NALOXONE

Antidote for narcotic analgesic poisoning

Dosage Forms

Solution for injection

400 μg/ml

Uses

  • Opioid over dosage
  • Confirm if patient is opioid free before treatment with naltrexone (Naloxone test)

Dose and Duration

Opioid over dosage

Adult and child over 12 years: by IV injection, 400 μg–2000 μg repeated at intervals of 2–3 minutes if there is no response; up to max 10 mg then review diagnosis

Neonate and child below 12 years: 10 μg/kg by IV injection; a subsequent dose of 100 μg/kg may be given if there is no response then review diagnosis

In case IV injection is not possible, use the same dose as an IM or SC injection

Naloxone test

Adult ≥18 years: by IV administration, 0.2 mg followed by 0.6 mg if there are no withdrawal symptoms within 30 seconds. Observe patient for any withdrawal symptom for 30 minutes

or by SC injection, 0.8 mg and observe patient for 30 minutes for any withdrawal symptoms

Contraindications

  • Hypersensitivity

Side Effects

  • Nausea, vomiting
  • Hyperventilation
  • Tachycardia
  • Headache, dizziness

Pregnancy

  • Can be used

Breast-feeding

  • Can be used

⚠️ Caution

  • Naloxone has a shorter duration of action than many opioids, so close monitoring and repeated injections may be required
  • Acute withdrawal syndromes may be precipitated by use of naloxone in patients with physical dependence on opioids or in over-dosage with large doses
  • Withdrawal syndrome may occur in neonates of opioid-dependent mothers
  • Naloxone also antagonises the analgesic effect of opioids
  • Use with caution in patients with cardiac irritability