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Identification
NameNalbuphine
Accession NumberDB00844  (APRD01132)
TypeSmall Molecule
GroupsApproved
DescriptionA narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors. Nalbuphine is the only opioid analgesic that is not a controlled substance in the United States.
Structure
Thumb
Synonyms
N-Cyclobutylmethyl-4,5alpha-epoxy-3,6alpha,14-morphinantriol
Nalbufina
Nalbuphin
Nalbuphine
Nalbuphinum
External Identifiers
  • EN-2234 A
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Nubain Injection 10mg/mlSolution10 mgIntramuscular; Intravenous; SubcutaneousSandoz Canada Incorporated1993-12-31Not applicableCanada
Nubain Injection 20mg/mlSolution20 mgIntramuscular; Intravenous; SubcutaneousSandoz Canada Incorporated1993-12-31Not applicableCanada
Approved Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Nalbuphine HydrochlorideInjection, solution20 mg/mLIntramuscular; Intravenous; SubcutaneousHospira, Inc.1989-02-03Not applicableUs
Nalbuphine HydrochlorideInjection, solution10 mg/mLIntramuscular; Intravenous; SubcutaneousGeneral Injectables & Vaccines, Inc2010-03-01Not applicableUs
Nalbuphine HydrochlorideInjection, solution10 mg/mLIntramuscular; Intravenous; SubcutaneousHospira, Inc.1989-02-03Not applicableUs
Nalbuphine HydrochlorideInjection, solution10 mg/mLIntramuscular; Intravenous; SubcutaneousCardinal Health1989-02-03Not applicableUs
Nalbuphine HydrochlorideInjection, solution10 mg/mLIntramuscular; Intravenous; SubcutaneousHospira, Inc.1989-02-03Not applicableUs
Nalbuphine HydrochlorideInjection, solution10 mg/mLIntramuscular; Intravenous; SubcutaneousCardinal Health1989-02-03Not applicableUs
Nalbuphine HydrochlorideInjection, solution20 mg/mLIntramuscular; Intravenous; SubcutaneousHospira, Inc.1989-02-03Not applicableUs
Nalbuphine HydrochlorideInjection, solution20 mg/mLIntramuscular; Intravenous; SubcutaneousMc Kesson Packaging Services Business Unit Of Mc Kesson Corporation2010-05-03Not applicableUs
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International Brands
NameCompany
MexifenMedicus
NalbuphineMylan
NalpainOrpha-Devel
NubainSandoz
Brand mixturesNot Available
Salts
Name/CASStructureProperties
Nalbuphine hydrochloride
23277-43-2
Thumb
  • InChI Key: YZLZPSJXMWGIFH-BCXQGASESA-N
  • Monoisotopic Mass: 393.170686096
  • Average Mass: 393.904
DBSALT000125
Categories
UNIIL2T84IQI2K
CAS number20594-83-6
WeightAverage: 357.4434
Monoisotopic: 357.194008357
Chemical FormulaC21H27NO4
InChI KeyNETZHAKZCGBWSS-CEDHKZHLSA-N
InChI
InChI=1S/C21H27NO4/c23-14-5-4-13-10-16-21(25)7-6-15(24)19-20(21,17(13)18(14)26-19)8-9-22(16)11-12-2-1-3-12/h4-5,12,15-16,19,23-25H,1-3,6-11H2/t15-,16+,19-,20-,21+/m0/s1
IUPAC Name
(1S,5R,13R,14S,17S)-4-(cyclobutylmethyl)-12-oxa-4-azapentacyclo[9.6.1.0¹,¹³.0⁵,¹⁷.0⁷,¹⁸]octadeca-7,9,11(18)-triene-10,14,17-triol
SMILES
O[[email protected]]1CC[C@@]2(O)[[email protected]]3CC4=CC=C(O)C5=C4[C@@]2(CCN3CC2CCC2)[[email protected]]1O5
Pharmacology
IndicationFor the relief of moderate to severe pain.
Structured Indications
PharmacodynamicsNalbuphine is a synthetic opioid agonist-antagonist analgesic of the phenanthrene series. Nalbuphine's analgesic potency is essentially equivalent to that of morphine on a milligram basis. The opioid antagonist activity of nalbuphine is one-fourth as potent as nalorphine and 10 times that of pentazocine. Nalbuphine by itself has potent opioid antagonist activity at doses equal to or lower than its analgesic dose. When administered following or concurrent with mu agonist opioid analgesics (e.g., morphine, oxymorphone, fentanyl), nalbuphine may partially reverse or block opioid-induced respiratory depression from the mu agonist analgesic. Nalbuphine may precipitate withdrawal in patients dependent on opioid drugs. Nalbuphine should be used with caution in patients who have been receiving mu opioid analgesics on a regular basis.
Mechanism of actionThe exact mechanism of action is unknown, but is believed to interact with an opiate receptor site in the CNS (probably in or associated with the limbic system). The opiate antagonistic effect may result from competitive inhibition at the opiate receptor, but may also be a result of other mechanisms. Nalbuphine is thought primarily to be a kappa agonist. It is also a partial mu antagonist analgesic, with some binding to the delta receptor and minimal agonist activity at the sigma receptor.
TargetKindPharmacological actionActionsOrganismUniProt ID
Kappa-type opioid receptorProteinyes
agonist
HumanP41145 details
Mu-type opioid receptorProteinyes
antagonist
HumanP35372 details
Delta-type opioid receptorProteinyes
antagonist
HumanP41143 details
Related Articles
AbsorptionThe mean absolute bioavailability was 81% and 83% for the 10 and 20 mg intramuscular doses, respectively, and 79% and 76% following 10 and 20 mg of subcutaneous nalbuphine.
Volume of distributionNot Available
Protein bindingNot appreciably bound.
MetabolismNot Available
Route of eliminationNot Available
Half lifeThe plasma half-life of nalbuphine is 5 hours, and in clinical studies the duration of analgesic activity has been reported to range from 3 to 6 hours.
ClearanceNot Available
ToxicityOral, acute LD50 is 1100 mg/kg in dog. Symptoms of overdose include primarily sleepiness and mild dysphoria.
