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nalbuphine
generic
Black Box Warnings .
Appropriate Use
should only be administered as anesthesia adjunct by healthcare professionals trained in use of IV anesthetics and management of respiratory effects of potent opioids; ensure opioid antagonist, resuscitative and intubation equipment, and oxygen readily available; reserve opioid analgesics for patients with inadequate tx alternatives; proper dosing and titration essential to decr. respiratory depression risk
Respiratory Depression
serious, life-threatening, or fatal cases may occur even with recommended use, especially during tx start or after dose incr; to decr. risk, initiate and titrate dose appropriately
Risks from Concomitant Use with Benzodiazepines, CNS Depressants
concomitant opioid use with benzodiazepines or other CNS depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death; reserve concomitant use for patients with inadequate alternative tx options
Adult Dosing .
Dosage forms: INJ: 10 mg per mL, 20 mg per mL
pain, moderate-severe
- [10 mg IV/IM/SC q3-6h prn]
- Max: 20 mg/dose up to 160 mg/day; Info: use lowest effective dose, shortest effective tx duration; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
anesthesia adjunct
- [0.25-0.5 mg/kg/dose IV x1 prn]
- Start: 0.3-3 mg/kg/dose IV x1
pruritus, opioid-induced (off-label)
- [2-5 mg IV x1]
renal dosing
- [adjust dose amount]
- renal impairment: decr. usual dose, amount not defined
- HD/PD: not defined
hepatic dosing
- [adjust dose amount]
- hepatic impairment: decr. usual dose, amount not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.