Narcan™ (naloxone) is an opiate antidote. Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin. When a person is overdosing on an opioid, breathing can slow down or stop and it can very hard to wake them from this state. Narcan (naloxone) is a prescription medicine that blocks the effects of opioids and reverses an overdose. It cannot be used to get a person high. If given to a person who has not taken opioids, it will not have any effect on him or her, since there is no opioid overdose to reverse. If a person has taken opioids and is then given Narcan™ (naloxone), the opioids will be knocked out of the opiate receptors in the brain. Narcan™ (naloxone) can help even if opioids are taken with alcohol or other drugs. After a dose of Narcan™ (naloxone), the person should begin to breathe more normally and it will become easier to wake them. It is very important to give help to an overdosing person right away. Brain damage can occur within only a few minutes of an opioid overdose as the result of a lack of oxygen to the brain. Narcan™ (naloxone) can be given by intramuscular (lM) injection – into the muscle of the arm, thigh or buttocks – or with a nasal spray device (into the nose). Nasal spray use is less common, but some large cities in the U.S. use the nasal spray version and it can be prescribed.
Narcan™ (naloxone) generally works within about 5 minutes. Repeated doses may be necessary if a person is still showing signs of overdose even after the first dose. Narcan™ (naloxone) starts to wear off after about 30 minutes and is mostly gone after about 90 minutes. By this time the body has processed enough of the opioids that the overdosing person is unlikely to stop breathing again. In some cases, such as after taking a massive dose or using long-acting opioids like methadone, the patient might need another Narcan™ (naloxone) dose and longer medical observation. Always watch the person after they receive a Narcan™ (naloxone) dose for signs of continued overdose.
NALOXONE NASAL SPRAY
Narcan Nasal Spray contains naloxone hydrochloride. Naloxone blocks or reverses the effects of opioid medication, including extreme drowsiness, slowed breathing, or loss of consciousness. An opioid is sometimes called a narcotic. Narcan Nasal Spray is used to treat an opioid overdose in an emergency situation. This medicine should not be used in place of emergency medical care for an overdose. Narcan Nasal Spray is also used to help diagnose whether a person has used an overdose of an opioid. In an emergency situation, it may not be possible before one is treated. Ensure to let the doctor know afterward that one has received this medication.
Before taking this medicine, one should not be treated with Narcan Nasal Spray if allergic to naloxone. To make sure Narcan Nasalspray is safe for one, inform the doctor if there is heart disease. It is not known whether Narcan Nasal Spray will harm an unborn baby. Let the doctor know if pregnant. It is not known whether naloxone nasal passes into breast milk or if it could harm a nursing baby. Let the doctor know if breast-feeding a baby. ln an emergency situation it may not be possible to tell the caregivers if one is pregnant or breast feeding. Make sure any doctor caring for the pregnancy or the baby knows that one has received Narcan Nasal Spray.
Take Narcan Nasal Spray exactly as prescribed. Follow all directions on the prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended’ This Narcan Nasal Spray must be given by a healthcare provider, emergency medical provider, or a family member or caregiver who is trained to properly give Narcan. Narcan Nasal Spray should be sprayed into the nose while the person is lying on his or her back. Overdose symptoms may include slowed breathing, or no breathing; very small or pinpoint pupils in the eyes; slow heartbeats; or extreme drowsiness, especially if one is unable to wake the person from sleep.
Even if one is not sure an opioid overdose has occurred, if the person is not breathing or is unresponsive, give Narcan Nasal Spray right away and then seek emergency medical care. Do not assume that an overdose episode has ended if symptoms improve. One may need to perform CPR (cardiopulmonary resuscitation) on the person while waiting for emergency help to arrive. After giving this medicine, stay with the person and watch for continued signs of overdose. Follow all medication instructions carefully.
Each single-use Narcan spray pump contains enough naloxone for L use only. Throw away after 1 use, even if there is still some medicine left in the pump after using a dose. IV route is recommended in emergency situations since it has the most rapid onset of action. The duration of action of some opioids exceed that of this drug, therefore, repeat doses may be needed; the need for repeat doses will depend on the amount, type, and route of administration of the opioid being antagonized. Patients should remain under continued surveillance; if a patients responds and relapses back into respiratory depression, additional doses should be given’ Additional supportive and/or resuscitative measures may be helpful while awaiting emergency medical assistance.
Since each spray pump contains only enough naloxone for one dose, an overdose is unlikely to occur. Avoid leaving a person alone after giving him or her a dose of Narcan Nasal Spray. An overdose can impair a person’s thinking or reactions.
