Naloxone
Classification
Narcotic antagonist
Indications
FR: Reversal of respiratory depression caused by suspected narcotic intoxication
Contraindications
Allergy or known hypersensitivity to naloxone
Adult dosages
FR: Reversal of respiratory depression caused by suspected narcotic intoxication
- 0.4 mg IM every 3 minutes as required, to maximum of 3 total doses
EMR: Reversal of respiratory depression caused by suspected narcotic intoxication
- 0.4 mg IM every 3 minutes as required, to a maximum of 4 total doses
- Second dose: 0.4 mg IM if required
- Third dose: 0.8 mg IM if required
- Fourth dose: 2 mg IM if required
PCP: Reversal of respiratory depression caused by suspected narcotic intoxication
- 0.4 mg IM/IV every 3 minutes as required, to a maximum of 3 total doses
- Second dose: 0.4 mg IM/IV if required
- Third dose: 0.8 mg IM/IV if required
- Fourth dose: 2 mg IM/IV if required (IV preferred)
ACP: Reversal of respiratory depression caused by suspected narcotic intoxication
- As per PCP schedule
- May also consider, in order:
- 4 mg IV
- 10 mg IV Requires CliniCall consultation -- 1-833-829-4099
Titrate doses to improve spontaneous respiratory effort. It is not necessary to administer sufficient naloxone to completely reverse the opioid effects.
Pediatric Considerations And Dosing
Never administer naloxone to neonates.
FR: Not authorized
EMR: Reversal of respiratory depression caused by suspected narcotic intoxication
- 0.1 mg/kg (to maximum of 2 mg per dose), repeated every 3 minutes, to maximum of 4 total doses
- Higher dose for pediatric patients as they are unlikely to experience withdrawal
Mechanism Of Action
Competitively antagonizes opioids bound to receptors in the central nervous system.
Pharmocokinetics
- Onset: 1 minute (intravenous); 3-5 minutes (intramuscular)
- Peak: unknown
- Half-life: 1-3 hours
- Duration: 45 minutes
Adverse Effects
- Sudden reversal of narcotic intoxication may provoke combativeness
- May produce withdrawal signs and symptoms
- Hypotension or hypertension
- Nausea and vomiting, sweating, tachycardia