Nalbuphine
 Nalbuphine Hydrochloride

Drugspedia.net

|Nalbuphine Nalbuphine Hydrochloride

Drugs search, click the first letter of a drug name: | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 1 | 2 | 3 | 4 | 5 | 6 | 8 | 9

   


Nalbuphine


Generic Name: Nalbuphine hydrochloride
Dosage Form: Injection

Ampul

Fliptop Vial

Protect from light.

Rx Only

Nalbuphine Description

Nalbuphine Hydrochloride Injection is a sterile, nonpyrogenic solution of Nalbuphine hydrochloride in water for injection. This product may be administered by subcutaneous, intramuscular or intravenous injection.

Each milliliter (mL) contains Nalbuphine hydrochloride 10 mg or 20 mg; sodium citrate, dihydrate 0.47 mg and citric acid, anhydrous 0.63 mg added as buffers and may contain sodium hydroxide and/or hydrochloric acid for pH adjustment; pH 3.7 (3.0 to 4.5). Contains sodium chloride for tonicity adjustment.

Multiple-dose vials contain 1.8 mg/mL methylparaben and 0.2 mg/mL propylparaben added as preservatives. Single-dose products contain no bacteriostat or antimicrobial agent and unused portions must be discarded.

Nalbuphine hydrochloride is a synthetic narcotic agonist-antagonist analgesic of the phenanthrene series chemically designated (-) -17 (cyclobutylmethy)-4, 5α-epoxymorphinan-3, 6α,14 triol, hydrochloride. It is chemically related to both the widely used narcotic antagonist, naloxone, and the potent narcotic analgesic, oxymorphone, and has the following molecular and structural formula:

M.W. 393.91

(C21H27NO4• HCl)

Nalbuphine - Clinical Pharmacology

Nalbuphine hydrochloride is a potent analgesic. Its analgesic potency is essentially equivalent to that of morphine on a milligram basis.

Its onset of action occurs within 2 to 3 minutes after intravenous administration, and in less than 15 minutes following subcutaneous or intramuscular injection. The plasma half-life of Nalbuphine is 5 hours and in clinical studies the duration of analgesic activity has been reported to range from 3 to 6 hours.

The narcotic antagonist activity of Nalbuphine is one-fourth as potent as nalorphine and 10 times that of pentazocine.

Indications and Usage for Nalbuphine

Nalbuphine hydrochloride is indicated for the relief of moderate to severe pain. Nalbuphine hydrochloride can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery.

Contraindications

Nalbuphine hydrochloride injection should not be administered to patients who are hypersensitive to it.

Warnings

Nalbuphine hydrochloride injection should be administered as a supplement to general anesthesia only by persons specifically trained in the use of intravenous anesthetics and management of respiratory effects of potent opioids.

Naloxone hydrochloride injection, resuscitative and intubation equipment and oxygen should be readily available.

Drug Dependence:

Nalbuphine has been shown to have a low abuse potential. When compared with drugs which are not mixed agonist-antagonists, it has been reported that Nalbuphine’s potential for abuse would be less than that of codeine and propoxyphene. Psychological and physical dependence and tolerance may follow the abuse or misuse of Nalbuphine. Therefore, caution should be observed in prescribing it for emotionally unstable patients, or for individuals with a history of narcotic abuse. Such patients should be closely supervised when long-term therapy is contemplated.

Care should be taken to avoid increases in dosage or frequency of administration which in susceptible individuals might result in physical dependence.

Abrupt discontinuation of Nalbuphine Hydrochloride following prolonged use has been followed by symptoms of narcotic withdrawal, i.e., abdominal cramps, nausea and vomiting, rhinorrhea, lacrimation, restlessness, anxiety, elevated temperature and piloerection.

Use in Ambulatory Patients: Nalbuphine may impair the mental or physical abilities required for the performance of potentially dangerous tasks such as driving a car or operating machinery. Therefore, Nalbuphine Hydrochloride Injection should be administered with caution to ambulatory patients who should be warned to avoid such hazards.

Use in Emergency Procedures: Maintain patient under observation until recovered from Nalbuphine effects that would affect driving or other potentially dangerous tasks.

Use in Pediatrics:

Clinical experience to support administration to patients under 18 years is not available at present.

