Nalbuphine 313blood levels of a hormone called cortisol. In the 1990s nalbuphine was popular
among bodybuilders using anabolic steroids. These individuals mainly used
nalbuphine to reduce pain caused by exercise regimens. Interviews with such
users revealed that many were suffering unwanted physical and mental effects
from nalbuphine and that many of these persons were abusing other drugs
as well. A case report tells of illicit nalbuphine injection causing muscle dam-
age—the opposite of what bodybuilders seek.
In low amounts nalbuphine can produce morphine effects. High doses tend
to make users feel nervous and uncomfortable, however, reducing nalbu-
phine’s attractiveness for illicit recreational use. At those higher dosage levels
people can experience vision trouble, sleep disturbance, weird dreams, and
thoughts running out of control. The drug is generally considered to have a
low potential for abuse, lower thanpropoxypheneorcodeine. Some research-
ers, however, describe the abuse liability as about equivalent topentazocine,
a drug with a notorious reputation for illicit misuse and that has effects similar
to those of nalbuphine. Tolerance and dependence may develop if a person
uses nalbuphine in amounts higher than normal medical doses. Withdrawal
symptoms are described as those of mild opiate withdrawal.
Drug interactions.Not enough scientific information to report.
Cancer.Standard laboratory tests do not indicate the drug has potential for
causing cancer. Long-term experiments with rats and mice have failed to pro-
duce cancer.
Pregnancy.Animal research using nalbuphine at high doses has not pro-
duced birth defects attributable to the drug. It passes from a pregnant woman
into the fetus and can build up there; one study found that newborn levels
could be six times higher than maternal levels. Due to effects on the newborn’s
heartbeat and breathing, controversy exists about the drug’s appropriateness
for easing pain of childbirth. Some researchers believe the substance is risky
during childbirth; some believe nalbuphine is safer than combinations of other
drugs. Nalbuphine passes into milk of nursing mothers but is not believed to
harm breast-feeding infants.
Additional scientific information may be found in:
Jasinski, D.R., and P.A. Mansky. “Evaluation of Nalbuphine for Abuse Potential.”Clin-
ical Pharmacology and Therapeutics13 (January–February 1972): 78–90.
Miller, R.R. “Evaluation of Nalbuphine Hydrochloride.”American Journal of Hospital
Pharmacy37 (1980): 942–49.
Saarialho-Kere, U. “Psychomotor, Respiratory and Neuroendocrinological Effects of
Nalbuphine and Haloperidol, Alone and in Combination, in Healthy Subjects.”
British Journal of Clinical Pharmacology26 (1988): 79–87.
Schmidt, W.K., et al. “Nalbuphine.”Drug and Alcohol Dependence14 (1985): 339–62.
Stambaugh, J.E. “Evaluation of Nalbuphine: Efficacy and Safety in the Management of
Chronic Pain Associated with Advanced Malignancy.”Current Therapeutic Re-
search: Clinical and Experimental31 (1982): 393–401.
Wines, J.D., et al. “Nalbuphine Hydrochloride Dependence in Anabolic Steroid Users.”
American Journal on Addictions8 (1999): 161–64.
Zacny, J.P., K. Conley, and S. Marks. “Comparing the Subjective, Psychomotor and
Physiological Effects of Intravenous Nalbuphine and Morphine in Healthy