Affected organisms
  • Humans and other mammals
Pathways
PathwayCategorySMPDB ID
Nalbuphine Action PathwayDrug actionSMP00691
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
Interactions
Drug Interactions
DrugInteractionDrug group
1,1,1,2 TetrafluoroethaneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with 1,1,1,2 Tetrafluoroethane.Investigational
2,5-Dimethoxy-4-ethylamphetamine2,5-Dimethoxy-4-ethylamphetamine may increase the analgesic activities of Nalbuphine.Experimental, Illicit
3,4-Methylenedioxyamphetamine3,4-Methylenedioxyamphetamine may increase the analgesic activities of Nalbuphine.Experimental, Illicit
3,4-Methylenedioxymethamphetamine3,4-Methylenedioxymethamphetamine may increase the analgesic activities of Nalbuphine.Experimental, Illicit
4-Bromo-2,5-dimethoxyamphetamine4-Bromo-2,5-dimethoxyamphetamine may increase the analgesic activities of Nalbuphine.Experimental, Illicit
7-NitroindazoleThe risk or severity of adverse effects can be increased when Nalbuphine is combined with 7-Nitroindazole.Experimental
AcepromazineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Acepromazine.Approved, Vet Approved
AceprometazineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Aceprometazine.Approved
AcetazolamideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Acetazolamide.Approved, Vet Approved
AclidiniumThe risk or severity of adverse effects can be increased when Aclidinium is combined with Nalbuphine.Approved
adipiplonThe risk or severity of adverse effects can be increased when Nalbuphine is combined with adipiplon.Investigational
AgomelatineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Agomelatine.Approved, Investigational
AlfaxaloneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Alfaxalone.Vet Approved
AlfentanilNalbuphine may decrease the analgesic activities of Alfentanil.Approved, Illicit
AlimemazineAlimemazine may increase the hypotensive activities of Nalbuphine.Approved, Vet Approved
AlphacetylmethadolNalbuphine may decrease the analgesic activities of Alphacetylmethadol.Experimental, Illicit
AlprazolamThe risk or severity of adverse effects can be increased when Alprazolam is combined with Nalbuphine.Approved, Illicit, Investigational
AlvimopanThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Alvimopan.Approved
AmilorideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Amiloride.Approved
AmisulprideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Amisulpride.Approved, Investigational
AmitriptylineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Amitriptyline.Approved
Ammonium chlorideAmmonium chloride may increase the excretion rate of Nalbuphine which could result in a lower serum level and potentially a reduction in efficacy.Approved, Vet Approved
AmobarbitalThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Amobarbital.Approved, Illicit
AmoxapineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Amoxapine.Approved
AmperozideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Amperozide.Experimental
AmphetamineAmphetamine may increase the analgesic activities of Nalbuphine.Approved, Illicit
Anisotropine MethylbromideThe risk or severity of adverse effects can be increased when Anisotropine Methylbromide is combined with Nalbuphine.Approved
AripiprazoleThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Aripiprazole.Approved, Investigational
ArticaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Articaine.Approved
AsenapineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Asenapine.Approved
Atracurium besylateThe risk or severity of adverse effects can be increased when Atracurium besylate is combined with Nalbuphine.Approved
AtropineThe risk or severity of adverse effects can be increased when Atropine is combined with Nalbuphine.Approved, Vet Approved
AzaperoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Azaperone.Vet Approved
AzelastineNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Azelastine.Approved
AzelastineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Azelastine.Approved
AzosemideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Azosemide.Investigational
BaclofenThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Baclofen.Approved
BarbitalThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Barbital.Illicit
BenactyzineThe risk or severity of adverse effects can be increased when Benactyzine is combined with Nalbuphine.Withdrawn
BendroflumethiazideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Bendroflumethiazide.Approved
BenperidolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Benperidol.Investigational
BenzatropineThe risk or severity of adverse effects can be increased when Benzatropine is combined with Nalbuphine.Approved
BenzocaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Benzocaine.Approved
BenzphetamineBenzphetamine may increase the analgesic activities of Nalbuphine.Approved, Illicit
Benzyl alcoholThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Benzyl alcohol.Approved
BezitramideNalbuphine may decrease the analgesic activities of Bezitramide.Experimental, Illicit, Withdrawn
BiperidenThe risk or severity of adverse effects can be increased when Biperiden is combined with Nalbuphine.Approved
BL-1020BL-1020 may increase the hypotensive activities of Nalbuphine.Investigational
BrexpiprazoleThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Brexpiprazole.Approved
BrimonidineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Brimonidine.Approved
BrimonidineBrimonidine may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved
BromazepamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Bromazepam.Approved, Illicit
BrompheniramineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Brompheniramine.Approved
BrotizolamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Brotizolam.Approved, Withdrawn
BumetanideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Bumetanide.Approved
BupivacaineThe risk or severity of adverse effects can be increased when Bupivacaine is combined with Nalbuphine.Approved, Investigational
BuprenorphineNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.Approved, Illicit, Investigational, Vet Approved
BuspironeThe risk or severity of adverse effects can be increased when Buspirone is combined with Nalbuphine.Approved, Investigational
ButabarbitalThe risk or severity of adverse effects can be increased when Butabarbital is combined with Nalbuphine.Approved, Illicit
ButacaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Butacaine.Vet Approved
ButalbitalThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Butalbital.Approved, Illicit
ButambenThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Butamben.Approved
ButethalThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Butethal.Approved, Illicit
ButorphanolButorphanol may decrease the analgesic activities of Nalbuphine.Approved, Illicit, Vet Approved
Canrenoic acidThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Canrenoic acid.Approved, Withdrawn
CanrenoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Canrenone.Investigational
CarbamazepineThe risk or severity of adverse effects can be increased when Carbamazepine is combined with Nalbuphine.Approved, Investigational
CarbinoxamineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Carbinoxamine.Approved
CarfentanilNalbuphine may decrease the analgesic activities of Carfentanil.Illicit, Vet Approved
CarisoprodolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Carisoprodol.Approved
CetirizineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Cetirizine.Approved
Chloral hydrateThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Chloral hydrate.Approved, Illicit, Vet Approved
ChlordiazepoxideThe risk or severity of adverse effects can be increased when Chlordiazepoxide is combined with Nalbuphine.Approved, Illicit
ChlormezanoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Chlormezanone.Approved, Withdrawn
ChloroprocaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Chloroprocaine.Approved
ChlorothiazideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Chlorothiazide.Approved, Vet Approved
ChlorphenamineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Chlorphenamine.Approved
ChlorphenoxamineThe risk or severity of adverse effects can be increased when Chlorphenoxamine is combined with Nalbuphine.Withdrawn
ChlorphentermineChlorphentermine may increase the analgesic activities of Nalbuphine.Illicit, Withdrawn
ChlorpromazineThe risk or severity of adverse effects can be increased when Chlorpromazine is combined with Nalbuphine.Approved, Vet Approved
ChlorprothixeneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Chlorprothixene.Approved, Withdrawn
ChlorthalidoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Chlorthalidone.Approved
ChlorzoxazoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Chlorzoxazone.Approved
CicletanineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Cicletanine.Investigational
CinchocaineThe risk or severity of adverse effects can be increased when Cinchocaine is combined with Nalbuphine.Approved, Vet Approved
CitalopramNalbuphine may increase the serotonergic activities of Citalopram.Approved
ClemastineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Clemastine.Approved
ClidiniumThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Clidinium.Approved
ClobazamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Clobazam.Approved, Illicit
clomethiazoleThe risk or severity of adverse effects can be increased when Nalbuphine is combined with clomethiazole.Investigational
ClomipramineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Clomipramine.Approved, Vet Approved
ClonazepamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Clonazepam.Approved, Illicit
ClonidineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Clonidine.Approved
ClorazepateThe risk or severity of adverse effects can be increased when Clorazepate is combined with Nalbuphine.Approved, Illicit
ClozapineThe risk or severity of adverse effects can be increased when Clozapine is combined with Nalbuphine.Approved
CocaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Cocaine.Approved, Illicit
CodeineNalbuphine may decrease the analgesic activities of Codeine.Approved, Illicit
ConivaptanThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Conivaptan.Approved, Investigational
CyclizineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Cyclizine.Approved
CyclobenzaprineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Cyclobenzaprine.Approved
CyclopentolateThe risk or severity of adverse effects can be increased when Cyclopentolate is combined with Nalbuphine.Approved
CyclothiazideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Cyclothiazide.Approved
CyproheptadineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Cyproheptadine.Approved
DantroleneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Dantrolene.Approved
DapiprazoleThe risk or severity of adverse effects can be increased when Dapiprazole is combined with Nalbuphine.Approved
DapoxetineNalbuphine may increase the serotonergic activities of Dapoxetine.Investigational
DarifenacinThe risk or severity of adverse effects can be increased when Darifenacin is combined with Nalbuphine.Approved, Investigational
deramciclaneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with deramciclane.Investigational
DesfluraneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Desflurane.Approved
DesipramineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Desipramine.Approved
DesloratadineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Desloratadine.Approved, Investigational
DesmopressinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Desmopressin.Approved
DesvenlafaxineNalbuphine may increase the serotonergic activities of Desvenlafaxine.Approved
DetomidineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Detomidine.Vet Approved
DexbrompheniramineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Dexbrompheniramine.Approved
DexetimideThe risk or severity of adverse effects can be increased when Dexetimide is combined with Nalbuphine.Withdrawn
DexmedetomidineThe risk or severity of adverse effects can be increased when Dexmedetomidine is combined with Nalbuphine.Approved, Vet Approved
DextroamphetamineDextroamphetamine may increase the analgesic activities of Nalbuphine.Approved, Illicit
DextromoramideNalbuphine may decrease the analgesic activities of Dextromoramide.Experimental, Illicit
DextropropoxypheneNalbuphine may decrease the analgesic activities of Dextropropoxyphene.Approved, Illicit, Withdrawn
DezocineNalbuphine may decrease the analgesic activities of Dezocine.Approved
DiazepamThe risk or severity of adverse effects can be increased when Diazepam is combined with Nalbuphine.Approved, Illicit, Vet Approved
DicyclomineThe risk or severity of adverse effects can be increased when Dicyclomine is combined with Nalbuphine.Approved
DiethylpropionDiethylpropion may increase the analgesic activities of Nalbuphine.Approved, Illicit
DifenoxinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Difenoxin.Approved, Illicit
DihydrocodeineNalbuphine may decrease the analgesic activities of Dihydrocodeine.Approved, Illicit
DihydroetorphineNalbuphine may decrease the analgesic activities of Dihydroetorphine.Experimental, Illicit
DihydromorphineNalbuphine may decrease the analgesic activities of Dihydromorphine.Experimental, Illicit
DimenhydrinateThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Dimenhydrinate.Approved
DiphenhydramineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Diphenhydramine.Approved
DiphenoxylateNalbuphine may decrease the analgesic activities of Diphenoxylate.Approved, Illicit
DoramectinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Doramectin.Vet Approved
DoxepinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Doxepin.Approved
DoxylamineDoxylamine may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved, Vet Approved
DPDPENalbuphine may decrease the analgesic activities of DPDPE.Investigational
DronabinolDronabinol may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved, Illicit
DroperidolDroperidol may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved, Vet Approved
DrospirenoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Drospirenone.Approved
DrotebanolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Drotebanol.Experimental, Illicit
DuloxetineNalbuphine may increase the serotonergic activities of Duloxetine.Approved
DyclonineThe risk or severity of adverse effects can be increased when Dyclonine is combined with Nalbuphine.Approved
EcgonineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ecgonine.Experimental, Illicit
ECGONINE METHYL ESTERThe risk or severity of adverse effects can be increased when Nalbuphine is combined with ECGONINE METHYL ESTER.Experimental
EcopipamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ecopipam.Investigational
EfavirenzThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Efavirenz.Approved, Investigational
EfonidipineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Efonidipine.Approved
EluxadolineNalbuphine may increase the constipating activities of Eluxadoline.Approved
EnfluraneThe risk or severity of adverse effects can be increased when Enflurane is combined with Nalbuphine.Approved, Vet Approved
EntacaponeThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Entacapone.Approved, Investigational
EplerenoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Eplerenone.Approved
EscitalopramNalbuphine may increase the serotonergic activities of Escitalopram.Approved, Investigational
EstazolamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Estazolam.Approved, Illicit
EszopicloneThe risk or severity of adverse effects can be increased when Eszopiclone is combined with Nalbuphine.Approved
Etacrynic acidThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Etacrynic acid.Approved
EthanolNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Ethanol.Approved
EthchlorvynolThe risk or severity of adverse effects can be increased when Ethchlorvynol is combined with Nalbuphine.Approved, Illicit, Withdrawn
EthopropazineThe risk or severity of adverse effects can be increased when Ethopropazine is combined with Nalbuphine.Approved
EthosuximideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ethosuximide.Approved
EthotoinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ethotoin.Approved
EthoxzolamideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ethoxzolamide.Withdrawn
Ethyl carbamateThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ethyl carbamate.Withdrawn
Ethyl loflazepateThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ethyl loflazepate.Approved, Illicit
EthylmorphineNalbuphine may decrease the analgesic activities of Ethylmorphine.Approved, Illicit
EtidocaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Etidocaine.Approved
EtifoxineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Etifoxine.Withdrawn
EtizolamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Etizolam.Approved
EtomidateThe risk or severity of adverse effects can be increased when Etomidate is combined with Nalbuphine.Approved
EtoperidoneNalbuphine may increase the serotonergic activities of Etoperidone.Approved
EtorphineNalbuphine may decrease the analgesic activities of Etorphine.Illicit, Vet Approved
EzogabineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ezogabine.Approved
FelbamateThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Felbamate.Approved
FencamfamineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Fencamfamine.Approved, Illicit, Withdrawn
FentanylNalbuphine may decrease the analgesic activities of Fentanyl.Approved, Illicit, Investigational, Vet Approved
FesoterodineThe risk or severity of adverse effects can be increased when Fesoterodine is combined with Nalbuphine.Approved
FexofenadineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Fexofenadine.Approved
FlibanserinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Flibanserin.Approved
FludiazepamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Fludiazepam.Approved, Illicit
FlunarizineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Flunarizine.Approved
FlunitrazepamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Flunitrazepam.Approved, Illicit
FluoxetineNalbuphine may increase the serotonergic activities of Fluoxetine.Approved, Vet Approved
FlupentixolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Flupentixol.Approved, Withdrawn
FluphenazineThe risk or severity of adverse effects can be increased when Fluphenazine is combined with Nalbuphine.Approved
FlurazepamThe risk or severity of adverse effects can be increased when Flurazepam is combined with Nalbuphine.Approved, Illicit
FluspirileneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Fluspirilene.Approved
Fluticasone PropionateThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Fluticasone Propionate.Approved
FluvoxamineThe risk or severity of adverse effects can be increased when Fluvoxamine is combined with Nalbuphine.Approved, Investigational
FosphenytoinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Fosphenytoin.Approved
FospropofolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Fospropofol.Approved, Illicit
FurosemideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Furosemide.Approved, Vet Approved
GabapentinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Gabapentin.Approved, Investigational
gabapentin enacarbilThe risk or severity of adverse effects can be increased when Nalbuphine is combined with gabapentin enacarbil.Approved
Gallamine TriethiodideThe risk or severity of adverse effects can be increased when Gallamine Triethiodide is combined with Nalbuphine.Approved
Gamma Hydroxybutyric AcidThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
GepironeThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Gepirone.Investigational
GlutethimideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Glutethimide.Approved, Illicit
GlycopyrroniumThe risk or severity of adverse effects can be increased when Glycopyrronium is combined with Nalbuphine.Approved, Investigational, Vet Approved
GuanfacineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Guanfacine.Approved, Investigational
HalazepamThe risk or severity of adverse effects can be increased when Halazepam is combined with Nalbuphine.Approved, Illicit, Withdrawn
HaloperidolThe risk or severity of adverse effects can be increased when Haloperidol is combined with Nalbuphine.Approved
HalothaneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Halothane.Approved, Vet Approved
HeroinNalbuphine may decrease the analgesic activities of Heroin.Approved, Illicit
HexamethoniumThe risk or severity of adverse effects can be increased when Hexamethonium is combined with Nalbuphine.Experimental
HexobarbitalThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Hexobarbital.Approved
HomatropineThe risk or severity of adverse effects can be increased when Homatropine is combined with Nalbuphine.Approved
HydrochlorothiazideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Hydrochlorothiazide.Approved, Vet Approved
HydrocodoneNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.Approved, Illicit
HydroflumethiazideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Hydroflumethiazide.Approved
HydromorphoneNalbuphine may decrease the analgesic activities of Hydromorphone.Approved, Illicit
Hydroxyamphetamine hydrobromideHydroxyamphetamine hydrobromide may increase the analgesic activities of Nalbuphine.Approved
HydroxyzineHydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved
HyoscyamineThe risk or severity of adverse effects can be increased when Hyoscyamine is combined with Nalbuphine.Approved
IloperidoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Iloperidone.Approved
ImipramineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Imipramine.Approved
IndalpineNalbuphine may increase the serotonergic activities of Indalpine.Investigational, Withdrawn
IndapamideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Indapamide.Approved
Ipratropium bromideThe risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Nalbuphine.Approved
IsofluraneThe risk or severity of adverse effects can be increased when Isoflurane is combined with Nalbuphine.Approved, Vet Approved
IsosorbideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Isosorbide.Approved
KetamineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ketamine.Approved, Vet Approved
KetazolamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ketazolam.Approved
KetobemidoneNalbuphine may decrease the analgesic activities of Ketobemidone.Approved
KW-3902The risk or severity of adverse effects can be increased when Nalbuphine is combined with KW-3902.Investigational
LamotrigineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Lamotrigine.Approved, Investigational
LevetiracetamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Levetiracetam.Approved, Investigational
LevobupivacaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Levobupivacaine.Approved
LevocabastineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Levocabastine.Approved
LevocetirizineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Levocetirizine.Approved
LevodopaThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Levodopa.Approved
Levomethadyl AcetateNalbuphine may decrease the analgesic activities of Levomethadyl Acetate.Approved
LevomilnacipranNalbuphine may increase the serotonergic activities of Levomilnacipran.Approved
LevorphanolNalbuphine may decrease the analgesic activities of Levorphanol.Approved
LidocaineThe risk or severity of adverse effects can be increased when Lidocaine is combined with Nalbuphine.Approved, Vet Approved
LisdexamfetamineLisdexamfetamine may increase the analgesic activities of Nalbuphine.Approved, Investigational
LithiumThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Lithium.Approved
LofentanilNalbuphine may decrease the analgesic activities of Lofentanil.Illicit
LoratadineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Loratadine.Approved
LorazepamThe risk or severity of adverse effects can be increased when Lorazepam is combined with Nalbuphine.Approved
LoxapineThe risk or severity of adverse effects can be increased when Loxapine is combined with Nalbuphine.Approved
Lu AA21004The risk or severity of adverse effects can be increased when Nalbuphine is combined with Lu AA21004.Investigational
LurasidoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Lurasidone.Approved
Magnesium SulfateMagnesium Sulfate may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved, Vet Approved
MannitolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Mannitol.Approved, Investigational
MaprotilineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Maprotiline.Approved
MecamylamineThe risk or severity of adverse effects can be increased when Mecamylamine is combined with Nalbuphine.Approved
MeclizineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Meclizine.Approved
MedetomidineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Medetomidine.Vet Approved
MelatoninThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Melatonin.Approved, Nutraceutical, Vet Approved
MelperoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Melperone.Approved
MephedroneMephedrone may increase the analgesic activities of Nalbuphine.Investigational
MephentermineMephentermine may increase the analgesic activities of Nalbuphine.Approved
MepivacaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Mepivacaine.Approved, Vet Approved
MeprobamateThe risk or severity of adverse effects can be increased when Meprobamate is combined with Nalbuphine.Approved, Illicit
MersalylThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Mersalyl.Approved
MesoridazineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Mesoridazine.Approved
MetaxaloneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Metaxalone.Approved
MethadoneNalbuphine may decrease the analgesic activities of Methadone.Approved
Methadyl AcetateNalbuphine may decrease the analgesic activities of Methadyl Acetate.Approved, Illicit
MethamphetamineMethamphetamine may increase the analgesic activities of Nalbuphine.Approved, Illicit
MethanthelineThe risk or severity of adverse effects can be increased when Methantheline is combined with Nalbuphine.Approved
MethapyrileneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Methapyrilene.Withdrawn
MethaqualoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Methaqualone.Illicit, Withdrawn
MethazolamideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Methazolamide.Approved
MethocarbamolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Methocarbamol.Approved, Vet Approved
MethohexitalThe risk or severity of adverse effects can be increased when Methohexital is combined with Nalbuphine.Approved
MethotrimeprazineNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.Approved
MethoxyfluraneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Methoxyflurane.Approved, Vet Approved
MethsuximideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Methsuximide.Approved
MethyclothiazideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Methyclothiazide.Approved
Methylene blueMethylene blue may increase the hypotensive activities of Nalbuphine.Investigational
MethylnaltrexoneThe risk or severity of adverse effects can be increased when Methylnaltrexone is combined with Nalbuphine.Approved
MethylphenobarbitalThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Methylphenobarbital.Approved
MetixeneThe risk or severity of adverse effects can be increased when Metixene is combined with Nalbuphine.Approved
MetolazoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Metolazone.Approved
MetyrosineNalbuphine may increase the sedative activities of Metyrosine.Approved
MidazolamThe risk or severity of adverse effects can be increased when Midazolam is combined with Nalbuphine.Approved, Illicit
MilnacipranNalbuphine may increase the serotonergic activities of Milnacipran.Approved
MinocyclineMinocycline may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved, Investigational
MirtazapineNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine.Approved
MMDAMMDA may increase the analgesic activities of Nalbuphine.Experimental, Illicit
MolindoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Molindone.Approved
MoricizineMoricizine may increase the hypotensive activities of Nalbuphine.Approved, Withdrawn
MorphineNalbuphine may decrease the analgesic activities of Morphine.Approved, Investigational
N-butylscopolammonium bromideThe risk or severity of adverse effects can be increased when N-butylscopolammonium bromide is combined with Nalbuphine.Vet Approved
NabiloneNabilone may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved, Investigational
NaloxegolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Naloxegol.Approved
NaltrexoneThe therapeutic efficacy of Nalbuphine can be decreased when used in combination with Naltrexone.Approved, Investigational, Vet Approved
NefazodoneNalbuphine may increase the serotonergic activities of Nefazodone.Approved, Withdrawn
NitrazepamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Nitrazepam.Approved
Nitrous oxideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Nitrous oxide.Approved, Vet Approved
NormethadoneNalbuphine may decrease the analgesic activities of Normethadone.Approved, Illicit
NortriptylineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Nortriptyline.Approved
NVA237The risk or severity of adverse effects can be increased when NVA237 is combined with Nalbuphine.Investigational
OlanzapineThe risk or severity of adverse effects can be increased when Olanzapine is combined with Nalbuphine.Approved, Investigational
OlopatadineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Olopatadine.Approved
OndansetronThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ondansetron.Approved
OpiumNalbuphine may decrease the analgesic activities of Opium.Approved, Illicit
OrphenadrineNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.Approved
OsanetantThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Osanetant.Investigational
OxazepamThe risk or severity of adverse effects can be increased when Oxazepam is combined with Nalbuphine.Approved
OxetacaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Oxetacaine.Investigational
OxprenololThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Oxprenolol.Approved
OxybuprocaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Oxybuprocaine.Approved
OxybutyninThe risk or severity of adverse effects can be increased when Oxybutynin is combined with Nalbuphine.Approved, Investigational
OxycodoneNalbuphine may decrease the analgesic activities of Oxycodone.Approved, Illicit, Investigational
OxymorphoneNalbuphine may decrease the analgesic activities of Oxymorphone.Approved, Investigational, Vet Approved
OxyphenoniumThe risk or severity of adverse effects can be increased when Oxyphenonium is combined with Nalbuphine.Approved
PaliperidoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Paliperidone.Approved
PancuroniumThe risk or severity of adverse effects can be increased when Pancuronium is combined with Nalbuphine.Approved
ParaldehydeNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.Approved
ParoxetineNalbuphine may increase the serotonergic activities of Paroxetine.Approved, Investigational
PegvisomantThe therapeutic efficacy of Pegvisomant can be decreased when used in combination with Nalbuphine.Approved
PentazocinePentazocine may decrease the analgesic activities of Nalbuphine.Approved, Vet Approved
PentobarbitalThe risk or severity of adverse effects can be increased when Pentobarbital is combined with Nalbuphine.Approved, Vet Approved
PentoliniumThe risk or severity of adverse effects can be increased when Pentolinium is combined with Nalbuphine.Approved
PerampanelPerampanel may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved
PerazineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Perazine.Investigational
PerospironeThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Perospirone.Approved
PerphenazineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Perphenazine.Approved
PethidineNalbuphine may decrease the analgesic activities of Pethidine.Approved
PhenobarbitalThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Phenobarbital.Approved
PhenoxyethanolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Phenoxyethanol.Approved
PhenterminePhentermine may increase the analgesic activities of Nalbuphine.Approved, Illicit
PhenytoinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Phenytoin.Approved, Vet Approved
PimozideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Pimozide.Approved
PipamperoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Pipamperone.Approved
PipecuroniumThe risk or severity of adverse effects can be increased when Pipecuronium is combined with Nalbuphine.Approved
PipotiazineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Pipotiazine.Approved
PirenzepineThe risk or severity of adverse effects can be increased when Pirenzepine is combined with Nalbuphine.Approved
PiretanideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Piretanide.Experimental
PiritramideNalbuphine may decrease the analgesic activities of Piritramide.Investigational
PizotifenThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Pizotifen.Approved
PolythiazideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Polythiazide.Approved
PomalidomideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Pomalidomide.Approved
PotassiumThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Potassium.Approved
Potassium CitrateThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Potassium Citrate.Approved, Vet Approved
PramipexoleNalbuphine may increase the sedative activities of Pramipexole.Approved, Investigational
PramocaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Pramocaine.Approved
PrazepamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Prazepam.Approved, Illicit
PregabalinThe risk or severity of adverse effects can be increased when Pregabalin is combined with Nalbuphine.Approved, Illicit, Investigational
PregnanoloneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Pregnanolone.Investigational
PrilocaineThe risk or severity of adverse effects can be increased when Prilocaine is combined with Nalbuphine.Approved
PrimidoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Primidone.Approved, Vet Approved
ProcaineThe risk or severity of adverse effects can be increased when Procaine is combined with Nalbuphine.Approved, Investigational, Vet Approved
ProchlorperazineThe risk or severity of adverse effects can be increased when Prochlorperazine is combined with Nalbuphine.Approved, Vet Approved
ProcyclidineThe risk or severity of adverse effects can be increased when Procyclidine is combined with Nalbuphine.Approved
PromazineThe risk or severity of adverse effects can be increased when Promazine is combined with Nalbuphine.Approved, Vet Approved
PromethazineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Promethazine.Approved
PropanthelineThe risk or severity of adverse effects can be increased when Propantheline is combined with Nalbuphine.Approved
ProparacaineThe risk or severity of adverse effects can be increased when Proparacaine is combined with Nalbuphine.Approved, Vet Approved
PropiopromazinePropiopromazine may increase the hypotensive activities of Nalbuphine.Vet Approved
PropiverineThe risk or severity of adverse effects can be increased when Propiverine is combined with Nalbuphine.Investigational
PropofolThe risk or severity of adverse effects can be increased when Propofol is combined with Nalbuphine.Approved, Investigational, Vet Approved
PropoxycaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Propoxycaine.Approved
ProtriptylineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Protriptyline.Approved
PSD502The risk or severity of adverse effects can be increased when Nalbuphine is combined with PSD502.Investigational
PseudoephedrinePseudoephedrine may increase the analgesic activities of Nalbuphine.Approved
QuazepamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Quazepam.Approved, Illicit
QuetiapineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Quetiapine.Approved
QuinethazoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Quinethazone.Approved
QuinidineThe risk or severity of adverse effects can be increased when Quinidine is combined with Nalbuphine.Approved
RacloprideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Raclopride.Investigational
RamelteonThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ramelteon.Approved, Investigational
RamosetronNalbuphine may increase the constipating activities of Ramosetron.Approved