Use in Pregnancy (other than labor):

Safe use of Nalbuphine hydrochloride in pregnancy has not been established. Although animal reproductive studies have not revealed teratogenic or embryotoxic effects, Nalbuphine should only be administered to pregnant women when, in the judgment of the physician, the potential benefits outweigh the possible hazards.

Use During Labor and Delivery:

Nalbuphine can produce respiratory depression and cardiac rhythm disturbances in the neonate. It should be used with caution in women during labor and delivery, and newborns should be monitored for respiratory depression, apnea, bradycardia and arrhythmias if Nalbuphine has been used.

Head Injury and Increased Intracranial Pressure: The possible respiratory depressant effects and the potential of potent analgesics to elevate cerebrospinal fluid pressure (resulting from vasodilation following CO2 retention) may be markedly exaggerated in the presence of head injury, intracranial lesions or a pre-existing increase in intracranial pressure. Furthermore, potent analgesics can produce effects which may obscure the clinical course of patients with head injuries. Therefore, Nalbuphine Hydrochloride Injection should be used in these circumstances only when essential, and then should be administered with extreme caution.

Interaction With Other Central Nervous System Depressants:

Although Nalbuphine possesses narcotic antagonist activity, there is evidence that in nondependent patients it will not antagonize a narcotic analgesic administered just before, concurrently, or just after an injection of Nalbuphine hydrochloride. Therefore, patients receiving a narcotic analgesic, general anesthetics, phenothiazines, or other tranquilizers, sedatives, hypnotics, or other CNS depressants (including alcohol) concomitantly with Nalbuphine may exhibit an additive effect. When such combined therapy is contemplated, the dose of one or both agents should be reduced.

Precautions

Impaired Respiration: At the usual adult dose of 10 mg/70 kg, Nalbuphine hydrochloride causes some respiratory depression approximately equal to that produced by equal doses of morphine. However, in contrast to morphine, respiratory depression is not appreciably increased with higher doses of Nalbuphine. Respiratory depression induced by Nalbuphine can be reversed by naloxone hydrochloride when indicated. Nalbuphine Hydrochloride Injection should be administered with caution at low doses to patients with impaired respiration (e.g., from other medication, uremia, bronchial asthma, severe infection, cyanosis or respiratory obstructions).

Impaired Renal or Hepatic Function: Because Nalbuphine is metabolized in the liver and excreted by the kidneys, patients with renal or liver dysfunction may overreact to customary doses. Therefore, in these individuals, Nalbuphine Hydrochloride Injection should be used with caution and administered in reduced amounts.

Myocardial Infarction: As with all potent analgesics, Nalbuphine hydrochloride should be used with caution in patients with myocardial infarction who have nausea or vomiting.

Biliary Tract Surgery: As with all narcotic analgesics, Nalbuphine hydrochloride should be used with caution in patients about to undergo surgery of the biliary tract since it may cause spasm of the sphincter of Oddi.

Cardiovascular System: During evaluation of Nalbuphine Hydrochloride Injection, in anesthesia, a higher incidence of bradycardia has been reported in patients who did not receive atropine preoperatively or in the preoperative period.

Adverse Reactions

The most frequent adverse reaction in 1066 patients treated with Nalbuphine Hydrochloride Injection is sedation 381 (36%). Less frequent reactions are: sweaty/clammy 99 (9%), nausea/vomiting 68 (6%), dizziness/vertigo 58 (5%), dry mouth 44 (4%), and headache 27 (3%).

Other adverse reactions which may occur (reported incidence of 1% or less) are:

CNS Effects: Nervousness, depression, restlessness, crying, euphoria, floating, hostility, unusual dreams, confusion, faintness, hallucinations, dysphoria, feeling of heaviness, numbness, tingling, unreality. The incidence of psychotomimetic effects, such as unreality, depersonalization, delusions, dysphoria and hallucinations has been shown to be less than that which occurs with pentazocine.

Cardiovascular: Hypertension, hypotension, bradycardia, tachycardia.

Gastrointestinal: Cramps, dyspepsia, bitter taste.

Respiration: Depression, dyspnea, asthma.

Dermatological: Itching, burning, urticaria.

Miscellaneous: Speech difficulty, urinary urgency, blurred vision, flushing and warmth.

Overdosage

Management of Overdosage: The immediate intravenous administration of naloxone hydrochloride is a specific antidote. Oxygen, intravenous fluids, vasopressors and other supportive measures should be used as indicated.

