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NALOXONE (NARCAN)
Class/Mechanism of Action
• Antidote, Opioid Antagonist
Competes and displaces opioids at opioid receptor sites, reversing narcotic effects.
Indications
• Labeled Indications
˚ Reversal of opioid drug effects, including respiratory depression
Contraindications
• Hypersensitivity to naloxone or any component of the formulation
Adverse Reactions/Precautions
• When correcting respiratory depression in a postoperative, intubated patient, carefully
titrate the dose to reverse hypoventilation; do not fully awaken the patient or reverse the
analgesic effect.
• Recurrence of respiratory and/or CNS depression is possible; continue to watch for respiratory
or CNS depression.
• May precipitate acute narcotic withdrawal in opioid-dependent patients, including pain,
tachycardia, hypertension, abdominal cramps, diarrhea, nausea, vomiting, agitation, and
irritability
• In neonates, opioid withdrawal may be life-threatening; symptoms may include excessive
crying, failure to feel, seizures, and hyperactive reflexes.
• Pregnancy: Category C
• Lactation: Yes, use caution
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Opioid Overdose Opioid Overdose
• IV (Push over 30 sec)/IM/IN/SubQ • IV/IM/IN/SubQ
˚ 0.4–2mg q2–3min prn ˚ <5 years or ≤20kg (Off-Label use):
■ If there is no response after 10mg total, 0.1mg/kg q2–3min prn (max dose: 2mg)
look for other causes of respiratory ˚ ≥5 years or >20kg: Adult dosing
depression. Reversal of Respiratory Depression with
■ Following reversal, may need to Therapeutic Opioid Doses
readminister after 20–60min • IV/IM/IN/SubQ
Reversal of Respiratory Depression with ˚ 1–15mcg/kg q20–60min
Therapeutic Opioid Doses
• IV (Push over 30 sec)/IM/IN/SubQ
˚ 0.05–0.2mg q2–3min prn; repeat doses
may be needed within 1–2hr intervals

144 • MEDICATIONS