Naloxone Intranasal

Naloxone intranasal is used for emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system (CNS) depression.

Naloxone intranasal is available under the following different brand names: Narcan Nasal Spray.

Dosage Forms and Strengths

Intranasal Solution

• 4mg/actuation

Dosage Considerations – Should be Given as Follows:

Opioid Overdose

• Indicated for emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system (CNS) depression.
• Initial dosing: 1 spray delivered by intranasal administration; delivers 4 mg of naloxone HCl

Repeat dosing

• Seek emergency medical assistance as soon as possible after administering the first dose
• The requirement for repeat doses depends on the amount, type, and route of administration of the opioid being antagonized
• Administer in alternate nostrils with each dose
• If the patient responds and relapses back into respiratory depression before emergency assistance arrives, administer an additional dose of naloxone intranasal using a new spray and continue surveillance of the patient
• If the desired response is not obtained after 2-3 minutes, administer an additional dose using a new spray
• If there is still no response and additional doses are available, administer additional doses every 2-3 minutes using a new spray with each dose until emergency medical assistance arrives
• Additional supportive and/or resuscitative measures may be helpful while awaiting emergency medical assistance

Dosage Modifications

Partial opioid agonists or mixed agonist/antagonists

• Reversal of respiratory depression by partial agonists or mixed agonist/antagonists (e.g., buprenorphine, pentazocine) may be incomplete and require higher doses of naloxone or repeated administration

Dosing Considerations

• Intended for immediate administration as emergency therapy in settings where opioids may be present
• Not a substitute for emergency medical care
• Geriatric patients have a greater frequency of decreased hepatic, renal, or cardiac function and concomitant disease or other drug therapy; therefore, the systemic exposure of naloxone can be higher in these patients