have taken, especially antidepressants, sedatives, or sleep aids.

Do not share your prescription for nalbuphine with anyone else. Doing so may put them in danger of addiction or dangerous side effects.

Pregnant women should not take nalbuphine unless it is definitely needed and the best possible treatment plan. It is not known if nalbuphine is safe for use by pregnant women. If you are pregnant, talk to your doctor about the possible risks you may face, and he or she will help you to decide if it is the right choice for you to take nalbuphine.

Make sure your doctor knows about all of your medical conditions before you are administered nalbuphine. Tell your doctor about all the medicines that you take, and do not start taking a new medicine unless your doctor has told you that it is safe to do so.

There are a number of possible side effects that you may experience. If any of the side effects are causing you concern, or if they get worse over time, talk to your doctor about them. He or she may be able to tell you ways to prevent or reduce some of the side effects.

Condition Treated:

  • Chronic or acute pain

Type Of Medicine

  • Narcotic analgesic
  • Synthetic opioid

Side Effects

Any medication comes with the risk of creating unintended side effects in addition to the positive effect it is intended to produce. If you are ever concerned about any side effects that you are experiencing, talk to your doctor, pharmacist, or a medical professional about them.

There are a number of different side effects that may be experienced by people taking nalbuphine. It is unlikely that you will experience all of these side effects.

If you experience any of the following side effects, contact your doctor as soon as possible:

  • Abrupt loss of consciousness
  • Anxiety, nervous feeling, or fear
  • Belief in false things that cannot be altered by facts
  • Blue fingernails or lips
  • Coughing up a pink froth
  • Difficulty breathing or shortness of breath
  • Difficulty swallowing
  • Fainting
  • Fever
  • Hallucination
  • Heartbeat that is rapid, irregular, or pounding
  • Heartbeat that is slow
  • Hyperventilating
  • Losing control of the bladder
  • Pain or discomfort in the chest
  • Pain or discomfort in the stomach
  • Paleness of the skin
  • Rapid or loud breathing
  • Reduced level of consciousness
  • Seizures or convulsions
  • Sensation of detachment
  • Spasm, jerking, trembling or shakiness of the extremities
  • Swelling of the face, eyes, or mouth
  • Swollen ankles or legs
  • Unusual sleepiness
  • Unusual sweating
  • Wheezing

It is possible that you will experience some side effects that are normal and do not require you to seek any medical attention. Usually, these side effects will decrease as your body adjusts to your use of the medication. If these side effects persist or get worse, talk to your doctor. He or she may be able to help you with ways to mitigate or prevent some of these side effects. You should also talk to your doctor if any of these side effects are causing you problems or if you have questions about them.

These side effects include:

  • Appetite loss
  • Belching
  • Blurring of the vision
  • Burning sensation
  • Calmness or relaxation
  • Changes in the rapidity of the heartbeat
  • Clammy or sweaty skin
  • Cough
  • Difficulty concentrating
  • Difficulty sleeping
  • Dizziness
  • Dryness of the mouth
  • Dysphoria
  • Fatigue
  • Feeling confused
  • Feeling discouraged, empty, or sad
  • Feeling of heaviness
  • Feeling of unreality
  • Feeling of warmth
  • Headache
  • Hearing or feeling pounding in the ears
  • Heartburn or indigestion
  • Injection site: pain, rash, swelling, scarring, soreness, tingling, bleeding, burning, blistering, cold, discoloration, feeling of pressure, itching, hives, or warmth
  • Lightheadedness, faintness, or dizziness when rising
  • Loss of pleasure or interest
  • Nausea or vomiting
  • Numb sensation
  • Sensation of floating
  • Sensation of restlessness
  • Sensation that you or your environment is moving constantly
  • Sleepiness
  • Sour stomach
  • Speech changes
  • Spinning feeling
  • Unusual anger or aggression
  • Unusual crying
  • Unusual sense of well-being
  • Unusual urge to urinate (strong or frequent)
  • Upset stomach or stomach pain
  • Welts, hives, rash, or itchy skin

You may also experience other side effects that have not been listed here. If you are experiencing any other side effects, talk to your doctor about them. You may also report any side effects that you have experienced to the FDA at 800-FDA-1080.

Dosage

Your dosage will be determined by your doctor and will depend on information individual to you, such as your weight, your medical history, and the strength of your medication.

Nalbuphine will be injected under your skin into a muscle or directly into your vein through an IV. Nalbuphine is usually administered every three to six hours depending on the patient's level of pain.

Tell your doctor if nalbuphine seems to be getting less effective at easing your pain.

Do not use nalbuphine unless you have been prescribed it by a doctor. Nalbuphine should only be used as prescribed and should only be administered by a healthcare professional.

If you suspect that you might be overdosing on nalbuphine, seek emergency medical attention right away. You can die from overdosing on nalbuphine. If you or someone around you experiences slowed or noisy breathing, extreme drowsiness, muscle weakness, tiny pupils, or unconsciousness, these are signs of serious overdose and you should call emergency services immediately. Nalbuphine overdose can be fatal.