RemifentanilNalbuphine may decrease the analgesic activities of Remifentanil.Approved
RemoxiprideThe risk or severity of adverse effects can be increased when Remoxipride is combined with Nalbuphine.Approved, Withdrawn
ReserpineThe risk or severity of adverse effects can be increased when Reserpine is combined with Nalbuphine.Approved
RisperidoneThe risk or severity of adverse effects can be increased when Risperidone is combined with Nalbuphine.Approved, Investigational
RitanserinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ritanserin.Investigational
RitobegronRitobegron may increase the analgesic activities of Nalbuphine.Investigational
RolofyllineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Rolofylline.Investigational
RomifidineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Romifidine.Vet Approved
RopiniroleNalbuphine may increase the sedative activities of Ropinirole.Approved, Investigational
RopivacaineThe risk or severity of adverse effects can be increased when Ropivacaine is combined with Nalbuphine.Approved
RotigotineNalbuphine may increase the sedative activities of Rotigotine.Approved
RufinamideThe risk or severity of adverse effects can be increased when Rufinamide is combined with Nalbuphine.Approved
S-EthylisothioureaThe risk or severity of adverse effects can be increased when Nalbuphine is combined with S-Ethylisothiourea.Experimental
Sage 547The risk or severity of adverse effects can be increased when Nalbuphine is combined with Sage 547.Investigational
ScopolamineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Scopolamine.Approved
Scopolamine butylbromideThe risk or severity of adverse effects can be increased when Scopolamine butylbromide is combined with Nalbuphine.Approved
SecobarbitalThe risk or severity of adverse effects can be increased when Secobarbital is combined with Nalbuphine.Approved, Vet Approved
SertindoleThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Sertindole.Approved, Withdrawn
SertralineNalbuphine may increase the serotonergic activities of Sertraline.Approved
SevofluraneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Sevoflurane.Approved, Vet Approved
Sodium oxybateSodium oxybate may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved
SolifenacinThe risk or severity of adverse effects can be increased when Solifenacin is combined with Nalbuphine.Approved
SpironolactoneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Spironolactone.Approved
StiripentolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Stiripentol.Approved
SuccinylcholineSuccinylcholine may increase the bradycardic activities of Nalbuphine.Approved
SufentanilNalbuphine may decrease the analgesic activities of Sufentanil.Approved, Investigational
SulpirideThe risk or severity of adverse effects can be increased when Sulpiride is combined with Nalbuphine.Approved
SuvorexantNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.Approved
TandospironeThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tandospirone.Investigational
TapentadolTapentadol may increase the central nervous system depressant (CNS depressant) activities of Nalbuphine.Approved
TasimelteonThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tasimelteon.Approved
TemazepamThe risk or severity of adverse effects can be increased when Temazepam is combined with Nalbuphine.Approved
TetrabenazineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tetrabenazine.Approved
TetracaineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tetracaine.Approved, Vet Approved
TetrodotoxinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tetrodotoxin.Investigational
ThalidomideNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.Approved, Investigational, Withdrawn
TheobromineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Theobromine.Approved
ThiamylalThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Thiamylal.Approved, Vet Approved
ThiethylperazineThiethylperazine may increase the hypotensive activities of Nalbuphine.Withdrawn
ThiopentalThe risk or severity of adverse effects can be increased when Thiopental is combined with Nalbuphine.Approved, Vet Approved
ThioridazineThe risk or severity of adverse effects can be increased when Thioridazine is combined with Nalbuphine.Approved
ThiothixeneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Thiothixene.Approved
TiagabineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tiagabine.Approved
TiaprideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tiapride.Investigational
TicrynafenThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ticrynafen.Withdrawn
TiletamineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tiletamine.Vet Approved
TiotropiumThe risk or severity of adverse effects can be increased when Tiotropium is combined with Nalbuphine.Approved
TizanidineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tizanidine.Approved
TolcaponeThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tolcapone.Approved, Withdrawn
TolterodineThe risk or severity of adverse effects can be increased when Tolterodine is combined with Nalbuphine.Approved, Investigational
TolvaptanThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tolvaptan.Approved
TopiramateThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Topiramate.Approved
TorasemideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Torasemide.Approved
TramadolNalbuphine may decrease the analgesic activities of Tramadol.Approved, Investigational
Trans-2-PhenylcyclopropylamineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Trans-2-Phenylcyclopropylamine.Experimental
TranylcypromineThe risk or severity of adverse effects can be increased when Tranylcypromine is combined with Nalbuphine.Approved
TrazodoneThe risk or severity of adverse effects can be increased when Trazodone is combined with Nalbuphine.Approved, Investigational
TriamtereneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Triamterene.Approved
TriazolamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Triazolam.Approved
TrichlormethiazideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Trichlormethiazide.Approved, Vet Approved
TrifluoperazineThe risk or severity of adverse effects can be increased when Trifluoperazine is combined with Nalbuphine.Approved
TriflupromazineThe risk or severity of adverse effects can be increased when Triflupromazine is combined with Nalbuphine.Approved, Vet Approved
TrihexyphenidylThe risk or severity of adverse effects can be increased when Trihexyphenidyl is combined with Nalbuphine.Approved
TrimethaphanThe risk or severity of adverse effects can be increased when Trimethaphan is combined with Nalbuphine.Approved
TrimipramineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Trimipramine.Approved
TriprolidineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Triprolidine.Approved
TropicamideThe risk or severity of adverse effects can be increased when Tropicamide is combined with Nalbuphine.Approved
TrospiumThe risk or severity of adverse effects can be increased when Trospium is combined with Nalbuphine.Approved
TubocurarineThe risk or severity of adverse effects can be increased when Tubocurarine is combined with Nalbuphine.Approved
Uc1010The risk or severity of adverse effects can be increased when Nalbuphine is combined with Uc1010.Investigational
UlaritideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ularitide.Investigational
UmeclidiniumThe risk or severity of adverse effects can be increased when Umeclidinium is combined with Nalbuphine.Approved
Valproic AcidThe risk or severity of adverse effects can be increased when Valproic Acid is combined with Nalbuphine.Approved, Investigational
VecuroniumThe risk or severity of adverse effects can be increased when Vecuronium is combined with Nalbuphine.Approved
VenlafaxineNalbuphine may increase the serotonergic activities of Venlafaxine.Approved
VigabatrinThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Vigabatrin.Approved
VortioxetineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Vortioxetine.Approved
XylazineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Xylazine.Vet Approved
ZaleplonThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Zaleplon.Approved, Illicit, Investigational
ZiconotideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ziconotide.Approved
ZimelidineNalbuphine may increase the serotonergic activities of Zimelidine.Withdrawn
ZiprasidoneThe risk or severity of adverse effects can be increased when Ziprasidone is combined with Nalbuphine.Approved
ZolazepamThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Zolazepam.Vet Approved
ZolpidemNalbuphine may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.Approved
ZonisamideThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Zonisamide.Approved, Investigational
ZopicloneThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Zopiclone.Approved
ZotepineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Zotepine.Approved
ZuclopenthixolThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Zuclopenthixol.Approved, Investigational
Food InteractionsNot Available
References
Synthesis Reference

Michael R. Magruder, “Nalbuphine-narcotic analgesic composition and method of producing analgesia.” U.S. Patent US4366159, issued August, 1981.