The administration of single doses of 72 mg of Nalbuphine hydrochloride subcutaneously to eight normal subjects has been reported to have resulted primarily in symptoms of sleepiness and mild dysphoria.

Nalbuphine Dosage and Administration

The usual recommended adult dose is 10 mg for a 70 kg individual administered subcutaneously, intramuscularly, or intravenously; this dose may be repeated every 3 to 6 hours as necessary. Dosage should be adjusted according to the severity of the pain, physical status of the patient, and other medications which the patient may be receiving (see Interaction With Other Central Nervous System Depressants under WARNINGS). In nontolerant individuals, the recommended single maximum dose is 20 mg with a maximum total daily dose of 160 mg.

The use of Nalbuphine Hydrochloride Injection as a supplement to balanced anesthesia requires larger doses than those recommended for analgesia. Induction doses of Nalbuphine hydrochloride range from 0.3 mg/kg to 3.0 mg/kg intravenously to be administered over a 10 to 15 minute period with maintenance doses of 0.25 to 0.50 mg/kg in single intravenous administrations as required. The use of Nalbuphine Hydrochloride Injection may be followed by respiratory depression which can be reversed with the narcotic antagonist naloxone hydrochloride.

Patients Dependent on Narcotics: Patients who have been taking narcotics chronically may experience withdrawal symptoms upon the administration of Nalbuphine hydrochloride injection. If unduly troublesome, narcotic withdrawal symptoms can be controlled by the slow intravenous administration of small increments of morphine, until relief occurs. If the previous analgesic was morphine, meperidine, codeine, or other narcotic with similar duration of activity, one-fourth of the anticipated dose of Nalbuphine hydrochloride can be administered initially and the patient observed for signs of withdrawal, i.e., abdominal cramps, nausea and vomiting, lacrimation, rhinorrhea, anxiety, restlessness, elevation of temperature or piloerection. If untoward symptoms do not occur, progressively larger doses may be tried at appropriate intervalsuntil the desired level of analgesia is obtained with Nalbuphine hydrochloride.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.

How is Nalbuphine Supplied

Nalbuphine Hydrochloride Injection is supplied as follows:

List No.

Container

Size (mL)

mg/mL

Total mg

1463

Ampul

1

10

10

1465

Ampul

1

20

20

1464

Fliptop Vial (multiple-dose)

10

10

100

1467

Fliptop Vial (multiple-dose)

10

20

200

Store at controlled room temperature 15° to 30°C (59° to 86°F).[See USP.]

Protect from light.

©Hospira 2004

EN-0125

Printed in USA

HOSPIRA, INC., LAKE FOREST, IL 60045 USA


Nalbuphine Hydrochloride (Nalbuphine Hydrochloride)
PRODUCT INFO
Product Code 0409-1463 Dosage Form INJECTION, SOLUTION
Route Of Administration INTRAMUSCULAR, INTRAVENOUS, SUBCUTANEOUS DEA Schedule
INGREDIENTS
Name (Active Moiety) Type Strength
Nalbuphine Hydrochloride (Nalbuphine) Active 10 MILLIGRAM  In 1 MILLILITER
Sodium Citrate Dihydrate Inactive 0.47 MILLIGRAM  In 1 MILLILITER
Citric Acid Anhydrous Inactive 0.63 MILLIGRAM  In 1 MILLILITER
Sodium Chloride Inactive  
Sodium Hydroxide Inactive  
Hydrochloric Acid Inactive  
IMPRINT INFORMATION
Characteristic Appearance Characteristic Appearance
Color Score
Shape Symbol
Imprint Code Coating
Size
PACKAGING
# NDC Package Description Multilevel Packaging
1 0409-1463-01 40 PACKAGE In 1 CASE contains a PACKAGE
1 10 AMPULE In 1 PACKAGE This package is contained within the CASE (0409-1463-01) and contains a AMPULE ()
1 1 MILLILITER In 1 AMPULE This package is contained within a PACKAGE and a CASE (0409-1463-01)

