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nalbuphine

Pronunciation: NAL bue feen

Brand: Nubain

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

MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH.

Nalbuphine can slow or stop your breathing, especially when you also use other medicines that can make you sleepy or slow your breathing.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Before you receive nalbuphine, tell your doctor about all other medicines you have recently used, especially a sedative or tranquilizer, sleep medicine, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for depression or seizures.

What is nalbuphine?

Nalbuphine is an opioid pain medication, sometimes called a narcotic.

Nalbuphine 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?

You should not be treated with nalbuphine if you are allergic to it, or if you have:

  • 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 a similar opioid medicine and are tolerant to it. Before you receive nalbuphine, 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 pancreas or adrenal gland;
  • a head injury, brain tumor, or seizures;
  • alcoholism, drug addiction, mental illness;
  • liver or kidney disease; or
  • a slow heart rate, or a heart attack.

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with nalbuphine and cause a serious condition called serotonin syndrome.

Although nalbuphine is sometimes used during labor and delivery, if you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.

Unless you are given nalbuphine during labor or delivery, tell your doctor if you are pregnant before you are treated with this medicine.

Nalbuphine can pass into breast milk and may cause drowsiness or breathing problems in a nursing baby. You should not breast-feed while you are using nalbuphine.

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.

Nalbuphine is usually given every 3 to 6 hours as needed. Your doctor may occasionally change your dose to make sure you get the best results.

Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.

Do not stop using nalbuphine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using nalbuphine.

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?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A nalbuphine overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.

What should I avoid while receiving nalbuphine?

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

What are the possible side effects of nalbuphine?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

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.

Tell your caregiver right away if you have:

  • shallow breathing, breathing that stops during sleep;
  • a light-headed feeling, like you might pass out;
  • severe drowsiness;
  • severe constipation; or
  • low cortisol levels --nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.

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?

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic ("water pill");
  • medicines for motion sickness, irritable bowel syndrome, or overactive bladder;
  • other narcotic medications --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.

Copyright 1996-2019 Cerner Multum, Inc. Version: 5.01. Revision date: 10/17/2019.

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