Drug interactions
Nalbuphine + Sodium oxybate
Severity: Major
Nalbuphine and Sodium oxybate: 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
Sodium oxybate is a potent CNS depressant, and combining it with opioids increases the risk of profound sedation, respiratory depression, coma and death.
What this interaction means in plain words
Nalbuphine and Sodium oxybate 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.
Nalbuphine belongs to Musculoskeletal; Sodium oxybate belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression via GABA-B/GHB receptor activity and opioid receptors.
What to do
Avoid if possible. If unavoidable, use the lowest doses and shortest duration and monitor respiratory status closely.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Nalbuphine and Sodium oxybate, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Nalbuphine
- Alvimopan + Nalbuphine Contraindicated
- Nalbuphine + Olanzapine / samidorphan Contraindicated
- Alprazolam + Nalbuphine Major
- Amobarbital + Nalbuphine Major
- Benzhydrocodone / acetaminophen + Nalbuphine Major
- Brexanolone + Nalbuphine Major
Other interactions of Sodium oxybate
- Alprazolam + Sodium oxybate Contraindicated
- Amobarbital + Sodium oxybate Contraindicated
- Butorphanol + Sodium oxybate Contraindicated
- Chloral hydrate + Sodium oxybate Contraindicated
- Clonazepam + Sodium oxybate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Nalbuphine with Sodium oxybate?
MediHelp rates the interaction as major. Nalbuphine and Sodium oxybate 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. Sodium oxybate is a potent CNS depressant, and combining it with opioids increases the risk of profound sedation, respiratory depression, coma and death.
How serious is the interaction between Nalbuphine and Sodium oxybate?
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. If unavoidable, use the lowest doses and shortest duration and monitor respiratory status closely.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
