From the Guidelines
Yes, Nubain (nalbuphine) can cause vomiting as a side effect, with nausea and vomiting seen in as many as 50% of patients when opioids are initiated or when the dose is increased greatly. The risk of vomiting may increase with higher doses or rapid intravenous administration. Nalbuphine works by binding to opioid receptors in the brain and spinal cord, which not only produces pain relief but can also trigger the chemoreceptor trigger zone in the brain that controls vomiting. According to the most recent study 1, metoclopramide is recommended as the first line for the management of chronic nausea, including opioid-related.
Management of Nausea and Vomiting
- Rule out other causes of nausea, such as constipation, other medications, or bowel obstruction
- Consider pretreatment with metoclopramide or prochlorperazine around the clock for the first few days of opioid therapy, with gradual weaning of the antiemetic
- For patients reporting previous episodes of nausea during past exposure to opioids, prevention may include pretreatment with metoclopramide or prochlorperazine
- Other options for managing nausea and vomiting include 5-HT3 receptor antagonists, anticholinergic agents, antihistamines, corticosteroids, and cannabinoids
Key Points
- Nubain can cause vomiting, especially when initiated or when the dose is increased
- Metoclopramide is recommended as the first line for managing chronic nausea, including opioid-related
- Patients taking Nubain should be aware of this potential side effect and notify their healthcare provider if vomiting becomes severe or persistent
- Healthcare providers may recommend taking the medication with food or prescribe an antiemetic medication to help manage this side effect, as suggested by 1.
From the FDA Drug Label
ADVERSE REACTIONS ... nausea/vomiting 68 (6%) ... Other allergic-type reactions reported include ... nausea, vomiting, ...
Nubain (nalbuphine) can cause vomiting. According to the drug label, nausea/vomiting was reported in 6% of patients, and vomiting was also listed as an other allergic-type reaction 2, 3.
- Key points:
- Nausea/vomiting incidence: 6%
- Vomiting listed as an allergic-type reaction
- Reported in clinical studies and post-marketing surveillance
From the Research
Nubain and Vomiting
- There is no direct evidence in the provided studies that Nubain (nalbuphine) causes vomiting.
- The studies primarily focus on the comparison of ondansetron and metoclopramide in reducing nausea and vomiting in various contexts, such as emergency department patients 4, women with nausea and vomiting in pregnancy 5, patients undergoing laparoscopic cholecystectomy 6, and patients receiving chemotherapy 7.
- However, one study compares the effectiveness of ondansetron and metoclopramide in treating severe nausea and vomiting of pregnancy, with ondansetron showing a more favorable effect in controlling severe vomiting 8.
- Since there is no direct evidence related to Nubain, it is essential to consult other sources or studies that specifically investigate the effects of Nubain on vomiting.