Nalbuphine Hydrochloride (Nalbuphine Hydrochloride)
PRODUCT INFO
Product Code 0409-1465 Dosage Form INJECTION, SOLUTION
Route Of Administration INTRAMUSCULAR, INTRAVENOUS, SUBCUTANEOUS DEA Schedule
INGREDIENTS
Name (Active Moiety) Type Strength
Nalbuphine Hydrochloride (Nalbuphine) Active 20 MILLIGRAM  In 1 MILLILITER
Sodium Citrate Dihydrate Inactive 0.47 MILLIGRAM  In 1 MILLILITER
Citric Acid Anhydrous Inactive 0.63 MILLIGRAM  In 1 MILLILITER
Sodium Chloride Inactive  
Sodium Hydroxide Inactive  
Hydrochloric Acid Inactive  
IMPRINT INFORMATION
Characteristic Appearance Characteristic Appearance
Color Score
Shape Symbol
Imprint Code Coating
Size
PACKAGING
# NDC Package Description Multilevel Packaging
1 0409-1465-01 40 PACKAGE In 1 CASE contains a PACKAGE
1 10 AMPULE In 1 PACKAGE This package is contained within the CASE (0409-1465-01) and contains a AMPULE ()
1 1 MILLILITER In 1 AMPULE This package is contained within a PACKAGE and a CASE (0409-1465-01)

Nalbuphine Hydrochloride (Nalbuphine Hydrochloride)
PRODUCT INFO
Product Code 0409-1464 Dosage Form INJECTION, SOLUTION
Route Of Administration INTRAMUSCULAR, INTRAVENOUS, SUBCUTANEOUS DEA Schedule
INGREDIENTS
Name (Active Moiety) Type Strength
Nalbuphine Hydrochloride (Nalbuphine) Active 10 MILLIGRAM  In 1 MILLILITER
Sodium Citrate Dihydrate Inactive 0.47 MILLIGRAM  In 1 MILLILITER
Citric Acid Anhydrous Inactive 0.63 MILLIGRAM  In 1 MILLILITER
Sodium Chloride Inactive  
Sodium Hydroxide Inactive  
Hydrochloric Acid Inactive  
Methylparaben Inactive 1.8 MILLIGRAM  In 1 MILLILITER
Propylparaben Inactive 0.2 MILLIGRAM  In 1 MILLILITER
IMPRINT INFORMATION
Characteristic Appearance Characteristic Appearance
Color Score
Shape Symbol
Imprint Code Coating
Size
PACKAGING
# NDC Package Description Multilevel Packaging
1 0409-1464-01 25 VIAL In 1 CASE contains a VIAL, MULTI-DOSE
1 10 MILLILITER In 1 VIAL, MULTI-DOSE This package is contained within the CASE (0409-1464-01)

Nalbuphine Hydrochloride (Nalbuphine Hydrochloride)
PRODUCT INFO
Product Code 0409-1467 Dosage Form INJECTION, SOLUTION
Route Of Administration INTRAMUSCULAR, INTRAVENOUS, SUBCUTANEOUS DEA Schedule
INGREDIENTS
Name (Active Moiety) Type Strength
Nalbuphine Hydrochloride (Nalbuphine) Active 20 MILLIGRAM  In 1 MILLILITER
Sodium Citrate Dihydrate Inactive 0.47 MILLIGRAM  In 1 MILLILITER
Citric Acid Anhydrous Inactive 0.63 MILLIGRAM  In 1 MILLILITER
Sodium Chloride Inactive  
Sodium Hydroxide Inactive  
Hydrochloric Acid Inactive  
Methylparaben Inactive 1.8 MILLIGRAM  In 1 MILLILITER
Propylparaben Inactive 0.2 MILLIGRAM  In 1 MILLILITER
IMPRINT INFORMATION
Characteristic Appearance Characteristic Appearance
Color Score
Shape Symbol
Imprint Code Coating
Size
PACKAGING
# NDC Package Description Multilevel Packaging
1 0409-1467-01 25 VIAL In 1 CASE contains a VIAL, MULTI-DOSE
1 10 MILLILITER In 1 VIAL, MULTI-DOSE This package is contained within the CASE (0409-1467-01)

