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Pharmacological Features, Therapeutic Efficacy and Side Effects of Nalbuphine: A Review

Introduction: Opioids can provide effective analgesia and routinely utilized to treat mild severe pain. Problems related with mu- agonist opioids like nausea, emesis, bowel and bladder disturbances, respiratory depression, pruritus and developing tolerance and dependence. This article will review about the utilization of Nalbuphine, which is a mixed opioid agonist- antagonist that FDA has indicated in moderate to severe pain treatment when an opioid drug is essential and alternative treatment methods have failed. The incidence of the common opioid side effects are low in case of Nalbuphine. Non-FDA approved uses of nalbuphine are in labor analgesia, pruritus associated with opioid, opioid-induced urinary retention and respiratory depression. It can be administered with the regularly utilized mu- opioid agonists like morphine, fentanyl etc. as a combination, giving better analgesia along with abating the incidence as well as the severity of side effects caused by mu-agonist. 
Methodology: This review article was prepared after a thorough study of the literature using data search engines such as ‘Scopus’,’ PubMed’, ‘Web of Science’, and ‘Google Scholar’. This article referred to prior Nalbuphine observational studies and case reports. 
Review Findings: After learning the pharmacology, uses, contraindications of Nalbuphine and reviewing the previous observational studies and case reports about Nalbuphine, the drug can be used for treating moderate to severe pain when an opioid drug is essential and reserve treatment methods have failed. Nalbuphine finds its use also in labor analgesia. The incidence of the usual side effects due to opioids are low in case of Nalbuphine. It can be administered with the regularly utilized mu- opioid agonists like morphine, fentanyl etc. as a combination , giving better analgesia along with abating the incidence as well as the severity of side effects caused by mu-agonist. 
Conclusion: Nalbuphine can be utilized for treating moderate to severe pain, as an adjuvant to balanced anesthesia for pre-operative / post-operative pain relief, for labor analgesia and to treat/ reduce the opioid induced side effects.