Narcan side effects
Get emergency medical help if there are signs of an allergic reaction to Narcan: hives; difficult breathing; swelling of the face, lips, tongue, or throat. Because Narcan reverses opioid effects, this medicine may cause sudden withdrawal symptoms such as: nausea, vomiting, diarrhea, stomach pain; fever, sweating, body aches, weakness; excessive crying; body aches; tremors or shivering, fast heart rate, pounding heartbeats, increased blood pressure; feeling nervous, restless, or irritable; increased or excessive unconscious or jerking movements; irregular, fast or slow, or shallow breathing; convulsion; pale or blue lips, fingernails, or skin; runny nose; shivering; sneezing; sweating; trembling; weakness; goose bumps, shivering; runny nose, yawning; or (in babies younger than 4 weeks old) seizures, crying, stiffness, overactive reflexes. Other drugs may interact with naloxone nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Inform the health care providers about all medicines being used now and any medicine about starting or stopping to use. As well as its needed effects, naloxone (the active ingredient contained in Narcan Nasal Spray) may cause unwanted side effects that require medical attention. There could be some incidence not known such as abdominal or stomach cramps.
Opioid overdose is an acute condition due to excessive opioids. Examples of opioids are: morphine, heroin, tramadol, oxycodone and methadone. It differs from opioid dependency. Although opioid overdose does not constitute a majority of the overdoses seen in the emergency department it is important to rule out in people given its potential for mortality and the ease of reversal. Dependence on prescription opioids can stem from treatment of chronic pain and in recent years is the cause of the increased number of opioid overdoses.
Opioids, because of their effect on the part of the brain that regulates breathing, can during overdoses lead to the person not breathing (respiratory depression) and therefore result in death. Opiate overdose symptoms and signs can be referred to as the “opioid overdose triad”; decreased level of consciousness, pinpoint pupils and respiratory depression. Other symptoms include seizures and muscle spasms. Sometimes a person experiencing an opiate overdose can lead to such a decreased level of consciousness that he or she won’t even wake up to their name being called or being shaken by another person. Prolonged hypoxia from respiratory depression can also lead to detrimental damage to the brain and spinal cord and can leave the person unable to walk or function normally, even if treatment with naloxone is given. Alcohol also causes respiratory depression and therefore when taken with opioids can increase the risk of respiratory depression and death.
Signs and Symptoms of Opioid Overdose
When a person takes a higher dose of opioids than their body and brain are able to manage, they may experience an overdose. An opioid overdose can be life-threatening, so one should seek professional medical help immediately if an overdose is suspected. When a person experiences an opioid overdose, there are 3 key symptoms to look for, referred to as the “opioid overdose triad“:
- Pinpoint pupils
- Slowed or stopped breathing
Respiratory depression is one of the most dangerous symptoms because it can lead to hypoxia or inadequate blood oxygenation, which can cause permanent brain damage or even death. Another concern with opioid medications is slowed or stopped heart rate, which can also be fatal. Additional symptoms to look for include limp body, pale face, clammy skin, purple or blue color to lips and fingernails, and vomiting. If any of these symptoms present in an opioid user, seek emergency medical help immediately.
ADVERSE EFFECTS OF OVERDOSE
- Frequency Not Defined,
- Precipitation of severe opioid withdrawal
- Increased blood pressure
- Musculoskeletal pain
- Nasal dryness
- Nasal congestion
- Nasal inflammation
OPIOID OVERDOSE TREATMENT
Initial treatment involves supporting the persons breathing and providing oxygen. Naloxone is then recommended among those who are not breathing.
Indicated for emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or CNS depression.
Initial dosing: 1 spray delivered by intranasal administration; delivers 4 mg of naloxone HCI Repeat dosing.
- Seek emergency medical assistance as soon as possible after administering the first dose.
- The requirement for repeat doses depends on the amount, type, and route of administration of the opioid being antagonized.
- Administer in alternate nostrils with each dose.
- If the patient responds and relapses back into respiratory depression before emergency assistance arrives, administer an additional dose of naloxone intranasal using a new spray and continue surveillance of the patient.
- If the desired response is not obtained after 2-3 minutes, administer an additional dose using a new spray.
- If there is still no response and additional doses are available, administer additional doses every 2-3 minutes using a new spray with each dose until emergency medical assistance arrives.
- Additional supportive and/or resuscitative measures may be helpful while awaiting emergency medical assistance.
Partial opioid agonists or mixed agonist/antagonists
– Reversal of respiratory depression by partial agonists or mixed agonist/antagonists (eg, buprenorphine, pentazocine) may be incomplete and require higher doses of naloxone or repeated repeated administration.
Intended for immediate administration as emergency therapy in settings where opioids may be present. Not a substitute for emergency medical care.
NARCAN AVAILABLE WITHOUT PRESCRIPTION
In some States, Naloxone is not yet available without a prescription. Currently the drug is only available to Emergency first responders while in some other, Naloxone has been made available without a prescription.
COST OF NARCAN NASAL SPRAY
94% of insured lives in the US have coverage for NARCAN Nasal Spray*. According to IMS Health, nearly three quarters (73%l of prescriptions for NARCAN Nasal Spray have a co-pay of S10 or less**.