Nabulex - Injection Nalbuphine Hydrochloride - 20mg/2ml 1 Injection(s) / Injection General Pharmaceuticals Ltd. Introduction: Nabulex is a pain relieving medicine. It is used to treat moderate to severe pain. It is also used as a premedication before surgery. This medicine is generally used when alternative medicines are ineffective or inadequate. Nabulex is generally administered by a healthcare professional. You should not self-administer this medicine at home. The dose and duration will depend on what you are taking it for and how well it helps your symptoms. The most common side effects of this medicine include injection site reactions (such as pain, redness, and swelling), nausea, vomiting, sweating a lot, and tiredness. If any of... Uses of Nabulex: Moderate to severe pain Side effects of Nabulex: HeadacheDizzinessSleepinessVomitingNauseaConstipation How to use Nabulex: Your doctor or nurse will give you this medicine. Kindly do not self administer. How Nabulex works: Nabulex is an opioid analgesic (pain reliever) which works by blocking transmission of pain signals to the brain to lower pain perception. What if you forget to take Nabulex?: If you miss a dose of Nabulex, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose. Indication: Moderate to severe pain, Pain associated with MI, Balanced anaesthesia Administration: IV Administration Administer each 10 mg by IV push over 3-5 minutes Adult Dose: Parenteral Moderate to severe pain Adult: IM/IV/SC: 10-20 mg 3-6 hrly as required. Non-opioid-tolerant patients: Max single dose: 20 mg. Max daily dose: 160 mg. Intravenous Adjunct in balanced anaesthesia Adult: Induction: 0.3-3 mg/kg over 10-15 min. Maintenance: 0.25-0.5 mg/kg as single admin if required. Hepatic impairment: Caution; dose reduction may be necessary; monitor Child Dose: Pain <1 year: Safety and efficacy not established >1 year: 0.1-0.2 mg/kg IV/IM/SC q3-4hr PRN; individual dose not to exceed 20 mg; not to exceed 160 mg/day Renal Dose: Renal impairment: Caution; dose reduction may be necessary; monitor Contraindication: Hypersensitivity. Absolute: Diarrhea associated with toxins, pseudomembranous colitis, respiratory depression (<12 beats/min) Acute asthma, bradycardia, inflammatory bowel disease, respiratory impairment Mode of Action: Nalbuphine is a phenanthrene derivative opioid analgesic with mixed opioid agonist and antagonist activity. It inhibits the ascending pain pathways, altering the perception of and response to pain by binding to opiate receptors in the CNS. It also produces generalised CNS depression. Precaution: May impair ability to drive or operate machinery. Emotionally unstable patients or patients with history of opiate abuse; closely monitor these patients during long-term therapy. Impaired respiration due to other drugs, uraemia, bronchial asthma, severe infection, cyanosis, respiratory obstruction. MI patients who exhibit nausea and vomiting and in those about to undergo biliary tract surgery. Head injury, intracranial lesions or pre-existing increased intracranial pressure. Renal or hepatic impairment. Elderly and debilitated patients. Pregnancy and lactation. Lactation: Insignificant amount distributed in milk; use with caution Side Effect: >10% Sedation (36%) 1-10% Clamminess (9%),Nausea and vomiting (6%),Dizziness (5%),Xerostomia (4%),Headache (3%) <1% Asthma,Bradycardia,Burning,Dyspnea,Hypertension,Hypotension,Itching,Miosis,Pulmonary edema,Respiratory depression,Tachycardia,Urticaria,Vertigo Potentially Fatal: Anaphylactic or anaphylactoid and other serious hypersensitivity reactions e.g. shock, respiratory distress, respiratory arrest, bradycardia, cardiac arrest, hypotension, laryngeal oedema. Pregnancy Category Note: Pregnancy category: B; D if used for prolonged periods or near term Interaction: Additive CNS depressant effects may occur with other CNS depressants e.g. alcohol, anaesthetics, anxiolytics, hypnotics, TCAs and antipsychotics.