naloxone - hydrochloride injection (Narcan, Evzio)

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GENERIC NAME: naloxone hydrochloride

BRAND NAME: Narcan (Discontinued Brand in the US), Evzio

DRUG CLASS AND MECHANISM: 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.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Injection: 0.4 and 1 mg/ml; Auto Injector: 0.4 mg/0.4 ml

STORAGE: Store Naloxone injections at room temperature 20 C to 25 C (68 F to 77 F).

PRESCRIBED FOR: Naloxone is used for partial or complete opioid competitive binding of mu-receptors to reverse respiratory depression and to treat opioid overdose symptoms. It is also used to increase blood pressure in people with septic shock.

DOSING:

Adults

  • 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.

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.

DRUG INTERACTIONS: 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.

PREGNANCY: There are no adequate studies done on Naloxone to determine safe and effective use in pregnant women.

NURSING MOTHERS: It is not known whether Naloxone enters breast milk; therefore, it is best to be cautious before using it in women who are breastfeeding.

SIDE EFFECTS: Side effects of Naloxone are increase or decrease in blood pressure, abnormal heart rate and rhythm, troubled breathing, cardiac arrest, fluid retention in lungs, and diarrhea.

REFERENCE: FDA Prescribing Information.


Medically Reviewed by a Doctor on 6/13/2014



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