ACOG Committee Opinion
Number 376, August 2007
(Reaffirmed 2012)


Committee on Obstetric Practice

This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed.


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Nalbuphine Hydrochloride Use for Intrapartum Analgesia

ABSTRACT: Safety concerns have been raised regarding the use of nalbuphine hydrochloride during labor. The American College of Obstetricians and Gynecologists finds data are insufficient to recommend any changes in nalbuphine hydrochloride administration at this time.

Nalbuphine hydrochloride (formerly marketed as Nubain) is a synthetic opioid agonist– antagonist analgesic commonly used for intrapartum analgesia. Concerns for fetal safety have been raised by one pharmaceutical company that no longer manufactures this agent (www.fda.gov/medwatch/safety/2005/aug_PI/Nubain_PI.pdf). To date there are insufficient data to support these concerns or to recommend any change in the administration of this medication for analgesia in labor.

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Nalbuphine Hydrochloride Use for Intrapartum Analgesia. ACOG Committee Opinion No. 376. American College of Obstetricians and Gynecologists. Obstet Gynecol 2007; 110:449.