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NALOXONE (NARCAN)

Class
Description
Onset and Duration
Indications
Contraindications
Adverse Reactions
Drug Interactions
How Supplied
Dosage and Administration
Special Considerations


NALOXONE (NARCAN)
Class

Synthetic opioid antagonist


NALOXONE (NARCAN)
Description

Naloxone is a competitive narcotic antagonist used in the management and reversal of overdoses caused by narcotics and synthetic narcotic agents. Unlike other narcotic antagonists, which do not completely inhibit the analgesic properties of opiates, naloxone antagonizes all actions of morphine.


NALOXONE (NARCAN)
Onset & Duration

Onset:
Within 2 min
Duration:
30-60 min

NALOXONE (NARCAN)
Indications

For the complete or partial reversal of CNS and respiratory depression induced by opioids:

Narcotic agonist
Morphine sulfate
Heroin
Hydromorphone (Dilaudid)
Methadone
Meperidine (Demerol)
Paregoric
Fentanyl citrate (Sublimaze)
Oxycodone (Percodan)
Codeine
Propoxyphene (Darvon)

Narcotic agonist and antagonist
Butorphanol tartrate (Stadol)
Pentazocine (Talwin)
Nalbuphine (Nubain)

Decreased level of consciousness
Coma of unknown origin
Circulatory support in refractory shock (investigational)


NALOXONE (NARCAN)
Contraindications

Hypersensitivity
Use with caution in narcotic-dependent patients who may experience withdrawal syndrome (including neonates of narcotic- dependent mothers)


NALOXONE (NARCAN)
Adverse Reactions

Tachycardia
Hypertension
Dysrhythmias
Nausea and vomiting
Diaphoresis


NALOXONE (NARCAN)
Drug Interactions

Is incompatible with bisulfite and with alkaline solutions.


NALOXONE (NARCAN)
How Supplied

0.02 mg/ml (neonate), 0.4 mg/ml, 1 mg/ml


NALOXONE (NARCAN)
Dosage and Administration

Adult:
0 4-2 mg IV, IM, SQ (or ET diluted); minimum recommended dosage is 2 mg; may be repeated at 5-min intervals to a maximum of 10 mg Infusion: 2 mg in 500 ml of D5W (4 mcg/ml), infuse at 0.4 mg/hr (100 ml/hr)
Pediatric:
0.1 mg/kg/dose IV, IM, SQ (or ET diluted); maximum dose of 0.8 mg; if no response in 10 min, administer an additional 0.1 mg/kg/dose

NALOXONE (NARCAN)
Special Considerations

Pregnancy safety: Category B.
Seizures have been reported (no causal relationship established ).
May not reverse hypotension.
Caution should be exercised when administering naloxone to narcotic addicts (may precipitate withdrawal with hypertension, tachycardia, and violent behavior).