ArticleJournal of the American College of Emergency Physicians open2025
Opioid-Induced Pruritus: A Case Series on Novel Uses of Nalbuphine in the Emergency Department.
Article in Journal of the American College of Emergency Physicians open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Opioid-induced pruritus is a frequent and distressing adverse effect of mu-opioid receptor agonists, often unresponsive to antihistamines such as diphenhydramine. Nalbuphine, a mixed kappa-opioid receptor agonist and mu-opioid receptor antagonist, offers both analgesia and pruritus prevention via targeted receptor mechanisms. We present 2 cases highlighting nalbuphine's utility in the emergency department: one demonstrating prophylactic low-dose nalbuphine (2.5 mg IV) coadministered with hydromorphone in a pruritus-prone patient and one where nalbuphine (10 mg IV) served as a primary analgesic. In both cases, patients achieved pain relief without experiencing pruritus or sedation. These cases underscore nalbuphine's potential as a safe and evidence-informed alternative in acute care settings.
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