Nalbufin-Pharmex solution for infection. 10mg/ml 1 ml No. 10

Nalbufin-Pharmex - opioid analgetic of group of agonists antagonists of opiate receptors. Indications – a pain syndrome of strong and average intensity; as an additional tool when carrying out anesthesia; for decrease in pain in before - and the postoperative period; anesthesia during childbirth.

Structure

• active ingredient: nalbuphine hydrochloride;
10 mg contain
• 1 ml of solution a hydrochloride of a nalbufin;
• other components: sodium chloride, sodium citrate, citric acid monohydrate, water for injections.

Contraindication

Hypersensitivity to a hydrochloride of a nalbufin or any of medicine components.

Children's age up to 18 years.

should not be applied in respiratory depression or the significant oppression of the central nervous system, the increased intracranial pressure, a head injury, acute alcohol poisoning, alcoholic psychosis, an obvious abnormal liver function and kidneys.

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

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

Side reactions

At the patients who are treated nalbufiny most often observe drowsiness.

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.

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

from kidneys and urinary tract. antidiuretic effect, a spasm of urinary tract

from a reproductive system and mammary glands: lowering of a libido or potency.

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

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

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

from skin and hypodermic cellulose: urticaria, itching.

General disturbances and reactions in the place of drug: a hypothermia, there can be local pain, hypostasis, reddening, burning and caumesthesia, inflows, the increased perspiration.

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for intravenous and intramuscular administration.

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

Maximum single dose – 0.3 mg/kg of body weight, the maximum daily dose – 2.4 mg/kg of body weight.

In a myocardial infarction often happens enough 20 mg of medicament entered slowly into 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 – 100–200 mkg/kg of body weight. When carrying out an intravenous anesthesia for introduction to an anesthesia – 0.3-1 mg/kg within 10–15 minutes, for maintenance of an anesthesia – to 250-500 mkg/kg are each 30 minutes.

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With care to appoint medicament sick advanced age, in the general exhaustion, insufficient function of breath.

Feature of use

At the patients having medicament addiction, medicine can cause a bad attack of abstinency.

Use during pregnancy or feeding by a breast

due to the lack of researches cannot appoint medicament during pregnancy or feeding a breast.

not to apply

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

during treatment should refrain from control of motor transport and work with other mechanisms.

At overdose the following symptoms are possible

: respiratory depression; arterial hypotension; circulatory unefficiency; deepening of a comma; spasms; a rhabdomyolysis that progresses to a renal failure.

to apply

At treatment of overdose:

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• at an early stage to patients in consciousness activated coal 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 effect of anesthetics, somnolent drugs, anxiolytics, antidepressants and neuroleptics for prevention of excessive oppression of the central nervous system (CNS) and oppression of activity of a respiratory center. Alcohol also strengthens the oppressing action of a nalbufin on central nervous system. The medicament should not be taken 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 morfoanalgetik. 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.