US4366159
General References
  1. Gear RW, Miaskowski C, Gordon NC, Paul SM, Heller PH, Levine JD: The kappa opioid nalbuphine produces gender- and dose-dependent analgesia and antianalgesia in patients with postoperative pain. Pain. 1999 Nov;83(2):339-45. [PubMed:10534607 ]
External Links
ATC CodesN02AF02
AHFS Codes
  • 28:08.12
PDB EntriesNot Available
FDA labelDownload (51.4 KB)
MSDSDownload (74.4 KB)
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.968
Blood Brain Barrier+0.9642
Caco-2 permeable+0.7337
P-glycoprotein substrateSubstrate0.8532
P-glycoprotein inhibitor INon-inhibitor0.8781
P-glycoprotein inhibitor IINon-inhibitor0.8923
Renal organic cation transporterInhibitor0.5431
CYP450 2C9 substrateNon-substrate0.8645
CYP450 2D6 substrateSubstrate0.5896
CYP450 3A4 substrateSubstrate0.5919
CYP450 1A2 substrateNon-inhibitor0.9046
CYP450 2C9 inhibitorNon-inhibitor0.9421
CYP450 2D6 inhibitorNon-inhibitor0.9231
CYP450 2C19 inhibitorNon-inhibitor0.9029
CYP450 3A4 inhibitorNon-inhibitor0.93
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9562
Ames testNon AMES toxic0.6897
CarcinogenicityNon-carcinogens0.9598
BiodegradationNot ready biodegradable0.9796
Rat acute toxicity2.6502 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.747
hERG inhibition (predictor II)Non-inhibitor0.8054
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
ManufacturersNot Available
Packagers
Dosage forms
FormRouteStrength
Injection, solutionIntramuscular; Intravenous; Subcutaneous10 mg/mL
Injection, solutionIntramuscular; Intravenous; Subcutaneous20 mg/mL
SolutionIntramuscular; Intravenous; Subcutaneous10 mg
SolutionIntramuscular; Intravenous; Subcutaneous20 mg
Prices
Unit descriptionCostUnit
Nubain 20 mg/ml ampule4.9USD ml
Nubain 10 mg/ml vial3.53USD ml
Nalbuphine 20 mg/ml ampul3.2USD ml
Nalbuphine 200 mg/10 ml vial2.66USD ml
Nalbuphine 10 mg/ml ampul1.46USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
PatentsNot Available
Properties
StateSolid
Experimental Properties
PropertyValueSource
melting point230 °C as HCl saltNot Available
water solubility35.5 mg/mL at 25 °C as HCl saltNot Available
logP1.4Not Available
pKa8.71 and 9.96 (hcl form)FDA Label
Predicted Properties
PropertyValueSource
Water Solubility2.09 mg/mLALOGPS
logP2ALOGPS
logP1.19ChemAxon
logS-2.2ALOGPS
pKa (Strongest Acidic)7.45ChemAxon
pKa (Strongest Basic)13.75ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count5ChemAxon
Hydrogen Donor Count3ChemAxon
Polar Surface Area73.16 Å2ChemAxon
Rotatable Bond Count2ChemAxon
Refractivity97 m3·mol-1ChemAxon
Polarizability38.59 Å3ChemAxon
Number of Rings6ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
Spectra
Spectrum TypeDescriptionSplash Key
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, NegativeNot Available
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as morphinans. These are polycyclic compounds with a four-ring skeleton with three condensed six-member rings forming a partially hydrogenated phenanthrene moiety, one of which is aromatic while the two others are alicyclic.
KingdomOrganic compounds
Super ClassAlkaloids and derivatives
ClassMorphinans
Sub ClassNot Available
Direct ParentMorphinans
Alternative Parents
Substituents
  • Morphinan
  • Benzylisoquinoline
  • Phenanthrene
  • Tetralin
  • Benzofuran
  • Aralkylamine
  • Alkyl aryl ether
  • Benzenoid
  • Piperidine
  • Tertiary alcohol
  • Cyclic alcohol
  • Tertiary aliphatic amine
  • Tertiary amine
  • Secondary alcohol
  • Polyol
  • 1,2-aminoalcohol
  • Oxacycle
  • Azacycle
  • Organoheterocyclic compound
  • Ether
  • Hydrocarbon derivative
  • Organooxygen compound
  • Organonitrogen compound
  • Amine
  • Alcohol
  • Aromatic heteropolycyclic compound
Molecular FrameworkAromatic heteropolycyclic compounds
External Descriptors

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
agonist
General Function:
Opioid receptor activity
Specific Function:
G-protein coupled opioid receptor that functions as receptor for endogenous alpha-neoendorphins and dynorphins, but has low affinity for beta-endorphins. Also functions as receptor for various synthetic opioids and for the psychoactive diterpene salvinorin A. Ligand binding causes a conformation change that triggers signaling via guanine nucleotide-binding proteins (G proteins) and modulates th...
