Brand and Other Names:Nubain
- Classes: Opioid Analgesics
Dosing & Uses
Dosage Forms & Strengths
Opioid-dependent patients: Administer ¼ dose, and observe for withdrawal signs
Not to exceed 160 mg/day
Opioid-Induced Pruritus (Off-label)
Prevention and treatment
Renal impairment: Caution; dose reduction may be necessary; monitor
Hepatic impairment: Caution; dose reduction may be necessary; monitor
Serious - Use Alternative
Significant - Monitor Closely
Nausea and vomiting (6%)
Absolute: Diarrhea associated with toxins, pseudomembranous colitis, respiratory depression (<12 beats/min)
Acute asthma, bradycardia, inflammatory bowel disease, respiratory impairment
Respiratory impairment; nalbuphine poses less risk of respiratory sedation than pure opioid agonists
May produce withdrawal in opioid-dependent patients
Pregnant patients (risk of serious fetal/neonatal adverse events associated with use during labor and delivery, including respiratory depression at birth, fetal bradycardia, apnea, cyanosis)
Head trauma, increased ICP
Hepatic or renal impairment
Patients undergoing biliary tract surgery
Pregnancy & Lactation
Pregnancy category: B; D if used for prolonged periods or near term
Lactation: Insignificant amount distributed in milk; use with caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Narcotic agonist-analgesic of kappa opiate receptors and partial antagonist of mu opiate receptors; inhibits ascending pain pathways, thus altering response to pain; produces analgesia, respiratory depression, and sedation
Onset: IM, 15 min; IV, 2-3 min
Duration: 3-6 hr
Peak plasma time: IM, 30 min; IV, 1-3 min
Protein bound: Not significant
Metabolized in liver
Half-life: 5 hr
Excretion: Urine, feces
Syringe: Diazepam, ketorolac, pentobarbital
Y-site: Allopurinol, amphotericin B cholesteryl sulfate, cefepime, docetaxel, methotrexate, nafcillin, piperacillin-tazobactam, sargramostim, sodium bicarbonate
Adjusted pH: 3.5-3.7
May be given undiluted
Administer each 10 mg by IV push over 3-5 minutes
Store vial at room temperature
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|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
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