Interactions

Some medications, when taken at the same time as other medications, can cause drug interactions. These interactions may reduce the effectiveness of one or both medications or may increase the risk or severity of side effects.

Tell your doctor or pharmacist about all the medications that you are taking, and do not begin taking new medications without checking with your doctor or pharmacist first. This includes prescription medications, over the counter medications, vitamins, or supplements.

The following medications should not be used at the same time as nalbuphine. Your doctor may take you off one of your medications.

  • Naltrexone

The following medications are not recommended for use with nalbuphine. However, taking them together may be necessary sometimes. Your doctor may change the way you take one or both of these medications to help you avoid interactions.

  • Dronedarone
  • Fenoldopam
  • Fingolimod
  • Oxymetazoline
  • Lacosamide
  • Diltiazem
  • Verapamil
  • Crizotinib
  • Epinephrine
  • Rivastigmine

Taking nalbuphine with any of the following medications may increase the risk or severity of some side effects. However, your doctor might determine that it is still best for you to take both medications. He or she may alter the way you take one of the medications or change your dosage.

  • Tramadol
  • Doxylamine
  • Hydrocodone
  • Levorphanol
  • Oxycodone
  • Bromazepam
  • Flibanserin
  • Morphine Sulfate Liposome
  • Meperidine
  • Periciazine
  • Alphaprodine
  • Fospropofol
  • Butorphanol
  • Lorazepam
  • Codeine
  • Pentazocine
  • Tapentadol
  • Sufentanil
  • Bromopride
  • Hydromorphone
  • Methadone
  • Alfentanil
  • Propoxyphene
  • Donepezil
  • Dihydrocodeine
  • Buprenorphine
  • Fentanyl
  • Meclizine
  • Carbinoxamine
  • Oxymorphone
  • Zolpidem
  • Morphine
  • Remifentanil

Some foods may interact with certain medications. Your doctor or pharmacist will tell you if there are certain foods that you should avoid, or if you need to maintain a special diet of any kind while taking nalbuphine.

Tobacco may cause interactions with some medications. Make sure you talk to your doctor or pharmacist about your use of tobacco. Your doctor or pharmacist will tell you if you need to alter your use of tobacco in order to ensure the optimal functioning of nalbuphine.

You should not consume alcohol while you are taking nalbuphine. Drinking alcohol while you are on nalbuphine can cause potentially fatal side effects.

Warnings

Make sure that you tell your doctor about your complete medical history. Tell your doctor about any medical conditions that you have or have had. Other medical conditions may affect the way you need to take nalbuphine or may make nalbuphine dangerous for you to take. Make sure your doctor knows if you have any of the following medical conditions:

  • Asthma or any other breathing issues
  • Bradycardia
  • Brain tumor
  • Head injuries or high pressure in the head
  • Heart attach
  • Kidney disease
  • Liver disease
  • Past or present alcohol abuse
  • Past or present dependence on drugs
  • Respiratory depression

Some of these conditions may make it unsafe for you to take nalbuphine. Others may mean that you need to use caution or be aware of certain symptoms. Your doctor will tell you about how your condition may change the way you need to take nalbuphine.

Do not take nalbuphine in any way except the way your doctor or pharmacist has instructed you to take it. Nalbuphine should only be administered by a medical professional and should never be used for any purpose other than it has been prescribed.

Do not share your prescription with others.

Before you take nalbuphine, make sure you have told your doctor about all of your allergies. It is possible that nalbuphine may contain inactive ingredients that you are allergic to.

Nalbuphine has not established to be safe for use by children. Children should not use nalbuphine without serious consideration of the possible risks it may pose. Children may be at higher risk of fatal overdose if they are given nalbuphine.

Nalbuphine can sleepiness or drowsiness. Do not drive, operate heavy machinery, or do tasks that require your full attention until you have learned how your body will react to nalbuphine.

Nalbuphine has not been established to be safe for use by pregnant women. If you are pregnant, talk to your doctor about the potential risks that you may face by taking nalbuphine.

Nalbuphine poses a minimal risk to the babies of breastfeeding women.

Storage

Nalbuphine should be stored in a tightly sealed container, at room temperature, and protected from light. If nalbuphine appears cloudy or discolored or contains suspended particles, dispose of it.

Do not use expired medications. When disposing of expired or unused medications, do not flush them down the toilet, pour them in the sink, or throw them in the garbage. Ask your pharmacist how to dispose of unused medications safely and appropriately.

Keep all medications stored safely out of the reach of children and pets.

Summary

Nalbuphine is a synthetic opioid, or narcotic, medication that is used to treat moderate to severe pain. Like all narcotics, nalbuphine can be addictive if used for an extended period of time or used in inappropriate ways.

If you are concerned that you may become addicted to nalbuphine, or if you suspect that you are addicted, talk to your doctor.

If you need to stop taking nalbuphine, your doctor can help you to wean off of it in order to avoid withdrawal symptoms, which are a result of physical dependence.