Pregnancy Classes

• Opioid antagonist that competes and displaces opioids at opioid receptor sites

• Opioid overdose: For the reversal of opioid depression (including respiratory depression) induced by opioids

• No absolute contraindications other than allergy

After reversal, may need to readminister dose(s) at a later interval (ie, 20 to 60 minutes) depending on type/duration of opioid.

Adult:

IM, IV, SubQ: Initial: 0.4 to 2 mg; may need to repeat doses every 2 to 3 minutes. If no response is observed after 10 mg total, consider other causes of respiratory depression

Intranasal: 4 or 8 mg as a single dose in one nostril; may repeat every 2 to 3 minutes in alternating nostrils

Pediatric:

Weight ≤20 kg:

IM, IV, SubQ: 0.1 mg/kg/dose; repeat every 2 to 3 minutes if needed; monitor closely

Intranasal: 4 or 8 mg as a single dose in one nostril; may repeat every 2 to 3 minutes in alternating nostrils

Weight ≤20 kg:

follow adult dosing

2 to 5 minutes

15 minutes

30 to 120 minutes

• Repeat Dosing: The duration of action of naloxone is shorter than that of most opioids. Therefore, repeat doses of naloxone may be necessary. Monitor vital signs and ECG.
• Intubation: administer naloxone prior to intubation in a patient with severe respiratory depression when opiate induced apnea is suspected
• Precipitation of withdrawal: Administration of naloxone can result in acute opiate withdrawal symptoms – agitation, tachycardia, pulmonary edema, nausea, vomiting, seizures.

• Cardiovascular
  • Hypertension
  • Hypotension
  • Arrhythmias
• Dermatologic
  • Diaphoresis
  • Piloerection
• Gastrointestinal
  • Abdominal pain
  • Diarrhea
  • Nausea
  • Vomiting
• Nervous system
  • Agitation
  • Body pain
  • Disorientation
  • Dizziness
  • Hallucination
  • Headache
  • Irritability
  • Nervousness
  • Paresthesia
  • Restlessness
  • Shivering
  • Yawning