Revised: 05/2006





1

balbuphine nalbuphine hydrochloride, malbuphine nalbuphine hydrochloride, jalbuphine nalbuphine hydrochloride, halbuphine nalbuphine hydrochloride, nzlbuphine nalbuphine hydrochloride, nslbuphine nalbuphine hydrochloride, nwlbuphine nalbuphine hydrochloride, nqlbuphine nalbuphine hydrochloride, nakbuphine nalbuphine hydrochloride, napbuphine nalbuphine hydrochloride, naobuphine nalbuphine hydrochloride, nalvuphine nalbuphine hydrochloride, nalnuphine nalbuphine hydrochloride, nalhuphine nalbuphine hydrochloride, nalguphine nalbuphine hydrochloride, nalbyphine nalbuphine hydrochloride, nalbhphine nalbuphine hydrochloride, nalbjphine nalbuphine hydrochloride, nalbiphine nalbuphine hydrochloride, nalb8phine nalbuphine hydrochloride, nalb7phine nalbuphine hydrochloride, nalbuohine nalbuphine hydrochloride, nalbulhine nalbuphine hydrochloride, nalbu-hine nalbuphine hydrochloride, nalbu0hine nalbuphine hydrochloride, nalbupgine nalbuphine hydrochloride, nalbupbine nalbuphine hydrochloride, nalbupnine nalbuphine hydrochloride, nalbupjine nalbuphine hydrochloride, nalbupuine nalbuphine hydrochloride, nalbupyine nalbuphine hydrochloride, nalbuphune nalbuphine hydrochloride, nalbuphjne nalbuphine hydrochloride, nalbuphkne nalbuphine hydrochloride, nalbuphone nalbuphine hydrochloride, nalbuph9ne nalbuphine hydrochloride, nalbuph8ne nalbuphine hydrochloride, nalbuphibe nalbuphine hydrochloride, nalbuphime nalbuphine hydrochloride, nalbuphije nalbuphine hydrochloride, nalbuphihe nalbuphine hydrochloride, nalbuphinw nalbuphine hydrochloride, nalbuphins nalbuphine hydrochloride, nalbuphind nalbuphine hydrochloride, nalbuphinr nalbuphine hydrochloride, nalbuphin4 nalbuphine hydrochloride, nalbuphin3 nalbuphine hydrochloride, nalbuphine balbuphine hydrochloride, nalbuphine malbuphine hydrochloride, nalbuphine jalbuphine hydrochloride, nalbuphine halbuphine hydrochloride, nalbuphine nzlbuphine hydrochloride, nalbuphine nslbuphine hydrochloride, nalbuphine nwlbuphine hydrochloride, nalbuphine nqlbuphine hydrochloride, nalbuphine nakbuphine hydrochloride, nalbuphine napbuphine hydrochloride, nalbuphine naobuphine hydrochloride, nalbuphine nalvuphine hydrochloride, nalbuphine nalnuphine hydrochloride, nalbuphine nalhuphine hydrochloride, nalbuphine nalguphine hydrochloride, nalbuphine nalbyphine hydrochloride, nalbuphine nalbhphine hydrochloride, nalbuphine nalbjphine hydrochloride, nalbuphine nalbiphine hydrochloride, nalbuphine nalb8phine hydrochloride, nalbuphine nalb7phine hydrochloride, nalbuphine nalbuohine hydrochloride, nalbuphine nalbulhine hydrochloride, nalbuphine nalbu-hine hydrochloride, nalbuphine nalbu0hine hydrochloride, nalbuphine nalbupgine hydrochloride, nalbuphine nalbupbine hydrochloride, nalbuphine nalbupnine hydrochloride, nalbuphine nalbupjine hydrochloride, nalbuphine nalbupuine hydrochloride, nalbuphine nalbupyine hydrochloride, nalbuphine nalbuphune hydrochloride, nalbuphine nalbuphjne hydrochloride, nalbuphine nalbuphkne hydrochloride, nalbuphine nalbuphone hydrochloride, nalbuphine nalbuph9ne hydrochloride, nalbuphine nalbuph8ne hydrochloride, nalbuphine nalbuphibe hydrochloride, nalbuphine nalbuphime hydrochloride, nalbuphine nalbuphije hydrochloride, nalbuphine nalbuphihe hydrochloride, nalbuphine nalbuphinw hydrochloride, nalbuphine nalbuphins hydrochloride, nalbuphine nalbuphind hydrochloride, nalbuphine nalbuphinr hydrochloride, nalbuphine nalbuphin4 