Nubain

Nubain is the brand name for nalbuphine, a semi-synthetic opioid analgesic used for moderate to severe pain and for analgesia during labor. Nalbuphine is a mixed opioid receptor agonist–antagonist, acting as a kappa-opioid receptor agonist and a mu-opioid receptor antagonist. This combination provides analgesia with a ceiling effect on respiratory depression and may reduce mu-related adverse effects, but it can precipitate withdrawal in patients dependent on mu-opioid agonists.

Nubain is indicated for relief of moderate to severe pain in adults and for obstetric analgesia during labor. It is also used as part of anesthesia regimens in perioperative settings. It is administered by injection, either intravenously or intramuscularly. Onset of analgesia is typically minutes after IV administration and longer after IM administration; duration is usually about 3 to 6 hours.

Common adverse effects include sedation, dizziness, nausea and vomiting, sweating, and headache. Like other opioids, it can cause respiratory depression, but to a lesser extent than pure mu agonists; high doses or coadministration with central nervous system depressants can increase risk. It may cause withdrawal symptoms in opioid-dependent patients. Contraindications include known hypersensitivity and caution in patients with respiratory impairment, biliary tract disease, liver disease, or in pregnancy due to potential neonatal effects such as respiratory depression or withdrawal.

Nalupuncture? No. Nalbuphine crosses the placenta and can affect the fetus; neonatal effects are a consideration when used during labor. Pharmacokinetically, nalbuphine is metabolized in the liver and excreted in urine. Interactions with CNS depressants, alcohol, and other opioids may enhance effects or precipitate withdrawal.