Nalbufin

Nalbufin – the anesthetizing opioid medicine.

Form of release and structure

Nalbufin is issued in the form of solution for injections: colourless or slightly painted, transparent or poorly opalescent (on 1 ml in glass ampoules, on 5 or 10 ampoules in a cardboard pack).

Is a part of 1 ml of injection solution:

• Active ingredient: a hydrochloride of a nalbufin (in the form of a dihydrate) – 10 or 20 mg;
• Auxiliary components: anhydrous citric acid, dihydrate sodium citrate, sodium chloride, water of a plant louse of injections.

Indications to use

• The expressed pain syndrome of various etiology, including a myocardial infarction, and also pains connected with malignant new growths, carrying out gynecologic interventions, which developed in the postoperative period;
• The general anesthesia (as additional medicine).

Contraindications

Absolute:

• Intracranial hypertensia;
• Acute alcoholic poisonings, alcoholic psychosis;
• Head injuries;
• Epileptic syndrome;
• The expressed oppression of the central nervous system and breath;
• Diseases of abdominal organs in an acute current (Nalbufin's introduction perhaps after diagnosis);
• Medicinal dependence to Promedolum, morphine, fentanyl and other morfinopodobny medicines (because of high probability of emergence of a withdrawal);
• Operative measures on a liver, a gall bladder, intra hepatic and extrahepatic bilious channels (gepatobiliarny system);
• Hypersensitivity to drug components.

Relative (Nalbufin it is necessary to apply with care in the presence of the following states / diseases):

• Renal and/or liver failure;
• Cachexia;
• Respiratory insufficiency (including connected with uraemia, chronic obstructive pulmonary diseases);
• Premature births and estimated immaturity of a fruit;
• Pregnancy and period of breastfeeding;
• Children's (up to 18 years) and advanced age.

Route of administration and dosage

Nalbufin's solution depending on indications is entered intramusculary or intravenously (preliminary cultivation by isotonic solution of sodium chloride is necessary).

The mode of dosing is defined by the doctor individually depending on portability of drug, expressiveness of a pain syndrome, features of the patient.

The recommended adult dose at a pain syndrome – 0,15-0,3 mg/kg. Between introductions of single doses of drug it is necessary to observe a break not less than 4 hours. The maximum doses of Nalbufin make: daily – 2,4 mg/kg, one-time – 0,3 mg/kg. Duration of use should not exceed 3 days.

At suspicion of a myocardial infarction once enter 20 mg of injection solution intravenously slowly (if necessary possibly increase in a dose up to 30 mg). In the absence of positive dynamics in 30 minutes it is possible to enter one more single dose.

Nalbufin's dose for premedication – 0,1-0,2 mg/kg. For introduction to an anesthesia solution appoint in a dose 0,3-1 mg/kg, then (for maintenance of an anesthesia) – each 30 minutes on 0,25-0,5 mg/kg.

At patients with opiate addiction cancellation symptoms which are stopped by morphine can develop. If before Nalbufin's use the patient received morphine, codeine or other opioid anesthetizing drugs, appoint 25% of a standard dose.

The doctor having experience with Nalbufin has to carry out therapy. It is necessary to provide existence of means for overdose treatment, including Naloxonum, and also the equipment for carrying out artificial ventilation of the lungs and an intubation.

Side effects

• Nervous system: drowsiness, dizziness, confusion of consciousness, slackness, headache, excitement, euphoria or depression;
• Cardiovascular system: change (decrease or increase) of arterial pressure, takhi-or bradycardia;
• Respiratory system: reduction of minute volume of breath;
• Alimentary system: vomiting, nausea, dyspepsia, dryness in a mouth, spastic pains;
• Allergic reactions: urticaria, throat hypostasis, itch, sneezing;
• Others: sweating strengthening, morbidity in an injection site of injection solution, a withdrawal (it is shown as weakness, spastic abdominal pains, dacryagogue, vomiting, nausea, a rhinorrhea, fervescence, feeling of alarm).

Special instructions

It is not necessary to exceed the doses recommended in the instruction as it can lead to development of physical dependence.

Ambulatory patients for the period of therapy need to abstain from control of motor transport and performance of potentially dangerous types of the works demanding bystry psychomotor reactions and special attention.

Medicinal interaction

At the same time with anesthetics, anxiolytics, antidepressants, hypnotic drugs and antipsychotic drugs Nalbufin it is necessary to apply under strict medical control (at use of similar combinations dose adjustment can be required).

At the same time it is impossible to appoint Nalbufin with alcohol and other opioid anesthetizing medicines.

At combined use with penicillin and derivatives of a fenotiazin the risk of development of dispepsichesky disturbances in the form of vomiting and nausea increases.

Terms and storage conditions

To store in protected from light, the place, unavailable to children, at a temperature of 15-30 °C.

Period of validity – 2 years.