hydrochloride, nalbuphine nalbuphin3 hydrochloride, nalbuphine nalbuphine gydrochloride, nalbuphine nalbuphine bydrochloride, nalbuphine nalbuphine nydrochloride, nalbuphine nalbuphine jydrochloride, nalbuphine nalbuphine uydrochloride, nalbuphine nalbuphine yydrochloride, nalbuphine nalbuphine htdrochloride, nalbuphine nalbuphine hgdrochloride, nalbuphine nalbuphine hhdrochloride, nalbuphine nalbuphine hudrochloride, nalbuphine nalbuphine h7drochloride, nalbuphine nalbuphine h6drochloride, nalbuphine nalbuphine hysrochloride, nalbuphine nalbuphine hyxrochloride, nalbuphine nalbuphine hycrochloride, nalbuphine nalbuphine hyfrochloride, nalbuphine nalbuphine hyrrochloride, nalbuphine nalbuphine hyerochloride, nalbuphine nalbuphine hydeochloride, nalbuphine nalbuphine hyddochloride, nalbuphine nalbuphine hydfochloride, nalbuphine nalbuphine hydtochloride, nalbuphine nalbuphine hyd5ochloride, nalbuphine nalbuphine hyd4ochloride, nalbuphine nalbuphine hydrichloride, nalbuphine nalbuphine hydrkchloride, nalbuphine nalbuphine hydrlchloride, nalbuphine nalbuphine hydrpchloride, nalbuphine nalbuphine hydr0chloride, nalbuphine nalbuphine hydr9chloride, nalbuphine nalbuphine hydroxhloride, nalbuphine nalbuphine hydrovhloride, nalbuphine nalbuphine hydrofhloride, nalbuphine nalbuphine hydrodhloride, nalbuphine nalbuphine hydrocgloride, nalbuphine nalbuphine hydrocbloride, nalbuphine nalbuphine hydrocnloride, nalbuphine nalbuphine hydrocjloride, nalbuphine nalbuphine hydroculoride, nalbuphine nalbuphine hydrocyloride, nalbuphine nalbuphine hydrochkoride, nalbuphine nalbuphine hydrochporide, nalbuphine nalbuphine hydrochooride, nalbuphine nalbuphine hydrochliride, nalbuphine nalbuphine hydrochlkride, nalbuphine nalbuphine hydrochllride, nalbuphine nalbuphine hydrochlpride, nalbuphine nalbuphine hydrochl0ride, nalbuphine nalbuphine hydrochl9ride, nalbuphine nalbuphine hydrochloeide, nalbuphine nalbuphine hydrochlodide, nalbuphine nalbuphine hydrochlofide, nalbuphine nalbuphine hydrochlotide, nalbuphine nalbuphine hydrochlo5ide, nalbuphine nalbuphine hydrochlo4ide, nalbuphine nalbuphine hydrochlorude, nalbuphine nalbuphine hydrochlorjde, nalbuphine nalbuphine hydrochlorkde, nalbuphine nalbuphine hydrochlorode, nalbuphine nalbuphine hydrochlor9de, nalbuphine nalbuphine hydrochlor8de, nalbuphine nalbuphine hydrochlorise, nalbuphine nalbuphine hydrochlorixe, nalbuphine nalbuphine hydrochlorice, nalbuphine nalbuphine hydrochlorife, nalbuphine nalbuphine hydrochlorire, nalbuphine nalbuphine hydrochloriee, nalbuphine nalbuphine hydrochloridw, nalbuphine nalbuphine hydrochlorids, nalbuphine nalbuphine hydrochloridd, nalbuphine nalbuphine hydrochloridr, nalbuphine nalbuphine hydrochlorid4, nalbuphine nalbuphine hydrochlorid3, albuphine nalbuphine hydrochloride, nlbuphine nalbuphine hydrochloride, nabuphine nalbuphine hydrochloride, naluphine nalbuphine hydrochloride, nalbphine nalbuphine hydrochloride, nalbuhine nalbuphine hydrochloride, nalbupine nalbuphine hydrochloride, nalbuphne nalbuphine hydrochloride, nalbuphie nalbuphine hydrochloride, nalbuphin nalbuphine hydrochloride, nalbuphine nalbuphine hydrochloride, nalbuphine nalbuphine hydrochloride, nalbuphine albuphine hydrochloride, nalbuphine nlbuphine hydrochloride, nalbuphine nabuphine hydrochloride, nalbuphine naluphine hydrochloride, nalbuphine nalbphine hydrochloride, nalbuphine nalbuhine hydrochloride, nalbuphine nalbupine hydrochloride, nalbuphine nalbuphne