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Naloxone

Narcotic antagonist

FR: Reversal of respiratory depression caused by suspected narcotic intoxication

 

Allergy or known hypersensitivity to naloxone

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:
    1. 4 mg IV
    2. 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. 

Never administer naloxone to neonates.

Follow weight-based dosing

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

 

Competitively antagonizes opioids bound to receptors in the central nervous system. 

  • Onset: 1 minute (intravenous); 3-5 minutes (intramuscular)
  • Peak: unknown
  • Half-life: 1-3 hours
  • Duration: 45 minutes
  • Sudden reversal of narcotic intoxication may provoke combativeness
  • May produce withdrawal signs and symptoms
  • Hypotension or hypertension
  • Nausea and vomiting, sweating, tachycardia

 

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