nalbuphine

What is the most important information I should know about nalbuphine?

What is nalbuphine?

Nalbuphine is an opioid pain medication that is used to treat moderate to severe pain. It is also used for treating pain just after surgery or childbirth.

Nalbuphine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before I receive nalbuphine?

• severe asthma or breathing problems; or
• a stomach or bowel obstruction (including paralytic ileus).

Your dose needs may be different if you are already using an opioid medicine and are tolerant to it. Tell your doctor about all other pain medicines you have recently used.

Tell your doctor if you have ever had:

• breathing problems, sleep apnea;
• problems with your gallbladder, pancreas, or adrenal gland;
• a head injury, brain tumor, or seizures;
• alcoholism or drug addiction;
• liver or kidney disease; or
• a slow heart rate, or a heart attack.

Although nalbuphine is sometimes used during childbirth, receiving this medicine during labor may cause side effects in the newborn baby, including slow heartbeats and breathing problems. Your baby's breathing, blood pressure, oxygen levels, and other vital signs will be watched closely.

Ask a doctor before using opioid medicine if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

How is nalbuphine given?

Nalbuphine is injected under the skin or into a muscle, or as an infusion into a vein. A healthcare provider will give you this injection.

When used to treat pain, nalbuphine is usually given every 3 to 6 hours as needed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

If you stop using nalbuphine suddenly after long-term use, you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

What happens if I miss a dose?

Because you will receive nalbuphine in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since nalbuphine is given in a medical setting, you will be watched closely to make sure you do not receive too much of this medicine. Your caregivers will quickly treat you if you have overdose symptoms.

What should I avoid while receiving nalbuphine?

What are the possible side effects of nalbuphine?

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

• shallow breathing, breathing that stops during sleep;
• a light-headed feeling, like you might pass out;
• severe drowsiness;
• severe constipation;
• low cortisol levels --nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness; or
• high levels of serotonin in the body --agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea.

Serious breathing problems may be more likely in older adults and those who are debilitated or have wasting syndrome or chronic breathing disorders.

Common side effects may include:

• drowsiness;
• dizziness, spinning sensation;
• dry mouth;
• headache;
• sweating;
• cold, clammy skin; or
• nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect nalbuphine?

• cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic ("water pill");
• medicines for motion sickness, irritable bowel syndrome, or overactive bladder;
• other opioids --opioid pain medicine or prescription cough medicine;
• a sedative like Valium --diazepam, alprazolam, lorazepam, Xanax, Klonopin, Versed, and others;
• drugs that make you sleepy or slow your breathing --a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness;
• drugs that affect serotonin levels in your body --a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.

This list is not complete. Other drugs may affect nalbuphine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Where can I get more information?

Your doctor or pharmacist can provide more information about nalbuphine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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