nalbuphine

This medication is used to treat moderate to severe pain. It is also used with other types of medication before and during surgery, labor/delivery, or other procedures. Nalbuphine is a narcotic pain reliever similar to morphine. It acts on certain centers in the brain to give you pain relief. Nalbuphine may block the effects of other narcotics and cause withdrawal symptoms in people dependent on narcotics. If possible, people who have recently used narcotics in high doses or for a long time should not use nalbuphine. (See also Side Effects section.)

Not applicable.

This medication is given by injection into a vein, into a muscle, or under the skin by a health care professional. If this medication is injected into a muscle or under the skin, change the location of the injection site each time to avoid developing problem areas under the skin. This medication is usually used every 3 to 6 hours as needed, or as directed by your doctor. The dosage is based on your medical condition and response to treatment. Pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well. If nausea occurs, consult your doctor or pharmacist for ways to decrease it (e.g., antihistamines, lying down with as little head movement as possible). This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as restlessness, runny nose, watering eyes, trouble sleeping, severe abdominal/muscle pain, nausea, vomiting, rapid breathing, fast heartbeat) may occur if you suddenly stop using this medication. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately. Rarely, abnormal drug-seeking behavior (addiction) is possible with this medication. Do not increase your dose, take it more frequently, or use it for longer than prescribed. Properly stop the medication when so directed. When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well. Tell your doctor if your pain persists or worsens.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine), narcotic blockers (e.g., naltrexone), cimetidine. Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that may make you drowsy. Ask your pharmacist about using those products safely.

This medication has been prescribed for your current condition only. Do not use it later for another condition unless told to do so by your doctor. A different medication may be necessary in that case.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow/shallow breathing, very deep sleep with trouble waking up.

Before using nalbuphine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as preservatives like parabens), which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: abdominal problems (e.g., gallbladder disease, pancreatitis, recent surgery), adrenal gland problems (e.g., Addison's disease), brain disorders (e.g., seizures, head injury, tumor, increased intracranial pressure), severe breathing problems (e.g., respiratory depression, hypercapnia, hypoxia), intoxication with alcohol or medications that depress the nervous system or your breathing (CNS/respiratory depressants such as tranquilizers/sedatives), slow gut movement (e.g., chronic constipation, paralytic ileus), heart problems (e.g., irregular heartbeat, recent heart attack), severe infectious diarrhea (e.g., Clostridium difficile-associated diarrhea), lung diseases (e.g., asthma, chronic obstructive pulmonary disease-COPD), physical dependence on narcotics, kidney disease, liver disease, mental/mood disorders (e.g., toxic psychosis), a certain spinal problem (kyphoscoliosis), personal or family history of regular use/abuse of drugs/alcohol, difficulty urinating (e.g., due to enlarged prostate or urethral stricture), underactive thyroid (hypothyroidism). This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages. To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, elderly people may be more sensitive to the effects of this drug, especially confusion and drowsiness. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Using it for long periods or in high doses near the expected delivery date is not recommended because of possible harm to the unborn baby. Infants born to mothers who have used this medication for an extended time may have withdrawal symptoms such as irritability, abnormal/persistent crying, vomiting, or diarrhea. Tell your doctor immediately if you notice any of these symptoms in your newborn. Nalbuphine may be used during labor. It is not recommended for use within 4 hours of the expected time of delivery because there is a risk of temporary problems with breathing and heartbeat in the newborn. Discuss the risks and benefits with your doctor. This drug may pass into breast milk. Consult your doctor before breast-feeding.

Not applicable. This medication is given in a hospital and will not be stored at home.

Drowsiness, dizziness, blurred vision, flushing, lightheadedness, headache, nausea, vomiting, constipation, dry mouth, and sweating may occur. Pain/redness/burning at the injection site may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you become constipated while using this drug, consult your pharmacist for help with selecting a laxative (e.g., stimulant-type with stool softener). Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Nalbuphine can cause withdrawal reactions in people who are physically dependent on narcotics. The seriousness of the withdrawal symptoms depends on the level of dependence and the dose of nalbuphine. Tell your doctor immediately if you develop symptoms such as anxiety, agitation, trouble sleeping, sweating, stomach cramps, and diarrhea. Tell your doctor right away if you have any serious side effects, including: mental/mood changes (e.g., anxiety, confusion, hallucinations). Get medical help right away if any of these rare but very serious side effects occur: difficult/slow/shallow breathing, fast/slow/irregular heartbeat, seizures, severe stomach/abdominal pain, change in the amount of urine. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.