What is naloxone?

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Generic Name: Naloxone Brand Name(s): Generics only. No brands available.

Know the basics

What is naloxone used for?

This medication is used for the emergency treatment of known or suspected narcotic (opiate) overdose. Serious overdose symptoms may include unusual sleepiness, unusual difficulty waking up, or breathing problems (ranging from slow/shallow breathing to no breathing). Other symptoms of overdose may include very small “pinpoint” pupils, slow heartbeat, or low blood pressure. If someone has serious overdose symptoms but you are not sure if he or she has overdosed, give this medication right away anyway, since lasting slow/shallow breathing may cause permanent damage to the brain or death.

This medication belongs to a class of drugs known as narcotic (opiate) antagonists. It works by blocking the effects of the narcotic in the brain. This medication may not work as well to block the effects of certain types of narcotics (mixed agonist/antagonists such as buprenorphine, pentazocine). With these types of narcotics, blocking may be incomplete or you may need a higher dose of naloxone.

The effects of naloxone will not last as long as the effects of the narcotic. Since treatment with this medication is not long-lasting, be sure to get medical help right away after giving the first dose of naloxone. Treatment of narcotic overdose should also include breathing treatment (such as oxygen given through tubes in the nose, mechanical ventilation, artificial respiration).

How should I take naloxone?

Read the Patient Information Leaflet and Instructions for Use provided by your pharmacist when you get this medication and each time you get a refill. Be sure to keep this medication handy in case it is needed. Learn ahead of time how to properly inject this medication and practice with the trainer device so you will be ready to use naloxone if needed. If you have any questions, ask your doctor or pharmacist.

The solution in this product should be clear. Check this product visually for particles or discoloration from time to time. If the solution is cloudy, discolored, or contains solid particles, replace it with a new auto-injector. (See also Storage section.)

Avoid accidentally injecting this medication into your hands or areas of the body other than the thigh. If this happens, tell the healthcare professional immediately.

The effects of this medication are rapid but not long-lasting. After giving naloxone, get medical help right away, even if the person wakes up. If symptoms return after giving an injection, give another naloxone injection using a new auto-injector every 2 to 3 minutes if available. Each auto-injector contains only one dose and cannot be reused. Continue to closely watch the person until emergency help is received. Tell the healthcare professional that you have given an injection of naloxone.

How do I store naloxone?

Naloxone is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store naloxone in the bathroom or the freezer. There may be different brands of naloxone that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush naloxone down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using naloxone?

Before using naloxone injection,

  • tell your doctor and pharmacist if you are allergic to naloxone injection, any other medications, or any of the ingredients in naloxone injection. Ask your pharmacist or check the manufacturer’s patient information for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Many medications that affect your heart or blood pressure may increase the risk that you will develop serious side effects of naloxone injection. Be sure to tell your doctor about all the medications you are taking.
  • tell your doctor if you have or have ever had heart, kidney, or liver disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you receive naloxone injection during pregnancy, your doctor may need to monitor your unborn baby carefully after you receive the medication.

Is it safe to take naloxone during pregnancy or breast-feeding?

There isn’t enough information about the safety of using this medication during pregnancy and breast-feeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication.

Know the side effects

What are the side effects of naloxone?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • chest pain, fast or irregular heartbeats;
  • dry cough, wheezing, feeling short of breath;
  • sweating, severe nausea or vomiting;
  • severe headache, agitation, anxiety, confusion, ringing in your ears;
  • seizure (convulsions);
  • feeling like you might pass out; or
  • slow heart rate, weak pulse, fainting, slow breathing (breathing may stop).

If you are being treated for narcotic drug addiction, the expected symptoms of withdrawal would include:

  • feeling nervous, restless, or irritable;
  • body aches;
  • dizziness, weakness;
  • diarrhea, stomach pain, mild nausea;
  • fever, chills, goosebumps; or
  • sneezing, runny nose.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with naloxone?

Naloxone may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval, especially:

  • Morphine
  • Morphine Sulfate Liposome
  • Naloxegol
  • Oxycodone
  • Oxymorphone
  • Clonidine
  • Yohimbine

Does food or alcohol interact with naloxone?

Naloxone may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with naloxone?

Naloxone may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Heart disease or
  • Kidney disease or
  • Liver disease—Use with caution. May make these conditions worse.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.

What is the dose of Naloxone for an adult?

Usual Adult Dose for Opioid Overdose

0.4 to 2 mg/dose IV/IM/subcutaneously. May repeat every 2 to 3 minutes as needed. Therapy may need to be reassessed if no response is seen after a cumulative dose of 10 mg.

Continuous infusion: 0.005 mg/kg loading dose followed by an infusion of 0.0025 mg/kg/hr.

What is the dose of Naloxone for a child?

Usual Pediatric Dose for Opioid Overdose

Infants, Children, and Adolescents:
Opioid intoxication (full reversal):
IV (preferred) or Intraosseous (IO): Note: May be administered IM, Subcutaneous, or endotracheal tube (ET), but onset of action may be delayed, especially if patient has poor perfusion; ET preferred if IV or IO route not available; doses may need to be repeated.

Infants and Children less than or equal to 5 years or less than or equal to 20 kg: 0.1 mg/kg/dose; repeat every 2 to 3 minutes if needed; may need to repeat doses every 20 to 60 minutes.

Children greater than 5 years or greater than 20 kg and Adolescents: 2 mg/dose; if no response, repeat every 2 to 3 minutes; may need to repeat doses every 20 to 60 minutes.

ET: Optimal endotracheal dose unknown; current expert recommendations are 2 to 3 times the IV dose.

Manufacturer recommendations: IV (preferred), IM, Subcutaneous:
Initial: 0.01 mg/kg/dose; if no response, a subsequent dose of 0.1 mg/kg may be given
Note: If using IM or Subcutaneous route, dose should be given in divided doses.

Continuous IV infusion:
Children: If continuous infusion is required, calculate the initial dosage/hour based on the effective intermittent dose used and duration of adequate response seen; titrate dose; a range of 2.5 to 160 mcg/kg/hour has been reported; taper continuous infusion gradually to avoid relapse.

Respiratory depression [therapeutic opioid use (e.g., postanesthesia)]:
PALS Guidelines, 2010: IV: 0.001 to 0.005 mg/kg/dose; titrate to effect
Manufacturer recommendations: Initial: 0.005 to 0.01 mg/kg; repeat every 2 to 3 minutes as needed based on response.

Opioid-induced pruritus:
Children and Adolescents: Limited data available

How is Naloxone available?

Naloxone is available in the following dosage forms and strengths:

Solution, Injection: 0.4 mg/mL

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

Symptoms of overdose may include:

  • seizures
  • slowed heartbeat
  • irritability
  • anxiety
  • tension
  • suspiciousness
  • sadness
  • difficulty concentrating
  • loss of appetite
  • dizziness
  • heaviness
  • sweating
  • nausea
  • stomach pain

What should I do if I miss a dose?

If you miss a dose of naloxone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: May 30, 2016 | Last Modified: January 4, 2017

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