Veterinary Anesthesia & Analgesia Support Group
Practical Information for the Compassionate Veterinary Practitioner
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    N Drugs
    Alphabetical Drug Summaries
    Dr. Bob Stein

1)   NALBUPHINE   Click here for detailed Nalbuphine information

a)      Classification

i)        Opioid

(1)   A mixed agonist/antagonist with primary agonistic activity at the kappa receptor

(a)    Generally antagonistic at the mu receptor

ii)       Nalbuphine is NOT a scheduled drug

      (1) There is no paperwork associated with the order or tracking of this drug

b)      General Information

i)        Limited analgesic efficacy – may be adequate for very mild pain

ii)       Free of any expected undesirable effect

iii)     More effective for visceral (soft tissue) than somatic (orthopedic) analgesic

c)      Advantages/Recommended use

i)        Most effective as a component in procedural sedation in combination with medetomidine

      (1) Click here for feline nalbuphine/medetomidine videos

      (2) Click here for canine nalbuphine/medetomidine videos

ii)       Useful as a reversal agent for unwanted mu agonist effects (dysphoria, respiratory depression, sedation, etc)

iii)   May help stabilize patient CV dynamics and survivability when used during the treatment shock

d)      Cautionary Information

i)        Little worth mentioning

ii)   Very low bioavailability when given orally

iii)     Short duration of effect

(1)   Dogs - 30 to 45 minutes

(2)   Cats – 45 to 60 minutes

iii)     Very high doses can produce excitement and dysphoria

e)      Dosage Information

i)        Dog & Cats

(1)   0.2 to 4.0 mg/kg (0.1 to 2.0 mg/lb) IV, IM

f)       Cost

i)        Low per dose – Nalbuphine costs much less than butorphanol




a)      A long acting mu opioid antagonists that is no longer available on the US market




a)      Classification

i)        An opioid antagonist

b)      General Information

i)        A short acting, pure antagonist

c)      Advantages/Recommended use

i)        To reverse unwanted effects of opioid medications

(1)   Can use small doses to partially reverse opioid effects

ii)       Duration of effect is 1 to 3 hours

d)      Cautionary Information

i)        Generally of shorter duration than most opioid agonists

(1)   Reversal effect may wear off before agonist has been cleared from body

(2)   Redosing may be necessary after 1 to 3 hours if undesirable agonist influence returns

ii)       Buprenorphine effects may not be reversible due to the high binding affinity

iii)     Butorphanol may not reverse as completely as pure Mu opioid agonists

e)      Dosage Information

i)        Dog & Cats - 0.02 to 0.1 mg/kg (0.01 to 0.05 mg/lb) IM or IV

(1)   Give 1/4 of calculated dose every 3 - 4 minutes until desired effect is achieved

f)       Cost

i)        Moderately low

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Last modified: February 16, 2011 .