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nalbuphine (Nubain)
Tradename: Nubain.
Indications: relief of moderate to severe pain
Dosage:
1) 10 mg IV/IM/SC every 3-6 hours
2) 10 mg/70 kg IV/IM/SC every 3-6 hours
3) maximum: 20 mg/dose
4) maximum daily dose 160 mg
Injection: 10 mg/mL (1 mL), 20 mg/mL (1 mL)
Pharmacokinetics:
1) onset of action:
a) IM/SC: < 15 minutes
b) IV: 2-3 minutes
2) peak effect:
a) IM: 30 minutes
b) IV: 1-3 minutes
Adverse effects:
1) common (> 10%)
- drowsiness, histamine release, sedation
2) less common (1-10%)
- rash, hypotension, anorexia, nausea/vomiting, dry mouth, dizziness, headache, pain at site of injection, weakness, sweaty or clammy feeling
3) uncommon (< 1%)
- blurred vision, biliary spasm, decreased urination, toxic megacolon, depression, hypertension, hallucinations, tachycardia, confusion, paradoxical CNS stimulation, shortness of breath, respiratory depression, GI irritation, nervousness, restlessness, nightmares, ureteral spasm, insomnia
Overdose:
1) airway support
2) naloxone 2 mg IV (0.01 mg/kg for children)
3) may repeat naloxone as needed up to 10 mg
Drug interactions:
- barbiturates
Interactions
drug interactions
drug adverse effects (more general classes)
General
mixed opioid agonist-antagonist (analgesic narcotic partial-mixed agonist)
Properties
INHIBITS: opiate
MISC-INFO: elimination route LIVER
pregnancy-category ?
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998