Nalben solution for infection. 10mg/ml amp. 1 ml No. 5 ***

Nalben – the analgetic applying as an additional tool when carrying out anesthesia for decrease in pain in before - and the postoperative period, for anesthesia during childbirth.

Structure

• active ingredient: nalbuphine;
dry matter of 10 mg contains
• 1 ml of solution a hydrochloride of a nalbufin in terms of 100%;
• other components: sodium citrate a dihydrate, citric acid monohydrate, sodium chloride, water for injections.

Contraindication

Hypersensitivity to a hydrochloride of a nalbufin or to any of medicament ingredients. Children's age aged up to 18 years.

Nalbufin should not be applied in respiratory depression or the significant oppression of central nervous system, the increased intracranial pressure, a head injury, acute alcoholic intoxication, alcoholic psychosis, a liver and renal failure.

does not recommend the combined use of medicament with pure agonists of a morfinomimetika.

is not recommended to use medicament without performing the corresponding diagnostics at a surgical belly syndrome as nalbufin can mask its manifestations.

Nalbufin should not be applied to women during feeding by a breast (except for use cases during childbirth).

Side reactions

At the patients treated by the medicament Nalbufin most often observed drowsiness.

from a warm system: increase or decrease in the ABP, orthostatic hypotension, bradycardia, tachycardia, heartbeat.

from organs of sight: illegibility or disorder of vision, miosis.

from a digestive tract: a constipation, nausea, vomiting, dryness in a mouth, spasms in a stomach.

General disturbances and reactions in the injection site: a hypothermia, there can be local pain, hypostasis, reddening, burning and feeling of heat, inflows, the increased perspiration.

from a gepatobiliarny system: disturbance of functional indicators of a liver, spasm of biliary tract.

from the immune system: Anaphylactic reactions.

from nervous system: dizziness, headaches, muscular rigidity, increase in intracranial pressure.

Mental disturbances: accustoming to drug, psikhomimetichesky reactions, neurotic reactions, drowsiness, a depression, confusion of consciousness, a dysphoria, disturbance of the speech, change of mood, concern, nervousness (restlessness), hallucinations, euphoria.

Possibility of physical and mental dependence and also tolerance during long-term treatment same, as well as for other derivatives of morphine.

Route of administration

Nalbufin is applied to intravenous and intramuscular administration.

Dosage should be calculated according to intensity of pain, a physical condition of the patient and to consider interaction with other at the same time applied medicines. Usually at a pain syndrome enter intravenously or intramusculary from 0.15 to 0.3 mg of medicament on 1 kg of body weight of the patient; the single dose of medicament is entered if necessary by each 3-6 hours.

Maximum single dosage for adults – 0.3 mg on 1 kg of body weight; the maximum daily dose – 2.4 mg on 1 kg of body weight.

In a myocardial infarction often happen enough 20 mg of medicament which administers slowly in a vein, however increase in a dose up to 30 mg can be required. In the absence of accurate positive dynamics of a pain syndrome – 20 mg repeatedly in 30 minutes.

For premedication of 100-200 mkg/kg of body weight.

When carrying out an intravenous anesthesia: for introduction to an anesthesia – 0.3-1 mg/kg during 10–15 minutes, for maintenance of an anesthesia – to 250-500 mkg/kg are each 30 minutes.

Feature of use

Use during pregnancy or feeding by a breast

due to the lack of researches medicament cannot be used during pregnancy and feeding by a breast.

not to use

.

Ability to influence speed of response at control of motor transport or other mechanisms

during treatment should abstain from control of motor transport or other mechanisms.

At overdose the following symptoms are possible

: respiratory depression, arterial hypotension, a circulatory unefficiency, deepening of a coma, a spasm, a rhabdomyolysis that progresses to a renal failure.

At treatment of overdose is applied:

• at an early stage to patients in consciousness – activated carbon inside;
• maintenance therapy (the oxygen, intravenous administration of replaceable liquid, means increasing arterial blood pressure);
• intravenous administration of Naloxonum (specific antidote).

Interaction with other medicines and other types of interactions

Under fixed observation and in the reduced doses should use medicament against the background of action of an anesthesia, somnolent drugs, anxiolytics, antidepressants and neuroleptics for prevention of excessive oppression of central nervous system and oppression of activity of a respiratory center. Alcohol also strengthens the oppressing action of a nalbufin on central nervous system. Drug should not be used together with other narcotic analgetics because of danger of weakening of analgeziruyushchy action and a possibility of provoking of a withdrawal at patients with dependence to opioids.

Combination to derivatives of a fenotiazin and medicaments of penicillin can strengthen nausea and vomiting.

. Alfentanil, codeine, dekstroproksifen, dihydrocodeine, fentanyl, methadone, morphine, oxycodone, pethidine, sufentanil, tramadol – is observed reduction of analgesic effect as a result of blocking of receptors with risk of appearance of a withdrawal.

. Alcohol – increase in sedation of morfinoanalgetik. Deterioration in attention can be dangerous at control of vehicles or work with other mechanisms. It is necessary to avoid consumption of alcoholic beverages and use of the medicines containing ethanol.

to Store

in original packing at a temperature not over 25 ºС. To store out of children's reach.