Nalbuphine is an opioid pain medication that is used to treat moderate to severe pain. It is also used for treating pain just after surgery or childbirth.

Nalbuphine may also be used for purposes not listed in this medication guide.

You should not be treated with nalbuphine if you are allergic to it, or if you have:

• severe asthma or breathing problems; or
• a stomach or bowel obstruction (including paralytic ileus).

Your dose needs may be different if you are already using an opioid medicine and are tolerant to it. Tell your doctor about all other pain medicines you have recently used.

Tell your doctor if you have ever had:

• breathing problems, sleep apnea;
• problems with your gallbladder, pancreas, or adrenal gland;
• a head injury, brain tumor, or seizures;
• alcoholism or drug addiction;
• liver or kidney disease; or
• a slow heart rate, or a heart attack.

Unless you are given nalbuphine during labor or delivery, tell your doctor if you are pregnant before you are treated with this medicine.

Although nalbuphine is sometimes used during childbirth, receiving this medicine during labor may cause side effects in the newborn baby, including slow heartbeats and breathing problems. Your baby's breathing, blood pressure, oxygen levels, and other vital signs will be watched closely.

Ask a doctor before using opioid medicine if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

Use Nubain (Injectable) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Tell your caregiver right away if you have:

• shallow breathing, breathing that stops during sleep;
• a light-headed feeling, like you might pass out;
• severe drowsiness;
• severe constipation;
• low cortisol levels--nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness; or
• high levels of serotonin in the body--agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea.

Serious breathing problems may be more likely in older adults and those who are debilitated or have wasting syndrome or chronic breathing disorders.

Common side effects may include:

• drowsiness;
• dizziness, spinning sensation;
• dry mouth;
• headache;
• sweating;
• cold, clammy skin; or
• nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.