Naloxone

5
Naloxone
Brands

DEA Class; Rx

Common Brand Names; Zimhi

  • Opioid Antagonists; 
  • Opioid Reversal Agents

naloxone intranasal (Rx)

Brand and Other Names:Narcan Nasal Spray, Kloxxado
  • Classes: Opioid Reversal Agents

Opioid antagonist; derivative of oxymorphone
Used for reversal of opioid-induced respiratory and CNS depression
Auto-injector and nasal formulations available to treat or prevent an overdose outside of health care setting

Indicated for the complete or partial reversal of opioid depression (including respiratory depression) induced by natural and synthetic opioids

Indicated for emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system (CNS) depression

Intended for immediate use as emergency therapy in settings where opioids may be present

For reversal of opiate agonist-induced respiratory depression.

For the treatment of pruritus due to specific conditions.
For the treatment of unexplained coma in an unresponsive patient.
For opiate agonist dependence diagnosis.

Hypersensitivity

Withdrawal reaction precipitated

Abrupt reversal of narcotic depression may result in nausea, vomiting, sweating, tachycardia, increased blood pressure and tremulousness

Cardiac arrest

Ventricular fibrillation

Dyspnea

Pulmonary edema

Abdominal cramps

Diarrhea

Cardiac arrest

Hypertension

Hypotension

Ventricular tachycardia

Paresthesia

Restlessness

Shivering

Tonic-clonic seizures

Yawning

Diaphoresis

Piloerection

Hot flash

Myalgia

Tremor

Weakness

Rhinorrhea

Sneezing

Caution in patients with cardiovascular disease or patients receiving medications with potential adverse cardiovascular effects

Caution in patients with history of seizures; avoid use in treatment of meperidine-induced seizures

Recurrence of respiratory depression may occur if opioid involved is long-acting or a partial agonist (eg, methadone, buprenorphine); observe patients until there is no further risk of recurrent respiratory or CNS depression

Avoid excessive dosages after use of opioids in surgery; abrupt postoperative reversal may unmask pain and may cause nausea, vomiting, sweating, seizures, hypertension, and tachycardia; other cardiovascular events, including pulmonary edema and arrhythmias may occur

Pregnancy category: C

Lactation: Not known if distributed in milk; use caution

Adults

2 mg per dose IV/IO/IM/subcutaneous (standard syringe); 5 mg per dose IM/subcutaneous (Zimhi auto-injector); 10 mg per dose IM/subcutaneous (10 mg/0.4 mL auto-injector); 1 spray (4 or 8 mg) per dose intranasally; doses may be repeated to maintain opiate reversal.

Geriatric

2 mg per dose IV/IO/IM/subcutaneous (standard syringe); 5 mg per dose IM/subcutaneous (Zimhi auto-injector); 10 mg per dose IM/subcutaneous (10 mg/0.4 mL auto-injector); 1 spray (4 or 8 mg) per dose intranasally; doses may be repeated to maintain opiate reversal.

Adolescents

2 mg per dose IV/IO/IM/subcutaneous (standard syringe); 5 mg per dose IM/subcutaneous (Zimhi auto-injector); 10 mg per dose IM/subcutaneous (10 mg/0.4 mL auto-injector); 1 spray (4 or 8 mg) per dose intranasally; doses may be repeated to maintain opiate reversal.

Children

12 years: 2 mg per dose IV/IO/IM/subcutaneous (standard syringe); 5 mg per dose IM/subcutaneous (Zimhi auto-injector); 10 mg per dose IM/subcutaneous (10 mg/0.4 mL auto-injector); 1 spray (4 or 8 mg) per dose intranasally; doses may be repeated to maintain opiate reversal.
5 to 11 years and weighing more than 20 kg: 2 mg per dose IV/IO/IM/subcutaneous (standard syringe); 5 mg per dose IM/subcutaneous (Zimhi auto-injector); 1 spray (4 or 8 mg) per dose intranasally; doses may be repeated to maintain opiate reversal.
1 to 4 years or weighing 20 kg or less: 0.1 mg/kg/dose IV/IO (standard syringe); 5 mg per dose IM/subcutaneous (Zimhi auto-injector); 1 spray (4 or 8 mg) per dose intranasally; doses may be repeated to maintain opiate reversal.

Infants

0.1 mg/kg/dose IV/IO (standard syringe); 5 mg per dose IM/subcutaneous (Zimhi auto-injector); 1 spray (4 or 8 mg) per dose intranasally; doses may be repeated to maintain opiate reversal.

Neonates

0.1 mg/kg/dose IV/IM (standard syringe); 5 mg per dose IM/subcutaneous (Zimhi auto-injector); 1 spray (4 or 8 mg) per dose intranasally; doses may be repeated to maintain opiate reversal.

Naloxone

injectable solution

  • 0.4mg/mL
  • 1mg/mL

injectable solution, high-dose

  • 5mg/0.5mL prefilled syringe (Zimhi)

intranasal solution (Narcan)

  • 2mg/actuation (equivalent to 1.8 mg naloxone)
  • 4mg/actuation (equivalent to 3.6 mg naloxone)

intranasal solution (Kloxxado)

  • 8mg/actuation (equivalent to 7.2 mg naloxone)
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