Parenteral Manual

Nalbuphine

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Nubain
Classification: 
Analgesic, Narcotic; Opiate Partial Agonist
Original Date: 
September 2007
Revised Date: 
March 2012
Indications: 
  • Prevention or treatment of opiod-induced pruritis
Reconstitution and Stability: 
  • Nalbuphine is available as 10 mg/mL solution for injection in 1 mL ampoules
  • Store at room temperature; protect from excessive light; store in carton until used
Compatibility: 

- Solution Compatible:  Dextrose up to D10, 0.9% NaCl, Ringer's Lactate

- Additives/Above Cassette Compatible: None

- Y-site Compatible:  Cefazolin, Cefotaxime, clindamycin, diphenhydramine, midazolam, metronidazole, ranitidine, KCl

Incompatible:  diazepam, dimenhydrinate, furosemide, hydrocortisone, ketorolac, methylprednisolone, piperacillin, piperaciilin/tazobactam

 

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC

YES

IM

YES

IV Direct

YES - Undiluted

IV Intermittent Infusion

Yes

Usual dilution: 0.1 mg/mL

Infusion time: 5-10 minutes; larger dose should be administered over 10-15 minutes

IV Continuous Infusion

NO

 

 

 

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

-  Opioid induced pruritus:  0.05 mg/kg/dose (Max 5 mg/dose) IV Q4-6H PRN

Adult:

-  Opiod induced pruritus:  2.5 - 5 mg IV; may repeat dose

Potential hazards of parenteral administration: 
  •  hypotension, tachycardia, bradycardia
  •  drowsiness, dizziness, dysphoria, sedation
  •  urticaria, pruritus, hypersensitivity reactions  
  •   nausea, vomiting
  •  urinary retention 
  •  respiratory depression 
  • blurred vision

 

Notes: 
  • Monitor: respiratory and mental status, blood pressure, pulse
  • Analgesic potency: 1 mg = 1 mg morphine

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