Naloxone


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Opioid dependence 0.2-3 g/day. IV Reversal of central depression from opioid use during surgery As naloxone hydrochloride: 100-200 mcg, may give additional 100 mcg if necessary at 2-3 minute intervals until adequate response is obtained. Dose may be repeated within 1-2 hours depending on the dose, type and time interval of last opioid administration. Opioid overdosage As naloxone hydrochloride: 0.4-2 mg repeated if necessary at 2-3 minute intervals. If there is no response after a total of 10 mg has been given, consider the possibility of overdosage with other drugs.
Dosage Details
Intravenous
Reversal of central depression from opioid use during surgery
Adult: As naloxone hydrochloride: 100-200 mcg, may give additional 100 mcg if necessary at 2-3 minute intervals until adequate response is obtained. Dose may be repeated within 1-2 hours depending on the dose, type and time interval of last opioid administration.
Child: As naloxone hydrochloride: 10-20 mcg/kg at 2-3 minute intervals until adequate response is obtained. May give additional dose if necessary at 1-2 hours interval depending on the dose, type and time interval of last opioid administration.

Intravenous
Opioid overdosage
Adult: As naloxone hydrochloride: 0.4-2 mg repeated if necessary at 2-3 minute intervals. If there is no response after a total of 10 mg has been given, consider the possibility of overdosage with other drugs.
Child: As naloxone hydrochloride: Initially, 10 mcg/kg followed by 100 mcg/kg , if necessary. Alternatively, may be given via IM inj, if IV admin is not possible.

Oral
Opioid dependence
Adult: As hydrochloride: 200 mg to 3 g daily.

Parenteral
Opioid-induced respiratory depression in neonates due to obstetric analgesia
Child: As naloxone hydrochloride: 10 mcg/kg via IV or IM inj, may be repeated at 2-3 minute intervals if necessary.
Reconstitution
Intravenous:
Opioid overdosage: Stable in 0.9% sodium chloride and 5% dextrose ing at 4 mcg/ml for 24 hr.
Reversal of central depression from opioid use dur...: Stable in 0.9% sodium chloride and 5% dextrose inj at 4 mcg/ml for 24 hr.
Parenteral:
Stable in 0.9% sodium chloride and 5% dextrose inj at 4 mcg/ml for 24 hr.
Incompatibility
Preparations containing bisulfite, metabisulfite, long-chain or high-molecular wt anions, or solutions with an alkaline pH.
Special Precautions
Patients physically dependent on opioids, or who have received large doses of opioids (acute withdrawal syndrome may be precipitated). Pregnancy and lactation.
Adverse Reactions
Occur secondarily to reversal (withdrawal) of narcotic analgesia and sedation. Mental depression, apathy, inability to concentrate, sleepiness, irritability, anorexia, nausea, and vomiting in high oral doses during initial treatment of opiate addiction.
Potentially Fatal: Severe cardiopulmonary effects (e.g. hypotension, hypertension, ventricular tachycardia and fibrillation, dyspnoea, pulmonary oedema, cardiac arrest) in postoperative patients, most frequently in those with preexisting CV disease. Recurrence of respiratory depression in long-acting opioids.
IM/IV/Nasal/Parenteral/SC: C
Drug Interactions
Decreased effect of opioid analgesics.
Potentially Fatal: Acute withdrawal reaction in physically dependent patients may occur with opioid analgesics. Severe cardiopulmonary effects may occur with cardiotoxic drugs.
Action
Description: Naloxone is a pure opioid antagonist that acts competitively at opioid receptors.
Onset: 2 min (IV); 2-5 min (endotracheal, IM, SC).
Duration: 30-120 min depending on route; IV has a shorter duration than IM.
Pharmacokinetics:
Distribution: Crosses placenta.
Metabolism: Extensively hepatic via glucuronidation.
Excretion: Urine (as metabolites); elimination half-life: 0.5-1.5 hr (adult); 3-4 hr (neonates).
Storage
Store at 25°C. Protect from light.
Disclaimer: This information is independently developed by MIMS based on Naloxone from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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