hydrochloride, nalbuphine nalbuphie hydrochloride, nalbuphine nalbuphin hydrochloride, nalbuphine nalbuphinehydrochloride, nalbuphine nalbuphine ydrochloride, nalbuphine nalbuphine hdrochloride, nalbuphine nalbuphine hyrochloride, nalbuphine nalbuphine hydochloride, nalbuphine nalbuphine hydrchloride, nalbuphine nalbuphine hydrohloride, nalbuphine nalbuphine hydrocloride, nalbuphine nalbuphine hydrochoride, nalbuphine nalbuphine hydrochlride, nalbuphine nalbuphine hydrochloide, nalbuphine nalbuphine hydrochlorde, nalbuphine nalbuphine hydrochlorie, nalbuphine nalbuphine hydrochlorid, anlbuphine nalbuphine hydrochloride, nlabuphine nalbuphine hydrochloride, nabluphine nalbuphine hydrochloride, nalubphine nalbuphine hydrochloride, nalbpuhine nalbuphine hydrochloride, nalbuhpine nalbuphine hydrochloride, nalbupihne nalbuphine hydrochloride, nalbuphnie nalbuphine hydrochloride, nalbuphien nalbuphine hydrochloride, nalbuphin e nalbuphine hydrochloride, nalbuphine nalbuphine hydrochloride, nalbuphine n albuphine hydrochloride, nalbuphine anlbuphine hydrochloride, nalbuphine nlabuphine hydrochloride, nalbuphine nabluphine hydrochloride, nalbuphine nalubphine hydrochloride, nalbuphine nalbpuhine hydrochloride, nalbuphine nalbuhpine hydrochloride, nalbuphine nalbupihne hydrochloride, nalbuphine nalbuphnie hydrochloride, nalbuphine nalbuphien hydrochloride, nalbuphine nalbuphin ehydrochloride, nalbuphine nalbuphineh ydrochloride, nalbuphine nalbuphine yhdrochloride, nalbuphine nalbuphine hdyrochloride, nalbuphine nalbuphine hyrdochloride, nalbuphine nalbuphine hydorchloride, nalbuphine nalbuphine hydrcohloride, nalbuphine nalbuphine hydrohcloride, nalbuphine nalbuphine hydroclhoride, nalbuphine nalbuphine hydrocholride, nalbuphine nalbuphine hydrochlroide, nalbuphine nalbuphine hydrochloirde, nalbuphine nalbuphine hydrochlordie, nalbuphine nalbuphine hydrochloried, nnalbuphine nalbuphine hydrochloride, naalbuphine nalbuphine hydrochloride, nallbuphine nalbuphine hydrochloride, nalbbuphine nalbuphine hydrochloride, nalbuuphine nalbuphine hydrochloride, nalbupphine nalbuphine hydrochloride, nalbuphhine nalbuphine hydrochloride, nalbuphiine nalbuphine hydrochloride, nalbuphinne nalbuphine hydrochloride, nalbuphinee nalbuphine hydrochloride, nalbuphine nalbuphine hydrochloride, nalbuphine nalbuphine hydrochloride, nalbuphine nnalbuphine hydrochloride, nalbuphine naalbuphine hydrochloride, nalbuphine nallbuphine hydrochloride, nalbuphine nalbbuphine hydrochloride, nalbuphine nalbuuphine hydrochloride, nalbuphine nalbupphine hydrochloride, nalbuphine nalbuphhine hydrochloride, nalbuphine nalbuphiine hydrochloride, nalbuphine nalbuphinne hydrochloride, nalbuphine nalbuphinee hydrochloride, nalbuphine nalbuphine hydrochloride, nalbuphine nalbuphine hhydrochloride, nalbuphine nalbuphine hyydrochloride, nalbuphine nalbuphine hyddrochloride, nalbuphine nalbuphine hydrrochloride, nalbuphine nalbuphine hydroochloride, nalbuphine nalbuphine hydrocchloride, nalbuphine nalbuphine hydrochhloride, nalbuphine nalbuphine hydrochlloride, nalbuphine nalbuphine hydrochlooride, nalbuphine nalbuphine hydrochlorride, nalbuphine nalbuphine hydrochloriide, nalbuphine nalbuphine hydrochloridde, nalbuphine nalbuphine hydrochloridee, etc.

USA hospitals | Natural mosquito repellent | New 401k contribution limits | PMS | Blue waffles disease | Keratosis pilaris on face tretment


© Copyright by Drugspedia.net 2006-2007. All rights reserved