Nalbuphine and Naltrexone interaction

Nalbuphine and Naltrexone: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Nalbuphine (Nalbuphine Hydrochloride) label · effective 2026-07-16

Major

Management of respiratory depression may include close observation, supportive measures, and use of opioid overdose reversal agents (e.g., naloxone, nalmefene), depending on the patient's clinical status [see OVERDOSAGE ].

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Minor

Naloxone may reverse these effects.

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Minor

Maternal administration of naloxone during labor has normalized these effects in some cases.

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Minor

Drug Interactions Benzodiazepines and other Central Nervous System (CNS) Depressants Although Nalbuphine Hydrochloride Injection possesses opioid antagonist activity, there is evidence that in nondependent patients it will not antagonize an opioid analgesic administered just before, concurrently, or just after an injection of Nalbuphine Hydrochloride Injection.

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From the Naltrexone label · effective 2026-01-30

Major

Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] .

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Major

Patients with current physiologic opioid dependence [see Warnings and Precautions ( 5.3 ) ] .

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Major

Patients in acute opioid withdrawal [see Warnings and Precautions ( 5.3 ) ] .

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Major

Any individual who has failed the naloxone challenge test or has a positive urine screen for opioids [see Warnings and Precautions ( 5.3 ) ] .

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Major

Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics (4) .

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.