Although animal reproductive studies have not revealed teratogenic or embryotoxic effects, nalbuphine should only be administered to pregnant women when, in the judgement of the physician, the potential benefits outweigh the possible hazards. It should be used with caution in women delivering premature infants. Furthermore, potent analgesics can produce effects which may obscure the clinical course of patients with head injuries. When such combined therapy is contemplated, the dose of one or both agents should be reduced. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low.
Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.
When such combined therapy is contemplated, the dose of one or both agents should be reduced. The incidence of psychotomimetic effects, such as unreality, depersonalization, delusions, dysphoria and hallucinations has been shown to be less than that which occurs with pentazocine. Oxygen, intravenous fluids, vasopressors and other supportive measures should be used as indicated. Dosage should be adjusted according to the severity of the pain, physical status of the patient, and other medications which the patient may be receiving. In non-tolerant individuals, the recommended single maximum dose is 20 mg, with a maximum total daily dose of 160 mg.