Naloxone: Overdose Reversal Uses, Warnings, Side Effects, Dosage (original) (raw)
- Uses
- Side Effects
- Warnings
- Dosage
- Drug Interactions
- Overdose
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: naloxone
Brand Names: Narcan, Evzio, Narcan Nasal Spray
Drug Class: Opioid Antagonists
What is naloxone (Narcan), and what is it used for?
Naloxone is a man-made opioid antagonist, which means that it blocks the action of opioid medications such as morphine and related drugs.
Naloxone works by binding to mu-receptors in the brain that opioids use to produce their effect on pain and other symptoms. By binding to mu receptors, naloxone reverses opioid activity in the body.
Doctors and other health care professionals use naloxone for partial or complete reversal of respiratory depression caused by synthetic (man-made) or natural opioids (narcotics), and to diagnose suspected or known acute opioid overdose.
Doctors also use naloxone to increase blood pressure in people with septic shock.
What are the side effects of naloxone?
Side effects of Naloxone include:
- increase or decrease in blood pressure,
- abnormal heart rate and rhythm,
- troubled breathing,
- cardiac arrest,
- fluid retention in lungs, and
- diarrhea.
Warnings for naloxone
- Do not administer to patients with known hypersensitivity to naloxone or any of its components.
- Naloxone may precipitate severe withdrawal symptoms in opioid-dependent individuals. Use with caution if potential benefits are expected to outweigh the risks. Initiate therapy at a lower dose.
- Respiratory depression may recur if the overdose is from a long-acting opioid. Monitor patient closely until stable and there is no risk of further respiratory or central nervous system (CNS) depression.
- Opiate withdrawal may be life-threatening in newborns if not promptly recognized and treated. Symptoms may include excessive crying, hyperactive reflexes, and convulsions.
- Use with caution in patients with cardiovascular diseases and patients taking medications with potential adverse cardiovascular effects.
- Use with caution in patients with a history of seizures. Avoid use in the treatment of meperidine-induced seizures.
- Exercise caution and avoid excessive dosages of naloxone after the use of opioids in surgery. Abrupt postoperative reversal may unmask pain and may cause symptoms that can include pulmonary edema and cardiac arrhythmias.
QUESTION What are opioids used to treat? See Answer
What is the dosage for naloxone?
Adult dosage
- Opioid overdose: 0.4 to 2 mg intravenous (IV), intramuscular (IM), or subcutaneous injection every 2 to 3 minutes as needed; however, after10 mg administered, it is recommended that its use be reassessed as the symptoms may not be due to opiate activity.
- Reversal of opiate activity: 0.1 to 0.2 mg IV, IM, or subcutaneous injection every 2 to 3 minutes as needed.
Dosage for children (5 years or older OR 20 kg or less):
- Opioid overdose: Initially 0.01 mg/kg IV; may increase to 0.1 mg/kg if necessary.
- Postoperative opioid depression: 0.005 to 0.01 mg IV every 2 to 3 minutes as needed.
Nasal spray dosage
- The initial dose of the nasal Spray in adults and pediatric patients is one spray into one nostril. An additional dose may given if the response is not adequate.
- If needed, administer additional doses every 2 to 3 minutes.
- Additional doses should be administered to alternate nostrils using a new naloxone nasal spray.
Which drugs interact with naloxone?
- Large doses of Naloxone are required when used together with buprenorphine since buprenorphine binds and dissociates slowly from mu receptors.
- Large doses of Naloxone may cause respiratory distress.
Health News
Overdose of naloxone
- Naloxone is administered primarily by trained health professionals, police officers and military personnel to reverse opioid effects and overdose is unlikely. Naloxone effects last for a duration of one to two hours. Naloxone does not have any significant effect on individuals who have not taken opioids.
- Abrupt reversal of opioids because of naloxone administration may cause severe withdrawal symptoms.
- Although no causal relationship has been established, after postoperative administration of naloxone, there have been reports of severe cardiopulmonary effects such as blood pressure rise or drop, rapid and irregular ventricular beats, shortness of breath, fluid in the lungs and cardiac arrest, leading to death.
- Naloxone overdose treatment may be discontinuation of the drug and supportive and symptomatic care.
Pregnancy and breastfeeding
- There are no adequate studies done on Naloxone to determine safe and effective use in pregnant women.
- It is not known whether Naloxone enters breast milk; therefore, it is best to be cautious before using it in women who are breastfeeding.
What else should I know about naloxone?
- Naloxone is available as injection of 0.4 and 1 mg/ml, auto Injector of 0.4 mg/0.4 ml, and nasal spray of 2mg and 4mg.
- Naloxone should be stored at room temperature 20 C to 25 C (68 F to 77 F).
- Narcan and Evzio are the brand names available for naloxone in the US.
- Narcan is available in generic form. You need a prescription from your doctor or other health care professional to obtain Narcan.
Summary
Naloxone hydrochloride injection is a drug used to treat signs and symptoms of drug and other substance abuse. Side effects, drug interactions, dosage, and pregnancy safety information should be reviewed prior to administering this medication. Naloxone is available as a generic drug, or under the brand names Narcan, Evzio, and Narcan Nasal Spray. You need a prescription from your health care provider for this drug.
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