Nalbuphine: Core Facts and Practical Uses
DOI:
https://doi.org/10.31584/psumj.2025279804Keywords:
kappa-opioid agonist, mu-opioid antagonist, nalbuphine, opioids, pain managementAbstract
Nalbuphine is a synthetic opioid with a unique mechanism of action, acting as an agonist at kappa-opioid receptors and an antagonist at mu-opioid receptors. This dual activity underpins its ability to provide effective pain relief, while reducing the likelihood of side effects typically associated with mu-opioid receptor stimulation. This review outlines the pharmacological properties, therapeutic uses, effectiveness, safety profile and potential benefits of nalbuphine in various clinical scenarios. Compared to morphine, nalbuphine offers similar levels of analgesia, but with a reduced risk of respiratory depression, itching, nausea and vomiting. It has demonstrated utility in managing perioperative pain, preventing and treating opioid-induced pruritus, and serving as an adjunct in both regional and neuraxial anesthesia. Nevertheless, its application in pediatric, and obstetric settings is debated due to a lack of comprehensive safety data. Additionally, in individuals with opioid dependence, nalbuphine should be used with care, as it may trigger withdrawal symptoms.
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