Common adverse reactions of nalbuphine that can be confused with an acute porphyric attack are nausea and vomiting. These side effects may potentially be porphyrinogenic if leading to a decrease in carbohydrate intake.

Nalbuphine is not suspected to be an inducer or a mechanism-based inhibitor of CYP enzymes, and is not observed to alter the metabolism of other CYP metabolized drugs.

Opioid, epoxymorphinan structure

Nalbuphine is an opioid used in the treatment of acute moderate to severe pain. It is administered as an intravenous injection.

Nalbuphine is metabolized in the liver. It undergoes hydroxylation by CYP450 enzymes and glucuronidation by UGTs (Wang 2014). It is excreted in the urine and feces as unchanged drug and glucuronide conjugates. There is no information regarding the specific enzymes participating in the metabolism, or pharmacokinetic drug interactions (FASS).