What the FDA labels say about taking them together
Nalbuphine and remifentanil
Remifentanil's FDA label of December 15, 2025 names nalbuphine in its drug interactions section; nalbuphine's label does not name remifentanil itself but warns about its class (Opioids (opioid agonists)). The remifentanil label: “May reduce the analgesic effect of ULTIVA and/or precipitate withdrawal symptoms.”
Check it at the source: the nalbuphine FDA label on DailyMed (effective December 31, 2025, Hospira, Inc.); the remifentanil FDA label on DailyMed (effective December 15, 2025, Mylan Institutional LLC).
What does the nalbuphine label say about remifentanil?
Nalbuphine's label does not name remifentanil itself; it warns about its class (Opioids (opioid agonists)):
Nalbuphine label, warningsLife-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 warningSERIOUS 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
What does the remifentanil label say about nalbuphine?
Remifentanil label, drug interactionsClinical Impact: May reduce the analgesic effect of ULTIVA and/or precipitate withdrawal symptoms. … responding appropriately to treatment and institute alternative analgesic treatment. Examples: butorphanol, nalbuphine, pentazocine, buprenorphine
Source: FDA drug label (Ultiva), Mylan Institutional LLC, effective December 15, 2025 (SPL set 4dbcb8f9-1987-4b66-bd2f-d251fda0be10), 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
| Nalbuphine | Remifentanil | |
|---|---|---|
| Labeled for | Pain | n/a |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $4.32 per mL 10 mg/mL ampul | n/a |
| Shortage now | No current entry | In shortage |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once