Drug interactions
Nalbuphine + Phenobarbital
Severity: Major
Nalbuphine and Phenobarbital: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Phenobarbital combined with an opioid produces additive sedation and respiratory depression, with a risk of profound CNS depression. The risk rises with higher doses and in vulnerable patients.
What this interaction means in plain words
Nalbuphine and Phenobarbital can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS and respiratory depression via opioid receptors and barbiturate enhancement of GABA-A activity.
What to do
Avoid if possible; otherwise use reduced doses and monitor sedation and respiratory rate. Warn patients against alcohol and driving.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Nalbuphine
- Alvimopan + Nalbuphine Contraindicated
- Nalbuphine + Olanzapine / samidorphan Contraindicated
- Alprazolam + Nalbuphine Major
- Amobarbital + Nalbuphine Major
- Benzhydrocodone / acetaminophen + Nalbuphine Major
- Brexanolone + Nalbuphine Major
Frequently asked questions
Can I take Nalbuphine with Phenobarbital?
MediHelp rates the interaction as major. Nalbuphine and Phenobarbital can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Phenobarbital combined with an opioid produces additive sedation and respiratory depression, with a risk of profound CNS depression. The risk rises with higher doses and in vulnerable patients.
How serious is the interaction between Nalbuphine and Phenobarbital?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; otherwise use reduced doses and monitor sedation and respiratory rate. Warn patients against alcohol and driving.
What other medicines interact with Nalbuphine?
MediHelp also lists interactions of Nalbuphine with, for example, Alvimopan, Olanzapine / samidorphan, Alprazolam. The full list is on the Nalbuphine page.
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