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What the FDA labels say about taking them together

Hydrocodone and nalbuphine

Hydrocodone's FDA label of May 29, 2026 names nalbuphine in its drug interactions section; nalbuphine's label does not name hydrocodone itself but warns about its class (Opioids (opioid agonists)). The hydrocodone label: “May reduce the analgesic effect of HYSINGLA ER and/or precipitate withdrawal symptoms.”

Check it at the source: the hydrocodone FDA label on DailyMed (effective May 29, 2026); the nalbuphine FDA label on DailyMed (effective December 31, 2025, Hospira, Inc.).

What does the hydrocodone label say about nalbuphine?

Hydrocodone label, drug interactions

Clinical Impact: May reduce the analgesic effect of HYSINGLA ER and/or precipitate withdrawal symptoms. Intervention: Avoid concomitant use. Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Muscle Relaxants

Hydrocodone label, warnings and precautions

Additionally, avoid the use of mixed agonist/antagonist analgesics (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including HYSINGLA ER.

Source: FDA drug label (Hysingla ER), Knoa Pharma LLC, effective May 29, 2026 (SPL set b7d23ac2-e776-9f62-3290-c64c2d6eb353), via openFDA; the full label on DailyMed

What does the nalbuphine label say about hydrocodone?

Nalbuphine's label does not name hydrocodone itself; it warns about its class (Opioids (opioid agonists)):

Nalbuphine label, warnings

Life-Threatening Respiratory Depression Serious, life-threatening, or fatal respiratory depression has been reported with the use of opioids, even when used as recommended.

Nalbuphine label, boxed warning

SERIOUS AND LIFE-THREATENING RISKS FROM USE OF NALBUPHINE HYDROCHLORIDE INJECTION ‎ Addiction, Abuse, and Misuse Because the use of Nalbuphine Hydrochloride Injection exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient's risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions [see WARNINGS ].

Source: FDA drug label (Nalbuphine Hydrochloride), Hospira, Inc., effective December 31, 2025 (SPL set 6025e8d4-5083-4c3a-58a0-050e7b0b6150), via openFDA; the full label on DailyMed

These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.

Both medicines on the record

1Hydrocodone generic labelers
6Nalbuphine generic labelers
HydrocodoneNalbuphine
Labeled forPainPain
Boxed warningYesYes
Pharmacy cost (NADAC)$7.95 per capsule 15 mg capsule$4.32 per mL 10 mg/mL ampul
Shortage nowNo current entryNo current entry

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

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