# Nalbuphine: veterinary dose and monograph

> Nalbuphine is a veterinary analgesic. An opioid AGONIST-ANTAGONIST (kappa-receptor agonist, mu-receptor antagonist) providing mild-to-moderate analgesia with a CEILING effect and notably less respiratory depression than pure mu-agonists. Indications include 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. This monograph lists 12 reference doses for dogs, cats, rabbits, ferrets, guinea pigs and hamsters and 3 more species, each with route, frequency and source.

Source: https://vetmasterji.com/drugs/nalbuphine · Last reviewed: 2026-10-01

## 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

*Nalbuphine doses for dogs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Mild-to-moderate pain — sole agent | 0.25–1 mg/kg | IV | interval not stated in Plumb’s | — |
| Pre-anaesthetic adjunct (in combination) | 0.2–0.4 mg/kg | IV | once, with other premedicants | — |
| Corneal pain (compounded ophthalmic drops) | One drop in the affected eye 2–6 times daily as needed | Ocular | q4–12h as needed | — |

- 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

*Nalbuphine doses for cats*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Mild-to-moderate pain — sole agent | 0.25–1 mg/kg | IM | interval not stated in Plumb’s | — |
| Pre-anaesthetic adjunct (in combination) | 0.2–0.4 mg/kg | IM | once, with other premedicants | — |

- 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

*Nalbuphine doses for horses*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| No reference dose for this species | Not established in Papich 5e or Plumb’s 10e — do not extrapolate from another species | — | — | — |

- 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

*Nalbuphine doses for rabbits*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Analgesia | 0.5–1.5 mg/kg | IV | q4h | — |

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

### Ferrets

*Nalbuphine doses for ferrets*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Analgesia | 0.5–1.5 mg/kg | IM | q4h | — |

- 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

*Nalbuphine doses for guinea pigs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Analgesia | 1–4 mg/kg | IM | q3h | — |

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

### Hamsters

*Nalbuphine doses for hamsters*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Analgesia | 1–2 mg/kg | SC | q2–4h | — |

- 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

*Nalbuphine doses for rats*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Analgesia | 1–2 mg/kg | SC | q2–4h | — |

- 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

*Nalbuphine doses for mice*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Analgesia | 1–2 mg/kg | SC | q2–4h | — |

- 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

*Nalbuphine doses for gerbils*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Analgesia | 1–2 mg/kg | SC | q2–4h | — |

- 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

> **Caution:** 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.

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- [Morphine Sulfate](https://vetmasterji.com/drugs/morphine)
- [Paracetamol (Acetaminophen)](https://vetmasterji.com/drugs/paracetamol)
- [Pethidine (Meperidine)](https://vetmasterji.com/drugs/pethidine)
- [Pregabalin](https://vetmasterji.com/drugs/pregabalin)
- [Tramadol](https://vetmasterji.com/drugs/tramadol)

## Frequently asked questions

### What is the dose of Nalbuphine for dogs?

Reference doses for Nalbuphine in dogs: 0.25–1 mg/kg IV interval not stated in Plumb’s (Mild-to-moderate pain — sole agent); 0.2–0.4 mg/kg IV once, with other premedicants (Pre-anaesthetic adjunct (in combination)); One drop in the affected eye 2–6 times daily as needed Ocular q4–12h as needed (Corneal pain (compounded ophthalmic drops)). Confirm against the label and the patient before use.

### What is the dose of Nalbuphine for cats?

Reference doses for Nalbuphine in cats: 0.25–1 mg/kg IM interval not stated in Plumb’s (Mild-to-moderate pain — sole agent); 0.2–0.4 mg/kg IM once, with other premedicants (Pre-anaesthetic adjunct (in combination)). Confirm against the label and the patient before use.

### Can Nalbuphine be given to horses?

Not established in Papich 5e or Plumb’s 10e — do not extrapolate from another species (No reference dose for this species).

### When should Nalbuphine not be used?

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.

### What are the side effects of Nalbuphine in animals?

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.

## Sources

- Plumb's Veterinary Drug Handbook
- Merck Veterinary Manual, 11th edition
- Papich, Papich Handbook of Veterinary Drugs, 5th edition

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VetMasterJi is a clinical decision-support and education platform for veterinary professionals and students. It does not provide veterinary advice, diagnosis or treatment for specific animals. All drug doses, calculators and differentials are references that must be independently verified before clinical use; the attending registered veterinarian remains solely responsible for every clinical decision.