naloxone

Generic Name: naloxone (nah LOX own)Brand Names: Narcan

What is naloxone?

Naloxone is an special narcotic drug that reverses the effects of other narcotic medicines.

Naloxone is used to reverse the effects of narcotic drugs used during surgery or to treat pain. Naloxone may also be used to treat narcotic drug overdose or to diagnose narcotic drug addiction.

Naloxone may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about naloxone?

Before using naloxone, tell your doctor if you are using any narcotic pain medicines. The pain-relieving effects of any narcotic medications you use will be reversed if you use them during your treatment with naloxone. Withdrawal symptoms could also occur, such as body aches, diarrhea, increased heart rate, fever, sweating, nausea or vomiting, irritability, trembling, weakness, and increased blood pressure. Your doctor may want to observe you after using naloxone to watch for side effects.

Naloxone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol while taking naloxone. Alcohol may increase dizziness caused by naloxone.

What should I discuss with my health care provider before using naloxone?

You should not use this medication if you are allergic to naloxone.

Before using naloxone, tell your doctor if you are allergic to any drugs, or if you have:

• a brain tumor or head injury;

• seizures;

• heart disease or a heart rhythm disorder; or

• a history of drug or alcohol addiction.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use naloxone.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether naloxone passes into breast milk or if it could harm a nursing baby. Do not use naloxone without telling your doctor if you are breast-feeding a baby.

How should I use naloxone?

Use this medication exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Naloxone is given as an injection under the skin, into a muscle, or into a vein. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Do not draw your naloxone dose into a syringe until you are ready to give yourself an injection. Do not use the medication if it has changed colors or has any particles in it. Call your doctor for a new prescription.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Store this medication at room temperature away from heat and moisture.

What happens if I miss a dose?

Contact your healthcare provider if you miss a dose of naloxone.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include seizure (convulsions), feeling light-headed, or fainting.

What should I avoid while using naloxone?

Naloxone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol while taking naloxone. Alcohol may increase dizziness caused by naloxone.

Naloxone side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using naloxone and call your doctor at once if you have any of these serious side effects:

• chest pain or fast or irregular heartbeats;

• feeling light-headed, fainting;

• seizure (convulsions); or

• difficulty breathing.

Less serious side effects may include:

• dizzines, weakness, tired feeling;

• nausea, vomiting, or diarrhea;

• feeling nervous, restless, or excited;

• sweating;

• runny nose; or

• trembling.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Naloxone Dosing Information

Usual Adult Dose for Opioid Overdose:

0.4 to 2 mg/dose IV/IM/subcutaneously. May repeat every 2 to 3 minutes as needed. Therapy may need to be reassessed if no response is seen after a cumulative dose of 10 mg.Continuous infusion: 0.005 mg/kg loading dose followed by an infusion of 0.0025 mg/kg/hr.

Usual Pediatric Dose for Opioid Overdose:

<20 kg: 0.1 mg/kg/dose IV/IM/subcutaneously. May repeat every 2 to 3 minutes as needed.>= 20 kg (or >= 6 years): 2 mg/dose IV/IM/subcutaneously. May repeat every 2 to 3 minutes as needed. Therapy may need to be reassessed if no response is seen after a cumulative dose of 10 mg.Continuous infusion: 0.005 mg/kg loading dose followed by an infusion of 0.0025 mg/kg/hr.Postanesthesia narcotic reversal: >= 1 month: 0.01 mg/kg. May repeat every 2 to 3 minutes as needed.

What other drugs will affect naloxone?

The pain-relieving effects of any narcotic pain medications you use will be reversed if you use them during your treatment with naloxone. Withdrawal symptoms could also occur, such as body aches, diarrhea, increased heart rate, fever, sweating, nausea or vomiting, irritability, trembling, weakness, and increased blood pressure. Your doctor may want to observe you after using naloxone to watch for side effects.

Before using naloxone, tell your doctor if you use any of the following drugs:

• buprenorphine (Buprenex, Subutex);

• butorphanol (Stadol);

• codeine (Tylenol with codeine);

• hydrocodone (Lortab, Vicodin);

• dezocine (Dalgan);

• hydromorphone (Dilaudid);

• levorphanol (Levo-Dromoran);

• meperidine (Demerol);

• methadone (Dolophine, Methadose);

• morphine (Kadian, MS Contin, Roxanol);

• nalbuphine (Nubain);

• nalmefene (Revex);

• naltrexone (ReVia);

• oxycodone (OxyContin, Roxicodone, Percocet);

• oxymorphone (Numorphan); or

• propoxyphene (Darvon, Darvocet).

This list is not complete and there may be other drugs that can interact with naloxone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about naloxone.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 2.03. Revision Date: 4/12/2009 4:36:58 PM.