Kinz injection

Generic:

Nalbuphine HCL

Available dosage form:

IV 10mg/20mg

Therapeutic class:

Morphinian derivative opioid analgesic.

Pharmacological class:

KAPPA acquired receptor agonist.

MU acquired receptor antagonist.

Mechanism of action:

Nalbuphine is a phenanthrine derivative with mixed opioid agonist and antagonist activity (agonist at kappa opiate receptors and partial antagonist at mu receptors in the CNS.

It inhibits the ascending pain pathways and alters the perception of and response to the pain. Additionally, it causes generalized CNS depression.

Manufacturer:

SAMI pharmaceuticals (Pvt) Ltd.

Storage:

15-30 degree celsius.

Prescription drug?

Yes

Indications and dosages:

Adult

• Pain:

  a) Non-opioid tolerant patient:

  10-20 mg/70Kg IV/IM/SC q3-2hrs PRN; individual do not exceed 20 mg.

  
  

  b)Opioid dependant patient:

  1/4th dose, and observe for withdrawal signs. Not exceeding 160mg/day.

  
  

• Anaesthesia supplement:

  0.3-3 mg/Kg IV over 10-15 min, then 0.25-0.5 mg/kg PRN.

  
  

• Opioid-induced pruritis (Off-label)

Paeds:

• Pain:

<1yr= safety and efficacy not established

>1yr= 0.1+0.2+mg/kg IV/IM/SC every 3-2 hrs PRN; individual dose doesn't exceed 20 mg; not to exceed 160 mg/day

Side effects:

• Pulmonary edema

• Agitation

• Reactions at the injection site such as vein swelling, burning, and hot sensations

• If >10%, sedation occurs, 1-10%, clamminess occurs.

• Nausea and vomiting

• Dizziness

• Xerostomia

• Headache

• <1%= asthma, bradycardia, burning, dyspnea, hypertension,

• pulmonary edema

• Hypoglycaemia (post-marketing complaint)

  
  

  Interactions (serious):

• Alvimopan

• Olanzapine/semidorphan

• Alfentanil

• Benzhydrocodon/acetaminophen

• Buprenorphine

• Cimetidine

• Clonidine

• Butrophenol

• Codeine

• Desvenlafaxine

• Hydrocodone

• Isocarboxazid

• Linezolid

• Loratadine

• Benzodiazepine

• Alprazolam

• Albuterol

• Amphetamine

• Amitriptyline

• Clonazepam

• Clomipramine

• Desloratadine

• Dopamine

• Ephedrine

• Haloperidol

• Lorazepam

• Melatonin

• Metazolam

• Morphine

• Phenobarbital

• Topiramate

Pregnancy/lactation

Not accepted

Cautions:

Do not administer, if the ampoule has cloudiness/ un-dissolved particles/ leaking.