Nalbuphine: veterinary dose and monograph

At a glance

Drug class

Analgesic

Also known as

Nubain, Nalbuphine HCl

Species with doses

Dogs, Cats, Rabbits, Ferrets, Guinea pigs, Hamsters, Rats, Mice and Gerbils

General dose range

0.25–1 mg/kg IV see species rows (no interval given for dogs/cats) — check the species tables for the indication

Routes

IV, Ocular, IM, SC

Last reviewed

1 October 2026

Indications

• Mild–moderate pain (analgesia with a ceiling, low respiratory-depression risk)
• Sedation/premedication (with a tranquilliser/alpha-2)
• Partial reversal of pure-mu-opioid respiratory depression while retaining analgesia
• Obstetric/peri-partum analgesia (less neonatal respiratory depression)

Nalbuphine dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Mild-to-moderate pain — sole agent: Plumb’s 10e p.924 (dogs/cats, extra-label): 0.25–1 mg/kg IV, IM or SC as the sole agent for mild-to-moderate pain; up to 2 mg/kg IV or IM has been suggested for dogs. Ceiling effect — not for severe pain. Papich 5e has no nalbuphine monograph.
• Pre-anaesthetic adjunct (in combination): Plumb’s 10e p.924 (dogs/cats, extra-label): 0.2–0.4 mg/kg IV, IM or SC combined with other pre-anaesthetic agents (e.g. midazolam, acepromazine, alpha-2 agonists).
• Corneal pain (compounded ophthalmic drops): Plumb’s ophthalmic monograph: compounded topical nalbuphine for corneal pain; do not combine with topical morphine (nalbuphine reverses mu effects).

Cats

• Mild-to-moderate pain — sole agent: Plumb’s 10e p.924 (dogs/cats, extra-label): 0.25–1 mg/kg IV, IM or SC as the sole agent for mild-to-moderate pain. (The “up to 2 mg/kg” figure is for dogs only.) Papich 5e has no nalbuphine monograph.
• Pre-anaesthetic adjunct (in combination): Plumb’s 10e p.924 (dogs/cats, extra-label): 0.2–0.4 mg/kg IV, IM or SC combined with other pre-anaesthetic agents (e.g. midazolam, acepromazine, alpha-2 agonists).

Horses

• No reference dose for this species: Neither Papich 5e nor Plumb’s 10e (pp.923–925 dose dogs/cats, calves and small mammals) gives a systemic nalbuphine dose for horses.

Rabbits

• Analgesia: Plumb’s 10e p.924 (extra-label): rabbits and ferrets 0.5–1.5 mg/kg IV or IM every 4 hours.

Ferrets

• Analgesia: Plumb’s 10e p.924 (extra-label): rabbits and ferrets 0.5–1.5 mg/kg IV or IM every 4 hours.

Guinea pigs

• Analgesia: Plumb’s 10e p.924 (extra-label): guinea pigs 1–4 mg/kg IM or SC every 3 hours.

Hamsters

• Analgesia: Plumb’s 10e p.924 (extra-label): gerbils, mice, rats and hamsters 1–2 mg/kg IM or SC every 2 to 4 hours (doses up to 8 mg/kg IM have been recommended).

Rats

• Analgesia: Plumb’s 10e p.924 (extra-label): gerbils, mice, rats and hamsters 1–2 mg/kg IM or SC every 2 to 4 hours (doses up to 8 mg/kg IM have been recommended).

Mice

• Analgesia: Plumb’s 10e p.924 (extra-label): gerbils, mice, rats and hamsters 1–2 mg/kg IM or SC every 2 to 4 hours (doses up to 8 mg/kg IM have been recommended).

Gerbils

• Analgesia: Plumb’s 10e p.924 (extra-label): gerbils, mice, rats and hamsters 1–2 mg/kg IM or SC every 2 to 4 hours (doses up to 8 mg/kg IM have been recommended).

Contraindications

Reliance on it for severe pain (ceiling effect — inadequate). Use in a patient physically dependent on pure mu-opioids (can precipitate withdrawal). Severe respiratory compromise without support. Known opioid hypersensitivity. Reduced doses in debilitated patients.

Adverse effects

• Sedation, dysphoria (less than pure agonists)
• Ceiling effect — increasing the dose does not increase analgesia
• Mild respiratory depression (ceilinged)
• Can precipitate withdrawal in mu-opioid-dependent patients

Drug interactions

• Pure mu-agonists (morphine/fentanyl): nalbuphine antagonises them (used to reverse respiratory depression; can reduce their analgesia or precipitate withdrawal)
• Other CNS depressants: additive sedation
• Benzodiazepines/alpha-2 agonists: combined for sedation/analgesia

Pregnancy and lactation

Causes less neonatal respiratory depression than pure agonists — used in obstetric analgesia; standard caution applies.

Monitoring

• Analgesia/sedation level and respiratory rate
• When reversing a mu-opioid: titrate to restore breathing while preserving comfort
• Watch for dysphoria; avoid in mu-opioid-dependent patients

Toxicity and overdose

Wide margin — the ceiling effect limits respiratory depression even at higher doses (a safety advantage). Overdose causes sedation and mild, ceilinged respiratory depression. In mu-opioid-dependent patients it can precipitate acute withdrawal.

Management: Naloxone reverses nalbuphine if needed (though respiratory depression is usually mild/ceilinged). Support ventilation/oxygenation and provide supportive care. Effects are generally self-limiting.

Clinical pearls

• A "gentle" opioid with a ceiling on both analgesia and respiratory depression — handy for mild–moderate pain and sedation with a good safety margin
• Its signature trick: partially REVERSE a pure mu-opioid's respiratory depression while KEEPING analgesia (kappa effect) — unlike naloxone, which removes the analgesia too
• Often non-scheduled in many regions — a practical advantage where controlled-drug logistics are limiting
• Not for severe pain (ceiling effect) and can precipitate withdrawal in mu-opioid-dependent patients

Mechanism of action

An agonist at kappa-opioid receptors (mediating spinal analgesia, sedation, with limited respiratory depression) and an antagonist/partial antagonist at mu-opioid receptors. The kappa agonism provides analgesia with a ceiling and minimal respiratory depression, while the mu antagonism both limits euphoria/respiratory depression and allows it to displace pure mu-agonists — reversing their respiratory depression while its own kappa analgesia continues.

Formulations and products

• Injection 10 mg/mL
• Injection 20 mg/mL
• Nubain / Nalbuphine — 10 / 20 mg/mL injection, Injection (human-label)

Storage

Injection: 15–30 °C, protect from light.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other analgesics

• Hydromorphone
• Lidocaine HCl
• Methadone
• Morphine Sulfate
• Paracetamol (Acetaminophen)
• Pethidine (Meperidine)
• Pregabalin
• Tramadol

Frequently asked questions