Nalbuphine
Opioid analgesic / From Wikipedia, the free encyclopedia
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Nalbuphine, sold under the brand names Nubain among others, is an opioid analgesic which is used in the treatment of pain.[5][8][6] It is given by injection into a vein, muscle, or fat.[5][6]
This article includes a list of general references, but it lacks sufficient corresponding inline citations. (December 2014) |
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Trade names | Nubain, Nalpain, Nalbuphin, others |
Other names | EN-2234A; N-Cyclobutylmethyl-14-hydroxydihydronormorphine; 17-Cyclobutylmethyl-4,5α-epoxymorphinan-3,6α,14-triol; N-Cyclobutylmethyl-4,5α-epoxy-3,6α,14-morphinantriol |
AHFS/Drugs.com | Monograph |
MedlinePlus | a682668 |
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Routes of administration | Intravenous, intramuscular, subcutaneous |
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Bioavailability | • Oral: 11% (young adults), >44% (elderly)[2] • IMTooltip Intramuscular injection: 81% (10 mg), 83% (20 mg) • SCTooltip Subcutaneous injection: 76% (20 mg), 79% (10 mg)[3] |
Protein binding | 50%[2] |
Metabolism | Liver (glucuronidation)[4][2] |
Metabolites | Glucuronide conjugates (inactive), others[5][4][2] |
Onset of action | • Oral: <1 hour[2] • Rectal: <30 minutes[2] • IVTooltip Intravenous injection: 2–3 minutes[6] • IMTooltip Intramuscular injection: <15 minutes[6] • SCTooltip Subcutaneous injection: <15 minutes[6] |
Elimination half-life | ~5 hours (3–6 hours)<[5] |
Duration of action | 3–6 hours[6] |
Excretion | Urine, bile, feces;[2] 93% within 6 hours[7] |
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ECHA InfoCard | 100.039.895 |
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Formula | C21H27NO4 |
Molar mass | 357.450 g·mol−1 |
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Side effects of nalbuphine include sedation, sweatiness, clamminess, nausea, vomiting, dizziness, vertigo, dry mouth, and headache.[8] Unlike other opioids, it has little to no capacity to cause euphoria or respiratory depression.[5][8] There is also little to no incidence of dysphoria, dissociation, hallucinations, and related side effects at typical therapeutic doses.[5][8] Nalbuphine is a mixed agonist/antagonist opioid modulator.[5][8] Specifically, it acts as a moderate-efficacy partial agonist or antagonist of the μ-opioid receptor (MOR) and as a high-efficacy partial agonist of the κ-opioid receptor (KOR), whereas it has relatively low affinity for the δ-opioid receptor (DOR) and sigma receptors.[9][8]
Nalbuphine was patented in 1963[10] and was introduced for medical use in the United States in 1979.[11][12] It is marketed in many countries throughout the world.[13]