Gene Name:
OPRK1
Uniprot ID:
P41145
Molecular Weight:
42644.665 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284 ]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423 ]
  3. Hoehe M, Duka T: Opiates increase plasma catecholamines in humans. Psychoneuroendocrinology. 1993;18(2):141-8. [PubMed:8388112 ]
  4. Chen SL, Huang EY, Chow LH, Tao PL: Dextromethorphan differentially affects opioid antinociception in rats. Br J Pharmacol. 2005 Feb;144(3):400-4. [PubMed:15655510 ]
  5. Tao PL, Liang KW, Sung WY, Wu YT, Huang EY: Nalbuphine is effective in decreasing the rewarding effect induced by morphine in rats. Drug Alcohol Depend. 2006 Sep 15;84(2):175-81. Epub 2006 Mar 6. [PubMed:16517095 ]
  6. Smith MA, Greene-Naples JL, Lyle MA, Iordanou JC, Felder JN: The effects of repeated opioid administration on locomotor activity: I. Opposing actions of mu and kappa receptors. J Pharmacol Exp Ther. 2009 Aug;330(2):468-75. doi: 10.1124/jpet.108.150011. Epub 2009 Apr 29. [PubMed:19403853 ]
  7. Mello NK, Mendelson JH, Sholar MB, Jaszyna-Gasior M, Goletiani N, Siegel AJ: Effects of the mixed mu/kappa opioid nalbuphine on cocaine-induced changes in subjective and cardiovascular responses in men. Neuropsychopharmacology. 2005 Mar;30(3):618-32. [PubMed:15602503 ]
  8. Gear RW, Miaskowski C, Gordon NC, Paul SM, Heller PH, Levine JD: The kappa opioid nalbuphine produces gender- and dose-dependent analgesia and antianalgesia in patients with postoperative pain. Pain. 1999 Nov;83(2):339-45. [PubMed:10534607 ]
  9. Peng X, Knapp BI, Bidlack JM, Neumeyer JL: Pharmacological properties of bivalent ligands containing butorphan linked to nalbuphine, naltrexone, and naloxone at mu, delta, and kappa opioid receptors. J Med Chem. 2007 May 3;50(9):2254-8. Epub 2007 Apr 4. [PubMed:17407276 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Voltage-gated calcium channel activity
Specific Function:
Receptor for endogenous opioids such as beta-endorphin and endomorphin. Receptor for natural and synthetic opioids including morphine, heroin, DAMGO, fentanyl, etorphine, buprenorphin and methadone. Agonist binding to the receptor induces coupling to an inactive GDP-bound heterotrimeric G-protein complex and subsequent exchange of GDP for GTP in the G-protein alpha subunit leading to dissociati...
Gene Name:
OPRM1
Uniprot ID:
P35372
Molecular Weight:
44778.855 Da
References
  1. Kishioka S, Ko MC, Woods JH: Diltiazem enhances the analgesic but not the respiratory depressant effects of morphine in rhesus monkeys. Eur J Pharmacol. 2000 May 26;397(1):85-92. [PubMed:10844102 ]
  2. Hoehe M, Duka T: Opiates increase plasma catecholamines in humans. Psychoneuroendocrinology. 1993;18(2):141-8. [PubMed:8388112 ]
  3. Zernig G, Lewis JW, Woods JH: Clocinnamox inhibits the intravenous self-administration of opioid agonists in rhesus monkeys: comparison with effects on opioid agonist-mediated antinociception. Psychopharmacology (Berl). 1997 Feb;129(3):233-42. [PubMed:9084061 ]
  4. Picker MJ: Discriminative stimulus effects of the mixed-opioid agonist/antagonist dezocine: cross-substitution by mu and delta opioid agonists. J Pharmacol Exp Ther. 1997 Dec;283(3):1009-17. [PubMed:9399970 ]
  5. McNicol ED, Boyce D, Schumann R, Carr DB: Mu-opioid antagonists for opioid-induced bowel dysfunction. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006332. doi: 10.1002/14651858.CD006332.pub2. [PubMed:18425947 ]
  6. Tao PL, Liang KW, Sung WY, Wu YT, Huang EY: Nalbuphine is effective in decreasing the rewarding effect induced by morphine in rats. Drug Alcohol Depend. 2006 Sep 15;84(2):175-81. Epub 2006 Mar 6. [PubMed:16517095 ]
  7. Smith MA, Greene-Naples JL, Lyle MA, Iordanou JC, Felder JN: The effects of repeated opioid administration on locomotor activity: I. Opposing actions of mu and kappa receptors. J Pharmacol Exp Ther. 2009 Aug;330(2):468-75. doi: 10.1124/jpet.108.150011. Epub 2009 Apr 29. [PubMed:19403853 ]
  8. Mello NK, Mendelson JH, Sholar MB, Jaszyna-Gasior M, Goletiani N, Siegel AJ: Effects of the mixed mu/kappa opioid nalbuphine on cocaine-induced changes in subjective and cardiovascular responses in men. Neuropsychopharmacology. 2005 Mar;30(3):618-32. [PubMed:15602503 ]
  9. Meerpohl JJ, Timmer A: [News from the cochrane library: mu opioid antagonists for opioid-induced bowel dysfunction]. Z Gastroenterol. 2008 Sep;46(9):917-21. doi: 10.1055/s-2008-1027720. Epub 2008 Sep 22. [PubMed:18810678 ]
  10. Peng X, Knapp BI, Bidlack JM, Neumeyer JL: Pharmacological properties of bivalent ligands containing butorphan linked to nalbuphine, naltrexone, and naloxone at mu, delta, and kappa opioid receptors. J Med Chem. 2007 May 3;50(9):2254-8. Epub 2007 Apr 4. [PubMed:17407276 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Opioid receptor activity
Specific Function:
G-protein coupled receptor that functions as receptor for endogenous enkephalins and for a subset of other opioids. Ligand binding causes a conformation change that triggers signaling via guanine nucleotide-binding proteins (G proteins) and modulates the activity of down-stream effectors, such as adenylate cyclase. Signaling leads to the inhibition of adenylate cyclase activity. Inhibits neurot...
Gene Name:
OPRD1
Uniprot ID:
P41143
Molecular Weight:
40368.235 Da
References
  1. Chen JC, Smith ER, Cahill M, Cohen R, Fishman JB: The opioid receptor binding of dezocine, morphine, fentanyl, butorphanol and nalbuphine. Life Sci. 1993;52(4):389-96. [PubMed:8093631 ]
  2. De Souza EB, Schmidt WK, Kuhar MJ: Nalbuphine: an autoradiographic opioid receptor binding profile in the central nervous system of an agonist/antagonist analgesic. J Pharmacol Exp Ther. 1988 Jan;244(1):391-402. [PubMed:2826773 ]
  3. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]
Comments
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Drug created on June 13, 2005 07:24 / Updated on August 17, 2016 12:23